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ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES

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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  1. ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES Gabriela Paleru, M.D. Susan Monaghan, Dr.P.H. USAID/ROMANIA

  2. ● 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

  3. Health systems in CEEC ● Chronic under-funding ● Inefficiency ● Over-staffing ● Resource flowing to urban, currative, and hospital-based care ● Corruption ● Lack of enforcement

  4. Medical Care Expenditures in Romania 2001

  5. 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.

  6. 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

  7. 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?

  8. What to do? ● Admission criteria ● Reduction of ALOS ● Incentives for ambulatory vs. hospital care ● Ensure insurance reimbursement for RH Hospital PHC Ambulatory

  9. Primary & Ambulatory Care ● FP ● STI screening ● Breast/Cervical Cancer ● Other preventive programs Hospital waste  PHC and sustainable RH services Hospitals

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