Addressing threats to sustainable reproductive health services
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ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES. Gabriela Paleru, M.D. Susan Monaghan, Dr.P.H. USAID/ROMANIA. ● Children dying of AIDS ● Babies dying due to the nosocomial infection ● Disease outbreaks ● Residents on strike for their salaries.

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ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES

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ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES

Gabriela Paleru, M.D.

Susan Monaghan, Dr.P.H.

USAID/ROMANIA


● Children dying of AIDS

● Babies dying due to the nosocomial infection

● Disease outbreaks

● Residents on strike for their salaries

Is RH a priority for the health officials?

Crisis

management


Health systems in CEEC

● Chronic under-funding

● Inefficiency

● Over-staffing

● Resource flowing to urban, currative, and hospital-based care

● Corruption

● Lack of enforcement


Medical Care Expenditures in Romania 2001


How to make the politicians to change priorities?

Help them:

  • to reallocate resources

  • to ensure transparency in use of public money

    so they will listen when it comes to focusing on RH.


12

ALOS US

10

ALOS Rom

8

6

4

2

0

Normal new born

Hypertension

Normal Vaginal

Delivery

Other osteo-muscular

interventions

Back problems

Minor hepatic problems

Apendicectomy w/

complications

Abortion

Cardiac failure

Otitis media

<17 years

Where the money goes in hospitals? top-10 diagnosis ALOS


3,0%

% cases Hungary

2,5%

% cases Romania

2,0%

1,5%

1,0%

0,5%

0,0%

Normal new-born

Hypertension

Normal vaginal delivery

Cardiac failure

Other osteo-muscular

surgical interventions

Minor hepatic problems

Abortion

Back problems

Otitis < 17 years

.

Wherethe money goes in hospitals?


What to do?

● Admission criteria

● Reduction of ALOS

● Incentives for ambulatory vs. hospital care

● Ensure insurance reimbursement for RH

Hospital PHC

Ambulatory


Primary &

Ambulatory Care

● FP

● STI screening

● Breast/Cervical Cancer

● Other preventive programs

Hospital waste  PHC and sustainable RH services

Hospitals


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