Annual Program Report 2004 - American International Health Alliance

Mission Statement 

To advance global health through volunteer-driven partnerships that mobilize communities 

to better address healthcare priorities while improving productivity and quality of care 

AIHA History 

Founded in 1992 by a consortium of American associations of healthcare providers and of health 

professions education, the American International Health Alliance (AIHA) is a nonprofit organization 

that facilitates and manages twinning partnerships between institutions in the United States and their 

counterparts overseas. Since 1992, AIHA has established and managed partnerships and programs 

that improve the health status of individuals in Eurasia. 

AIHA has supported to date 116 partnerships linking American volunteers with communities, institutions 

and colleagues in 22 countries in a concerted effort to improve healthcare services. Operating 

with funding from the United States Agency for International Development (USAID), the Health 

Resources and Services Administration (HRSA) of the US Department of Health and Human 

Services, the Library of Congress, the Susan G. Komen Breast Cancer Foundation, and other organizations, 

AIHA’s programs represent one of the US health sector’s most coordinated responses to 

global health concerns. 

AIHA has developed and refined a voluntary, partnership model in which a US community’s healthrelated 

institutions are paired with community institutions in developing and transitional countries. 

The partnerships embrace city, county and statewide relationships. Through peer-to-peer exchanges, 

these partnerships develop practical solutions to problems, create model programs, disseminate lessons 

learned, and effect broad, systemic change during and after the AIHA-funded partnership period.

TABLE OF 

CONTENTS 

From the Executive Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 

AIHA Partnership Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 

Where We Work 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 

HIV/AIDS and Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

Healthcare Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

Health Professions Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 

Healthy Communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 

Information and Communication Technology . . . . . . . . . . . . . . . . . 23 

Active Partnerships and Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 

The Year in Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 

Partner Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 

Funders and Strategic Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 

Board of Directors and Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 

Photo: Anne Maynard 

During a professional exchange in Tampa, Uzbek CLDP 

delegates teach their US hosts a national dance. 

Annual Program Report 2004

FROM THE EXECUTIVE 

DIRECTOR 

AIHA’s unique partnership “twinning” model continued to flourish and 

make important contributions to improving health and healthcare 

throughout the world during 2004, particularly through human and organizational 

capacity-building efforts. This report seeks to capture the growing 

range of AIHA programs and activities that reflect a dynamic and 

responsive organization capable of adapting to meet the changing needs of 

partner countries. 

The year 2004 was one of transition, consolidation and expansion. Several 

long-running primary healthcare partnerships ended and programs to 

address HIV/AIDS increasingly took center stage. Other programs continued 

to build on past partnership successes and new partnerships and programs 

were added to AIHA’s portfolio. 

Representative of the transition was bidding farewell to 27 partnerships in 

nine countries, as well as closing AIHA’s office in Armenia and scaling back 

the office in Ukraine as the USAID-funded programs in those countries 

were significantly reduced after more than 12 fruitful years. While individual 

partnerships graduated, in Georgia, Russia and elsewhere, new activities 

were funded and initiated in these countries. AIHA is proud of its graduated 

partnerships and the many accomplishments that encompass significant and 

sustainable improvements in the provision of healthcare services and health 

professions training and education. 

The year also saw the consolidation and institutionalization of successes 

achieved by past partnerships and programs. A stellar example is the 

hospital nursing excellence awards received by four hospitals in Armenia 

and Russia that had participated in AIHA partnerships in the 1990s. Many 

graduated partners now serve as mentors to new partners and provide 

training and other assistance sharing what they have learned through their 

own partnership experience. In one example, the current project on 

Strengthening Tuberculosis Control in Moldova is collaborating with the 

University Primary Healthcare Center in Chisinau and the TB Center of 

Excellence in Latvia, both AIHA partner institutions, and benefiting from 

their training capacities. 

Annual Program Report 2004 1

Program expansion was reflected in the establishment 

of 11 USAID-funded partnerships this year: 

three in Azerbaijan and Georgia that continue to 

focus on primary healthcare; two in Russia that 

focus on family planning and reproductive health; 

four in Russia that reflect a growing emphasis on 

HIV/AIDS; and two regional health professions 

partnerships in Central Asia. In keeping with 

efforts to expand the contributions of the partnership 

model to meet emerging challenges, AIHA 

received new funding for programs outside 

Eurasia. In one of the most exciting developments, 

HRSA awarded AIHA a five-year project to establish 

a Twinning Center for HIV/AIDS in support 

of the President’s Emergency Plan for AIDS Relief, 

which currently targets 12 African countries, two 

Caribbean countries and Vietnam. The project has 

the potential for establishing as many as 100 new 

twinning partnerships over the next five years. 

Reflecting a widening funding base, AIHA 

implemented projects in 2004 with grants from 

the Library of Congress and the Susan G. Komen 

Breast Cancer Foundation. These projects, which 

support community leadership development and 

breast health respectively, also contribute to 

capacity building efforts for ongoing healthcare 

improvements within the target countries by 

nurturing leaders and providing them with 

knowledge and practical skills to address priority 

health problems. 

Program expansion also entailed new and 

strengthened collaborative relationships, notably 

with the World Health Organization. While partnerships 

remain the core of our work, AIHA 

increased its capacity to directly implement projects, 

continuing to draw and engage volunteers, 

including our former partners. 

AIHA and its partners can point to numerous 

achievements in 17 countries during 2004. These 

achievements are organized and described in this 

report within five broad areas of AIHA programs: 

HIV/AIDS and tuberculosis; healthcare services; 

health professions education; healthy communities; 

and information and communications technology. 

Our work was made possible by the dedicated team 

of professionals who make up our staff in 

Washington, DC, and AIHA offices in eight countries, 

by the invaluable participation of legions of 

US healthcare professionals from 28 cities who last 

year provided more than 3,400 days of volunteer 

service, by the hundreds of counterpart health professionals 

and others who demonstrated leadership 

and courage to implement change in their countries, 

and by the many organizations and donors 

that provided critical collaboration and support. 

We hope this report provides some insights into 

AIHA’s programmatic activities. We welcome your 

inquiries and encourage you to visit us on the Web 

at www.aiha.com for more information. 

James P. Smith 

2 American International Health Alliance

AIHA PARTNERSHIP 

MODEL 

Key Elements 

Voluntarism: significant in-kind contributions of human, material and 

financial resources 

Institution-based partnering for capacity-building and systematic change 

Peer-to-peer collaborative relationships that build trust and respect 

Transfer of knowledge, ideas and skills through professional exchanges 

and mentoring 

Benefits flowing in both directions 

Replication and scaling-up of successful models 

Sustainability of achievements and relationships 

“Partnership of partnerships” for networking, sharing and common 

approaches and solutions 

Photo: Barry Kinsella 

Since 1992, AIHA partnerships have helped practitioners in low-resource countries bring 

high-quality healthcare services to people in their communities. 


WHERE WE WORK 2004 

Eurasia 

Caucasus: 1 Armenia, Azerbaijan, Georgia 

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Graduation of 10 partnerships 

Dissemination conference for Armenian partnerships marking end of a decade of collaboration 

Two Armenian hospitals receive “Journey to Excellence” award from the American Nurses Credentialing Center in 

recognition of improvements in quality of nursing care 

Initiation of 2 new partnerships in Georgia and 1 in Azerbaijan 

Opening of primary healthcare clinic in Narimanov District in Baku, Azerbaijan 

Opening of emergency pediatric center at Iashvili Children’s Central Hospital in Tbilisi, Georgia 

Opening of Learning Resource Centers in Ganja, Azerbaijan, and in Gori and Guria District, Georgia 

Certification of 19 trainers from the Mtshkheta Family Medicine and Regional Training Center in Georgia 

Georgian textbook on health management education published; health management education toolkit in Russian prepared 

Central and Eastern Europe: 2 Albania, Croatia, Hungary, Kosovo, Latvia, Romania 

■ Dissemination conference on health management at conclusion of the Tirana, Albania/Bucharest, Romania partnership 

(the first AIHA partnership not involving a US partner) 

■ Opening of the “Town Health Center,” a model primary healthcare clinic in Lezha, Albania 

■ Opening of women’s health information and resource center, 2 satellite centers, 8 health information kiosks in Gyo ″ r, 

Hungary 

■ Enhancement of family medicine antenatal care skills in Kosovo 

■ International Training Centre at the State Centre of Tuberculosis and Lung Diseases of Latvia officially designated as a World 

Health Organization Collaborating Centre for Research and Training in Management of Multidrug-Resistant Tuberculosis 

■ Roundtable on HIV/AIDS stigma and discrimination and publication of handbook in Croatia 

■ Romanian Society for Breast Imaging formed and radiology quality assurance initiated at 5 pilot sites 

Central Asia: 3 Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan 

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Launch of 2 new regional partnerships: on medical education and for nursing education and leadership 

Manual on Family Nursing finalized and the draft requirements for nursing registration approved by the Central Asia 

Nursing Council 

Review of accreditation process for medical schools in collaboration with the Central Asia Council of Rectors 

Initiation of health management course for undergraduate medical students in Uzbekistan 

Expanded support to Family Medicine Training Center in Turkmenistan for primary healthcare 

Funding of 10 projects designed by nurses to promote early detection and awareness of breast cancer 

Prevention of Mother-to-Child Transmission of HIV training provided for professionals from 3 replication sites in Kazakhstan: 

Pavlodar, Temirtau, Karaganda 

Visits of 15 Uzbek delegates through the Community Leadership Development Program to learn about community-based 

healthcare delivery, rural health, and tuberculosis treatment and prevention services in the United States 

First alumni meeting of the Uzbek Community Leadership Development Program delegation held in Tashkent, with 

delegates reporting on progress of their projects 

Moldova 4 

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Renovation of the National TB Reference Laboratory and 2 regional TB laboratories 

Approval of revised laboratory guidelines and environmental mitigation and infection control plan 

Enhancement of TB diagnosis and treatment skills of 350 primary care physicians and nurses 

Baseline survey of public’s knowledge, attitudes and practices regarding TB 

Distribution of TB information to practitioners and journalists 

Development of public awareness campaigns 

Integrated platform for TB and HIV/AIDs surveillance system agreed to with Ministry of Health and UNAIDS 


Latvia 2 Russia 5 Kazakhstan 3 Kyrgyzstan 3 

Hungary 2 Ukraine 6 

Moldova 4 

Romania 

Croatia 2 2 

Kosovo 2 Georgia 1 

Albania 2 

Armenia 1 

Uzbekistan 3 

Azerbaijan 1 

Turkmenistan 3 Tajikistan 3 

Eritrea 7 

Russia 5 

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Graduation of 4 primary healthcare partnerships with subsequent replication of 2 successful programs at other sites 

Launch of 4 comprehensive HIV/AIDS care, treatment and support partnerships 

Launch of family planning/reproductive health partnerships in Moscow Oblast/Dubna and Volgograd 

Two Russian hospitals receive “Journey to Excellence” award from the American Nurses Credentialing Center in 

recognition of improvements in quality of nursing care 

Visits of 57 Russian delegates through the Community Leadership Development Program to learn about HIV/AIDS 

services in the United States 

Youth AIDS prevention and health promotion programs initiated by networks of alumni from Community Leadership 

Development Program 

Model Prevention of Mother-to-Child Transmission of HIV program established in Samara and Togliatti 

Training in Prevention of Mother-to-Child Transmission of HIV for more than 40 policymakers and administrators from 

5 oblasts (regions) of Russia 

Ukraine 6 

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Graduation of 6 primary healthcare partnerships, concluding with a regional conference on sustainability 

Odessa program on Prevention of Mother-to-Child Transmission of HIV recognized as model in region; Training Center 

established to facilitate regional scale-up and recognized as center of excellence 

Inauguration of Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia; training implemented for 

Ukrainian care teams responsible for providing antiretroviral therapy in the country 

All-Ukrainian conference on standardized patient approach to medical education 

Teen counseling center opened at University Primary Healthcare Center in Kharkiv 

Nursing conference for 500 primary healthcare nurses sponsored by Kharkiv Primary Healthcare Center 

Opening of 2 dental clinics at University Family Medicine Training Center in Uzhgorod 

Translation into Ukrainian and distribution of manual on neonatal resuscitation 

Africa 

Award of new 5-year cooperative agreement by the US Department of Health and Human Services, Health Resources and 

Services Administration to establish an HIV/AIDS Twinning Center to serve 15 focus countries (including 12 in Africa: 

Botswana, Cote d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda 

and Zambia, plus Guyana, Haiti and Vietnam); initial consultations with US government country teams in focus countries 

on HIV/AIDS plans and twinning opportunities 

Eritrea 7 

■ Award of new USAID Health Professions Education Partnership Program in Eritrea (began in 2005) 


HIV/AIDS AND 

TUBERCULOSIS 

“Before the campaign, 

we struggled to find 

ways to get 

information about our 

programs and 

tuberculosis on 

television, but now 

several channels have 

come to us with 

proposals for 

broadcasts on the 

fight against TB. Print 

and broadcast 

journalists have been 

calling our offices to 

ask for help preparing 

materials because 

they are being 

bombarded by 

readers and listeners 

who have questions 

about the disease.” 

– Irina Zatusevski, 

AIHA’s senior health 

communications specialist 

in Moldova 

As HIV/AIDS and other infectious diseases, notably tuberculosis, have 

increasingly become urgent healthcare issues in Eurasia (where the world’s 

fastest growing HIV epidemics can be found) as well as in other parts of 

the world, AIHA is devoting greater resources to the control of these diseases. 

From interventions to prevent transmission to diagnosis, care and 

treatment, AIHA partnerships and projects support efforts to combat 

HIV/AIDS and TB by strengthening services for persons living with 

HIV/AIDS and TB and increasing human and knowledge resources to 

institute and replicate effective models of care. AIHA’s focus is on regional 

capacity-building, as well as piloting new programs and establishing centers 

of excellence. 

HIV/AIDS Regional Capacity-building 

(Eurasia) 

On March 11, AIHA opened the Regional 

Knowledge Hub for the Care and Treatment of 

HIV/AIDS in Eurasia (Knowledge Hub) in collaboration 

with the World Health Organization 

(WHO) and Deutsche Gesellschaft für 

Technische Zusammenarbeit (GTZ). Based in 

Kiev, Ukraine, the Knowledge Hub’s principal 

objective is to create human resources to 

care for people living with HIV/AIDS 

(PLWHA) by developing the expertise of 

healthcare professionals, strengthening the 

training capacity for passing on knowledge 

and skills, and compiling a body of 

evidence-based resources and informational 

materials. The Knowledge Hub is 

collaborating with international experts 

and educational institutions in the 

region on training workshops and 

online resources for practitioners. 

In 2004, with funding from the Global Fund to Fight AIDS, 

Tuberculosis and Malaria, didactic and clinical training in antiretroviral 


therapy (ART) was conducted for 

multidisciplinary care teams from six 

priority oblasts in Ukraine. This was 

followed by on-site mentoring on ART 

for pediatric, adolescent and adult 

patients. By the end of the year, the 

Knowledge Hub had trained and 

mentored 66 ART caregivers. 

EurasiaHealth AIDS 

Knowledge Library 

In support of capacity-building efforts 

throughout the region, the 

EurasiaHealth AIDS Knowledge 

Library (www.eurasiahealth.org) gives 

practitioners in Eurasia access to current 

guidelines and research. Along 

with strategic partners active in the 

region, AIHA is building the Library to serve as the 

primary source of Russian-language information 

on HIV/AIDS care and treatment and the foundation 

for the Knowledge Hub’s Internet-based 

resources. AIHA supports identification, collection, 

adaptation and translation of new HIV/AIDS 

research and guidelines. Other HIV/AIDS care, 

treatment and prevention materials for which limited 

information is available in Russian are being 

translated. The Library contains more than 250 

documents, including full-text articles and 

abstracts. During 2004, 10 key resource documents 

were translated and posted, including: 2003 

Medical Management of HIV Infection (J. Bartlett, 

J. Gallant, eds.); WHO HIV/AIDS Treatment and 

Care Protocols for Countries of the Commonwealth of 

Independent States; HIV Medicine 2003 (H. Albrecht, 

C. Hoffmann and B.S. Kamps, eds.); Antiretroviral 

Therapy in Resource-Limited Settings (GALEN 

Module No. 9); Palliative Care in HIV Management 

(GALEN Module No. 15); and WHO/CDC PMTCT 

Generic Training Package, August 2004. 

Prevention of Mother-to-Child 

Transmission of HIV: 

Replication and Scale-up 

(Ukraine, Russia, Kazakhstan) 

Since 2001, the United States Agency for International 

Development (USAID) has supported AIHA’s 

project to develop and disseminate a model for 

Prevention of Mother-to-Child Transmission of 

The ribbon commemorating the official opening of the Knowledge Hub is cut 

by Peter Weis, scientist in the HIV/AIDS Care and Support Department at 

WHO/Geneva; Michael Adelhardt, head of the Initiatives Support Project, 

GTZ; James Smith, AIHA executive director; and Vladimir Zagorodniy, deputy 

minister, Ministry of Health of Ukraine. 

HIV (PMTCT) in Eurasia. Initially implemented in 

Odessa, Ukraine, the project introduced systemic 

and institutional changes in HIV/AIDS prevention 

and treatment. Its objectives are to ensure PMTCT 

integration in primary care; the use of evidencebased 

treatment protocols; the development of 

appropriate training materials and curricula; and 

the creation of local capacity for training healthcare 

workers and trainers to replicate the model. The 

project led to a 75 percent reduction in the rate of 

vertical HIV transmission from 24 to 6 percent in 

the Odessa catchment area (2 million people) and 

the PMTCT model was endorsed by the Ukrainian 

Ministry of Health for nationwide replication. A 

case management monitoring database was developed 

as an integral part of the project to document 

baseline data and results and to serve as a quality 

improvement tool. Internationally accepted 

PMTCT indicators were reviewed and adapted to 

the Ukrainian situation. As a result of its demonstrated 

effectiveness, the Odessa database is being 

used as the basis for a national PMTCT monitoring 

system in Ukraine and is being adapted for use in 

other countries. The Odessa PMTCT model was 

presented at poster sessions at the XV International 

AIDS Conference in Bangkok in July and at the 

October conference of the International Society for 

Quality in Health Care in Amsterdam. 

USAID funding supported replication of the Odessa 

model at five sites outside Ukraine that were selected 

Photo: Vira Illiash 


for their high HIV/AIDS prevalence: two in Russia 

and three in Kazakhstan. Professionals from these 

sites are receiving practical, skills-based training in 

PMTCT-related topics from partners at Odessa’s 

Southern Ukraine AIDS Education Center, which is 

recognized as a center of excellence in the region. 

AIHA, with USAID support, took the lead in adapting 

the Centers for Disease Control and Prevention/ 

World Health Organization (CDC/WHO) PMTCT 

Generic Training Curriculum for use in the region. 

AIHA also initiated the adaptation as part of a twoyear 

effort to adapt, pilot and begin the certification 

process for trainers in PMTCT. 

HIV/AIDS Care and Treatment 

Partnerships 

(Russia) 

In collaboration with the Ministry of Health, four 

new partnerships were formed in July to assist 

Russia in curbing the world’s fastest growing 

HIV/AIDS epidemic. With USAID funding, the 

Orenburg/New York, Samara/Providence, 

Saratov/Bemidji and St. Petersburg/New Haven 

partnerships are creating comprehensive models 

for care, treatment and social support for people 

living with HIV/AIDS. The partnerships extend 

beyond medical care to social services, NGOs, 

communities and the patients themselves. Models 

developed by the partnerships will be used by the 

Ministry of Health to scale up efforts to provide 

services along the continuum of care for PLWHA. 

During 2004, the partners conducted initial assessments, 

collected demographic data and information 

on health and social services, and identified 

the principal community concerns for each region. 

AIHA is collaborating closely with the University 

Research Corporation’s Quality Assurance Project 

at the four partnership sites. 

confidentiality of medical records. Participants 

formulated plans to review proposed improvements 

to the existing legal and regulatory framework, 

school-based sex education and public 

awareness efforts. One concrete result is the 

HIV/AIDS Stigma and Discrimination Handbook 

designed to promote non-discriminatory discussion 

in the media and public. The Handbook was 

launched in December at the Stampar School with 

the US Ambassador to Croatia attending the event. 

HIV/AIDS Twinning Center 

(Africa, Caribbean, Vietnam) 

In September, AIHA was awarded a cooperative 

agreement from the US Department of Health and 

Human Services, Health Resources and Services 

Administration (HRSA), to create an HIV/AIDS 

Twinning Center in support of the President’s 

Emergency Plan for AIDS Relief in Botswana, Cote 

d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, 

Mozambique, Namibia, Nigeria, Rwanda, South 

Africa, Tanzania, Uganda, Vietnam and Zambia. 

AIHA leads a consortium that includes the 

International Training and Education Center on 

HIV (I-TECH) and the Futures Group. 

The Twinning Center will establish twinning partnerships 

and a Volunteer Healthcare Corps to support 

capacity-building in the 15 focus countries to 

institutionalize HIV/AIDS care and treatment 

models and allow for rapid scale-up. The 

Twinning Center began operating toward the end 

of 2004 with staff conducting strategic planning 

Reducing Stigma and Discrimination 

(Croatia) 

In April, AIHA and the Stampar School of Public 

Health in Zagreb jointly organized a workshop 

and roundtable on HIV/AIDS stigma and discrimination, 

the first such event in Croatia. More than 

50 attendees representing physicians, law professors, 

media, legislators, AIDS organizations, NGOs 

and USAID discussed causes of discrimination, 

misconceptions about transmission, and lack of 

AIHA partnerships work to improve diagnostic capabilities 

at host institutions through hands-on training. 

Photo: AIHA archives 


Photo: Dmitrii Volkov 

meetings and initiating consultations with HRSA 

and country teams on incorporating partnerships 

and volunteers into the HIV/AIDS plans of the 

focus countries. 

National Tuberculosis Control 

(Moldova) 

With USAID funding, AIHA is implementing a comprehensive 

project, Strengthening Tuberculosis 

Control in Moldova, in support of WHO’s Directly 

Observed Therapy-Short Course (DOTS) strategy. 

The four-year project, begun in 2003, is upgrading 

laboratories; enhancing skills in detection, treatment 

and follow-up; improving TB surveillance; and 

increasing awareness of symptoms and treatment. 

The renovated National TB Reference Laboratory 

and two Regional Reference Laboratories reopened 

in March 2005 for World TB Day, with equipment 

provided by the Global Fund to Fight AIDS, 

Tuberculosis and Malaria. An environmental mitigation 

and infection control plan and revised guidelines 

for laboratory procedures were approved. A 

total of 15 laboratory staff, TB specialists, PHC 

physicians and nurses, and medical professors 

received instructor training at the International 

Training Center at the State Center of Tuberculosis 

and Lung Diseases of Latvia. These individuals subsequently 

trained 350 PHC practitioners in cooperation 

with the World Bank and the State Medical and 

Pharmaceutical University “Nicolae Testemitanu.” 

Providers now have the information and skills to 

better communicate with TB patients. 

Results of a baseline knowledge, attitudes and practices 

survey were used to design a public awareness 

Culture method room in the newly-reopened National TB 

Reference Laboratory in Chisinau. 

campaign, “TB can be treated! See the doctor!”, that 

was launched in 2004 and continued in 2005. The 

campaign addresses a stark result of the survey – 

nearly one-fourth of respondents believed TB cannot 

be cured completely. Awareness raising activities 

included press briefings and providing interview 

opportunities for journalists. A series of televised TB 

roundtables included AIHA’s Project Director, representatives 

from the Ministry of Health, Institute of 

Phthisiopneumology, Municipal TB Clinic, National 

TB Control Programme and The Global Fund to 

Fight AIDS, Tuberculosis and Malaria. 

Design and indicators for a TB surveillance system 

were agreed upon with the Ministry of 

Health. The software is being developed in collaboration 

with the Scientific-Practical Center for 

Sanitary Management. AIHA joined forces with 

UNAIDS on a common surveillance system platform, 

with AIHA developing the TB component 

and UNAIDS developing the HIV/AIDS component. 

This interagency cooperation facilitated 

achievement of an agreement by authorities of the 

breakaway Transnistria region to carry out TB 

control activities consistent with DOTS within the 

framework of the Moldovan National 

Tuberculosis Program. 

Center of Excellence for 

Multidrug-resistant TB 

(Latvia) 

In November, the International Training Center at 

the State Center of Tuberculosis and Lung Diseases 

of Latvia was designated officially as a WHO 

Collaborating Center for Research and Training in 

Management of Multidrug-resistant TB (MDR-TB). 

At the opening ceremonies in Riga, the Latvian 

Minister of Health presented an award to the US 

coordinator of the Riga/Little Rock partnership in 

recognition of the role the University of Arkansas 

for Medical Sciences (UAMS) played in the certification 

of the Center. With USAID funding, UAMS 

assisted the Center during 2002-2004 in enhancing 

teaching methodologies and management skills and 

instituting a business plan for financial stability. The 

Center is recognized for its world-class training in 

diagnosis, treatment and management of MDR-TB 

and has trained trainers for the Moldova TB project. 


HEALTHCARE 

SERVICES 

“AIHA programs are 

valuable not only for 

promoting changes in 

the NIS healthcare 

infrastructure, but also 

for fundamentally 

changing the thinking 

of the people involved 

in the programs, who 

are enriched with the 

knowledge and 

resources needed for 

successful reforms.” 

– US Ambassador to 

Ukraine John Herbst 

Improving access to quality healthcare services – from primary to tertiary levels 

– is a cornerstone of AIHA programs. AIHA and its partners have helped 

to establish models of healthcare, introduce new or improved services and 

strengthen the human and organizational capacity to deliver quality care. 

Program focus areas including family medicine nursing, women’s wellness, 

hospital management, emergency medicine and breast health have made substantial 

contributions to improving standards of healthcare across Eurasia. 

Primary Healthcare 

(Albania, Armenia, Azerbaijan, Georgia, Kazakhstan, Kosovo, 

Russia, Turkmenistan, Ukraine) 

Primary care has been the central focus of partnerships since 1999 in 

response to priorities in the targeted countries to transform healthcare 

delivery from specialized services to a patient- and family-centered primary 

care approach. During 2004, 22 

USAID-funded primary healthcare 

(PHC) partnerships graduated and 

four were initiated or remained 

active. The graduated partnerships 

have left a legacy of model clinics 

and trained providers offering new 

or improved services to hundreds of 

thousands throughout the nine 

Eurasian countries. 

Albania 

The Lezha/Pittsburgh partnership 

graduated in March after opening 

the Lezha Town Health Center the 

previous month. The Center, a 

model primary healthcare clinic for 

the country, serves 86,000 people 

and provides women’s and children’s 

consultations, family planning, 

obstetrical care, laboratory services, 

Primary care partners focus on providing a 

wide range of diagnostic, treatment and 

prevention services to ensure the well-being 

of patients of all ages. 

Photo: Kathryn Utan 


patient information, community health education 

classes and a Learning Resource Center. Weekly 

education programs are held for pregnant women, 

new parents and adolescents. 

Armenia 

Five PHC partnerships graduated in September 

and a dissemination conference marked the culmination 

of AIHA’s 12-year program in Armenia, 

which also encompassed hospital partnerships and 

programs in women’s health, emergency medical 

services, infection control, neonatal resuscitation 

and nursing. The PHC partnerships leave behind 

five model clinics that continue to offer quality 

primary care services in their communities. 

During 2004, continued training and public health 

outreach at Sevan Polyclinic in the Gegarkunik 

region and Vanadzor Polyclinic No. 5 in the Lori 

region expanded diagnosis, screening and disease 

management services in rural areas. At the Health 

Training Center at Vanadzor Polyclinic No. 5, five 

new modules were developed for the PHC curriculum. 

A total of 11 modules were adapted in compliance 

with the country’s “unified curriculum” 

and presented to the Ministry of Health. In addition 

to women’s health services, Yerevan’s 

Armenian American Wellness Center began offering 

primary care for the entire community and 

instituted a patient survey to collect information 

for improving services. 

Clinicians at the Armenian American Wellness Center in 

Yerevan review the results of a mammogram before consulting 

with a patient. 

Azerbaijan 

The new Ganja/Livermore PHC partnership 

opened a Learning Resource Center and three partnerships 

graduated in 2004. Established in 2002 

under the Baku/Houston partnership, the Mir 

Kasimov Women’s Wellness Center continued to 

provide education on childbirth, family planning, 

STDs, and breast and cervical cancer screening. In 

Baku’s Narimanov District, a model PHC clinic, 

which serves as a site for the new family medicine 

training course at the Institute of Postgraduate 

Medical Education, opened as a result of the partnership 

with Portland, Oregon. A mental health 

component was introduced and 740 patients were 

registered for mental health services. Through the 

Baku/Richmond partnership, the Binagadi District 

Health Department improved collection and analysis 

of health data and conducted 88 health education 

sessions on infectious disease prevention, 

healthy lifestyles and substance abuse. A total of 

1,662 people, including 353 internally-displaced 

persons, attended the sessions in 2004. 

Georgia 

One primary healthcare partnership graduated, 

having established a sustainable model PHC center 

that serves approximately 10,000 people in the 

Mtshkheta-Mtianeti region. The partnership’s 

Family Medicine and Regional Training Center formally 

opened this year and Georgian authorities 

licensed and certified 19 trainers who provided 940 

hours of family medicine training in the region. 

Building on the partnership’s success, the Center 

for International Health in Milwaukee is engaged 

in a new partnership in the adjacent Shida Kartli 

Region to improve the clinical skills of primary 

care physicians and nurses at ambulatory health 

centers. Another new PHC partnership began in 

the Guria region with La Crosse, Wisconsin, and 

the Guria District Health Administration established 

a Learning Resource Center in October. 

Kazakhstan 

After the Demeu Family Medicine Center opened 

in 2000, improvements in the delivery of health 

services in the Kazakh capital city of Astana convinced 

the Ministry of Health and the Ministry of 

Labor and Social Welfare to replicate the PHC 

model introduced by the Astana/Pittsburgh partnership. 

Following the signing of a memorandum 

of understanding between AIHA and the two ministries 

in 2004, three family group practices in 

Photo: AIHA Archives 


Photo: Courtesy of Sabirabad Regional Hospital 

In Azerbaijan, AIHA partners are bringing much-needed primary 

care services to the nation's many internally displaced persons. 

other regions of Kazakhstan were selected to participate 

in implementing the model of integrated 

primary care and social services. Volunteer 

Services Overseas and Columbia University’s 

School of Social Work are collaborating with 

AIHA to develop and implement the social services 

components of the project. 

Kosovo 

A reproductive health partnership between 

Dartmouth Medical School and the municipality 

of Gjakova in Kosovo is strengthening family medicine-based 

antenatal care. Training materials and 

patient forms in Albanian and English were developed 

based on WHO’s Antenatal Care Model. In 

November, a US antenatal care specialist facilitated 

the first full antenatal care training in Gjakova. Ten 

of the 11 participants passed the post-training 

knowledge and skills tests and were certified. 

Earlier in the year, a PHC partnership between 

Gjilan and Dartmouth wrapped up a highly successful 

three-year project that improved the quality 

of family medicine practice by implementing new 

patient management systems, institutionalizing 

continuous quality improvement processes, and 

establishing community-based health programs. 

Russia 

Four primary healthcare partnerships graduated 

during 2004, having established three PHC centers, 

two Women’s Wellness Centers and two 

community health education centers, along with 

numerous new models of primary care services, 

including for the management of chronic diseases 

such as asthma and hypertension. Each partnership 

received additional funding to replicate successful 

programs at other sites. These replications 

included the Tomsk community health education 

centers, the Samara asthma management and 

nursing management programs, the Sarov hypertension 

management program and the Kurgan 

neonatal program. The partnerships held a joint 

best practices dissemination conference for 535 

professionals and provided training and technical 

assistance at the replication sites. More than 1,300 

professionals attended training and specialized 

dissemination conferences and 5,000 people participated 

in health promotion and disease management 

programs during the year. 

Two additional primary healthcare partnerships – 

Sakhalin/Houston and Volgograd/Little Rock – 

successfully completed their projects during 2004. 

In Sakhalin, a Teen Health Education Center and a 

Mayoral Health Council are now actively engaged 

in community-based health promotion activities. 

In Volgograd, partners established a family medicine 

clinic that serves as a residency training site. 

The two partnerships received new funding for 

HIV/AIDS prevention and family planning/reproductive 

health, respectively. 

Turkmenistan 

An additional project was initiated in Ashgabat to 

build on the work of the Ashgabat/North Dakota 

partnership (1999-2003). The project focuses on 

further strengthening PHC capacity building at 

the Family Medicine Training Center, opened in 

2000. Curriculum and training needs were 

assessed to develop a women’s health module in 

family medicine. 

Ukraine 

Six PHC partnerships graduated, ending the 

USAID-funded partnership program and leaving a 

legacy of 12 sustainable model PHC centers and 

numerous PHC physicians and nurses trained at the 

five skills-based training centers established by the 

partnerships. The PHC centers provide high-quality 

care to a population of approximately 75,000 

people. The Donetsk and Kramatorsk/Pittsburgh 

partners trained 65 practitioners from 22 women’s 

health centers as Lamaze instructors and introduced 

treatment protocols for cervical erosion, bronchitis, 


hypertension and pneumonia at the Kramatorsk 

Women’s Wellness Center and the Kramatorsk 

Family Medicine Department. A pediatric and an 

adult dental clinic opened at the Uzhgorod 

University Family Medicine Training Clinic. At the 

Velykiy Berezny Family Medicine Center, referrals to 

specialists decreased to 27 percent by mid-2004 

from 53 percent at its opening in 2000. The 

Kiev/Philadelphia partnership held a conference for 

100 participants from 18 oblasts to review clinical 

skills and assessment using standardized patient 

methodology. A teen counseling center was opened 

and a PHC nursing conference was held in Kharkiv. 

A new nursing curriculum developed by the partnership 

with LaCrosse was introduced at the 

Kharkiv Post-Graduate Medical Academy as the 

basis for a new four-year nursing degree program. 

New Family Planning/Reproductive 

Health Partnerships 

(Russia) 

In response to one of Russia’s continuing national 

health priorities – improving reproductive health to 

reverse negative population growth – USAID provided 

funding in July for two new partnerships 

aimed at enhancing primary care providers’ ability to 

meet family planning needs and integrating reproductive 

health and patient education into primary 

care in two oblasts. The Moscow Oblast-Dubna/ 

La Crosse and Volgograd/Little Rock partnerships are 

providing training in reproductive health and effective 

patient education and outreach techniques. The 

objectives of these partnerships are to increase access 

to family planning services, to train additional family 

planning practitioners, to expand use of family planning 

services by women and couples at PHC facilities 

and to raise contraceptive prevalence rates in underserved 

communities. 

Breast Health 

(Central Asia and Romania) 

The Susan G. Komen Breast Cancer Foundation 

funded two AIHA projects to improve skills and services 

related to breast cancer detection and treatment. 

The Romanian project is co-funded by USAID. 

Radiology Quality Assurance in Romania 

With support from US volunteer specialists recruited 

by AIHA, the Romanian Society for Breast Imaging 

A nurse at Yerevan’s St. Grigor Lusavorich Medical Center receives 

a “Journey to Nursing Excellence” ribbon from Mary Ann Anderson 

of Wake Forest University’s Baptist Medical Center. 

was formed to organize training and to serve as a 

liaison with the Ministry of Health for radiology 

quality assurance. At five pilot sites, 20 radiology 

technicians, radiologists and physicists were trained 

and quality assurance testing equipment and supplies 

were purchased and installed. The newlyintroduced 

quality assurance processes greatly 

improved mammography procedures and patient 

positioning, resulting in improved quality of breast 

x-ray images. USAID is selecting five additional sites 

at which Romanian trainers will provide training. 

The quality assurance manual of the American 

College of Radiology was adapted and translated into 

Romanian to serve as a procedure manual. 

Central Asia Nursing and Breast Health 

The project’s long-term goal is to improve breast 

health by upgrading nurses’ roles and skills in 

detection and treatment of breast cancer in 

Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. 

At the initial workshop in May, 40 nurses were 

trained as breast health educators and invited to 

submit proposals for community-based breast 

health projects. The 14 nurses who submitted proposals 

attended a second workshop in November 

where participants discussed their proposed projects 

and received training in advocacy and adult education 

techniques. Ten of the projects (totaling $5,000) 

were subsequently selected for funding. The projects 

range from training nurses in clinical and breast 

self-exam to raising community awareness to promote 

early detection. 

Photo: Courtesy of Linda Aiken 


Hospital Nursing Quality Improvement 

A three-year pilot program for nurses to improve 

the quality of hospital care culminated in 2004 

with the prestigious “Journey to Excellence” award 

by the American Nurses Credentialing Center 

(ANCC) given to four hospitals that had participated 

in now-graduated partnerships, two in Russia 

and two in Armenia. The USAID-supported program 

introduced evidence-based standards of professional 

nursing based on ANCC’s accreditation 

program for nursing care excellence, which recognizes 

excellence in hospitals in its “Magnet” 

Program. Each hospital was assisted by US experts 

in nursing standards and a partnership with a US 

hospital that had achieved ANCC Magnet status. 

Teams of nurses and physicians were formed to 

implement standards, which led to substantial 

improvements in quality of care and patient satisfaction. 

These hospitals now serve as national 

models of excellence in healthcare quality. 

Women’s Wellness Centers 

AIHA produced a report on an assessment conducted 

in late-2003 of the network of Women’s 

Wellness Centers established by AIHA between 

1997 and 2003. These Women’s Wellness Centers 

(WWCs) represent model comprehensive outpatient 

centers serving women of all ages. The selfassessment 

questionnaires, completed by 29 of the 

32 established WWCs, revealed that more than 90 

percent are continuing to provide services within 

the five core service categories of the WWC 

model – prenatal and perinatal care, family planning, 

sexually-transmitted diseases, cancer screening 

and diagnosis, and services to elderly women. 

The Centers also reported improved implementation 

of clinical guidelines and protocols 

as a result of training and information 

resources made available through the program, 

as well as improved physical facilities and availability 

of equipment, leading to better patient 

care and outcomes. 

tailored to the region. Based on the US Department 

of Transportation’s national standard curriculum, 

the workshop was held in Tbilisi in April and used 

trainers affiliated with Harvard Medical School. 

Each center received hard copies and CD-ROMs of 

the instructor and student manuals. The centers, 

while no longer receiving direct AIHA support, 

have continued to flourish. Since the centers were 

established beginning in 1994, they have trained 

more than 50,000 healthcare professionals and first 

responders in topics from first aid to medical 

emergencies and disaster management. 

Georgian Hospital Improvement 

On June 1, an emergency pediatric center was 

opened at the Iashvili Children’s Central Hospital 

(CCH) in Tbilisi. An emergency specialist from 

Atlanta assisted in the start-up under the USAIDfunded 

Tbilisi/Atlanta partnership. More than 

7,000 critically injured children received state-ofthe-art 

emergency care at the center since its opening. 

The partnership is also creating a professional 

nursing model and improving hospital management 

at CCH and Gudushauri Hospital (National 

Medical Center-NMC). In-service nurses’ training 

courses in pain management, infection control, 

surgical peri-operative techniques, intubation 

techniques, and treatment of acute and chronic 

ostheomielitis were held at the hospitals. The 

finances and administration of CCH and NMC 

were reviewed, training was provided on budgeting 

and monitoring, and recommendations are 

being implemented to improve fiscal management 

and performance indicators. 

Emergency Medical Response 

Trainers from AIHA’s network of 14 

Emergency Medical Services Training Centers 

located in nine countries received a week-long 

skills-based training on a new curriculum for 

non-medical personnel (first responders) 

Healthcare professionals, police, firefighters and other first responders learn 

critical life-saving skills at AIHA’s network of EMS Training Centers. 

Photo: AIHA archives 


HEALTH PROFESSIONS 

EDUCATION 

“The success of 

healthcare reform in a 

country is directly 

related to its ability to 

develop a cadre of 

high-quality 

professionals capable 

of working within the 

new system. The 

partnership allows 

medical schools to 

exchange ideas and 

enhance the 

professional skills of 

faculty, as well as help 

promote the 

development of 

medical education 

reform in the Central 

Asian Republics.” 

– Professor Talgat 

Muminov, rector of the 

Kazakh State Medical 

University, Almaty, 

Kazakhstan 

Building human and institutional capacity through health professions 

education is a key component of healthcare reform and integral to AIHA’s 

efforts to contribute to improved healthcare. Since 1996, AIHA has been 

supporting educational partnerships and programs that seek to strengthen 

formal education and professional training for physicians, nurses and 

healthcare managers. 

Medical Education Reform Underway in Central Asia 

In partnership with University of 

South Florida (USF), seven medical 

education institutions from 

Kazakhstan, Kyrgyzstan, Tajikistan 

and Uzbekistan are piloting reforms 

in the region. The partnership focuses 

on establishing regional standards 

and accreditation, improving administrative 

capacity for planning and 

monitoring, enhancing the ability of 

faculty to design appropriate curricula, 

enhancing institutional capacity 

to conduct research, and promoting 

student development activities. 

During 2004, links were established 

with US and European medical education 

organizations for pilot projects, 

accreditation processes and data 

By improving medical education and professional 

development opportunities, partners are also improving 

institutional efficiency and the quality of 

patient care. 

requirements were studied, and research standards and grant-writing were 

reviewed. The partners and the region’s Council of Rectors agreed to develop 

a Central Asian Medical Education Database to track information on institutions, 

curriculum and quality indicators to support regional accreditation. 

Central Asia Council of Rectors 

The Council of Rectors is spearheading unified approaches among Central 

Asian countries in admission standards, graduate qualifications, standardized 

examinations, professional licensure, accreditation and workforce 

planning to support health system reforms. The Council, established in 2000 



Photo: John Capati 

The concept that we can accomplish more through collaboration 

than working alone is a cornerstone of AIHA's twinning 

model. Team-building exercises such as this one encourage 

physicians, nurses and other care providers to work together to 

provide comprehensive, integrated healthcare services. 

with support from AIHA and Abt Associates with 

USAID funding, has broad representation of medical 

education institutions in Central Asia, with 10 

from Kazakhstan, eight from Kyrgyzstan, two from 

Tajikistan, 10 from Uzbekistan and one from 

Turkmenistan. In 2004, its activities were tied 

closely to the medical education partnership’s 

activities. The Council discussed regional standards 

of medical education and uniform qualifications 

for graduates. The rectors have agreed to begin 

drafting accreditation standards using guidelines of 

the World Federation for Medical Education. 

Strengthening Nursing Education and 

Leadership in Central Asia 

The first multi-institutional and multi-country 

partnership on nursing education and leadership 

was initiated in Kazakhstan, Kyrgyzstan and 

Uzbekistan with the University of Minnesota’s 

School of Nursing (UMN). The partnership is 

strengthening nursing curricula, teaching strategies, 

practice standards and professional independence. 

Nurse educators from UMN assessed implementation 

of the existing nursing curricula and 

recommended a phased approach for basic and 

advanced curriculum models. In June, the partners 

held a planning workshop in Bishkek in conjunction 

with the Central Asia Nursing Council and 

formulated partnership priorities and objectives. 

Central Asia Nursing Council 

Created in 1999, with support from AIHA and 

USAID, the Central Asia Nursing Council’s principal 

goal is to promote collaboration in nursing 

education, practice, specialty training, research, 

management, regulations and associations in the 

five countries of the region. During 2004, the 

Council finalized the Manual on Family Nursing 

for distribution, approved the draft Regulations on 

Nurse Registration System, and revised model 

clinical practice guidelines on malaria, tuberculosis 

and diabetes. 

Health Management Education in 

Uzbekistan 

In 2004, the Tashkent/Lexington, Kentucky, health 

management education partnership focused on 

developing the undergraduate health management 

curriculum, with graduate and continuing education 

courses to be developed in later years. In May, 

a training-of-trainers (ToT) workshop in the new 

curriculum was given to 15 faculty members and 

administrators at the First and Second Tashkent 

State Medical Institutes. University of Kentucky 

faculty assisted in the first 36-hour course taught 

to medical students and the Uzbek faculty has 

since taught the course to 470 students. 

Support for Healthcare Policy 

Development and Health Management 

in Turkmenistan 

At the request of Turkmenistan’s Ministry of 

Health and Medical Industry, AIHA initiated a 

new project with USAID support to develop a 

Health Management Training Center at the 

Ashgabat Medical Institute. The Kazakhstan 

School of Public Health and Virginia 

Commonwealth University, formerly of the 

Almaty/Richmond health management education 

partnership, provided health management ToT 

training as part of the new project. In addition, 

AIHA organized a study tour for five health and 

finance ministry officials to learn about different 

approaches to healthcare financing in the United 

States and Canada. The group visited private 

health insurance companies, government-financed 

programs and universities. 



Health Management Training in 

Georgia 

The Tbilisi/Scranton, Pennsylvania, partnership 

wrapped up nearly five years of USAID-funded 

collaboration in September. The National Health 

Management Center in Tbilisi and its satellites in 

Batumi, Kutaisi and Telavi are continuing to provide 

courses developed by the partners to hospital 

managers, physicians and nurses. The partners 

published the quarterly, interdisciplinary Journal 

of Health Services Management and Public Health 

and a textbook in Georgian titled, Public Health 

and Management. In collaboration with the 

National Institutes of Health, partners also prepared 

a toolkit in Russian titled, Health Care 

Management Guidelines. 

Nursing Distance Education in 

Armenia 

Under the USAID-funded Nursing Distance 

Education Project, graduate nursing students at 

Erebouni Medical College in Yerevan participated in 

on-line courses with counterparts at the University 

of Nebraska Medical Center’s School of Nursing to 

strengthen advanced nursing education in Armenia. 

The project also demonstrated the use of distance 

learning technology for developing nursing education 

in a resource-poor country. During 2004, 10 

students from Erebouni completed Internet-based 

courses on curriculum design and research in nursing. 

Four courses were completed during the twoyear 

project. The project was interrupted with the 

end of funding for AIHA programs in Armenia. 

AIHA partnerships have helped create a new generation of 

highly-skilled nurses by improving opportunties for their education 

and professional development. 

Theoretical lessons combined with hands-on clinical training 

help partners hone their skills. 

Public Health and Health Management in 

Albania 

In January, the Tirana/Bucharest, Romania, partnership 

(the first not involving a US partner) held 

a dissemination conference to share their experiences 

and outcomes and to market the primary 

care management course developed through the 

partnership. The partners presented processes for 

identifying training needs for health professions 

and developing the training-of-trainers course in 

Albania. Given the similarities in healthcare 

reforms in Albania and Romania, the capacity 

building for public health and health management 

served both partners. The partnership graduated 

in March. 

New Eritrea Award 

In December, USAID awarded AIHA the Health 

Professions Education Partnership Program 

designed to build a foundation for meeting urgent 

health workforce education needs in Eritrea. In 

view of the critical role of physicians and the 

diminished size of Eritrea’s medical workforce, the 

program will emphasize the strengthening of medical 

education through support to Eritrea’s new 

academic health center, comprising the recentlyestablished 

Orotta School of Medicine, related 

nursing and allied health professions schools, and 

affiliated teaching hospitals. The project, closely 

coordinated with the Ministry of Health’s workforce 

plans and policies, began in 2005. 



HEALTHY 

COMMUNITIES 

“Resources are 

limited, but 

our creativity 

is unlimited.” 

– Tashkent, 

Uzbek meeting participant 

Since its inception, AIHA has encouraged and supported community-based 

approaches to addressing priority health problems. In 1996, with USAID 

funding, AIHA adapted and began employing the healthy communities 

model, which defines health broadly as not merely the absence of disease 

but the well-being of the population as a whole. The model, related to the 

World Health Organization’s Healthy Cities movement, is based on engaging 

citizens and public and private entities in promoting healthy behaviors 

and improving quality of life. AIHA has established six healthy communities 

partnerships to date, two of which were active in 2004 in Hungary. 

More recently AIHA integrated the healthy communities model into the 

Community Leadership Development Program (CLDP) which, with funding 

from the Library of Congress’ Open World Leadership Center, has 

brought civic and healthcare leaders from more than 40 communities in 

Russia and Uzbekistan to the United States. Participants are hosted within 

US communities and gain knowledge and skills to better enable them to 

mobilize their own communities to address priority health and social issues. 

Promoting Healthy Communities in Hungary 

Two healthy communities partnerships in Hungary graduated in 2004. The 

Pécs/Harrisburg partnership brought together business and arts leaders to 

encourage their involvement in promoting women’s health through arts and 

cultural programs in the 23 member 

communities of the Hungarian 

Association of Healthy Cities. The 

Gyo″r/Pittsburgh partnership conducted 

an adolescent pregnancy prevention 

campaign in February targeting girls 

between the ages of 14–18 at schools 

and gathering places for youth. The 

campaign concluded with a disco and 

discussion attended by 90 teens and 

supported by $15,000 in donated media 

time. A women’s health and information 

resource center, “For Women’s 

Health,” was opened in Gyo″r in March 

Partners work to prevent chronic diseases by 

educating the public at health fairs and other 

outreach events. 

Photo: Courtesy of Laura Faulconer 


and during the year held 54 classes attended by 

1,146 people and distributed 10,900 leaflets on 

health topics. Two satellite centers and eight information 

kiosks were set up at healthcare sites, a 

pharmacy, a cultural center, a shopping mall, a 

business park, the public library, and the Family 

and Marriage Institute. Both partnerships graduated 

in September. 

Russian and Uzbek Civic and Healthcare 

Leaders Visit the United States 

With the third year of funding from the Library of 

Congress, AIHA continued to engender mutual 

understanding and healthy communities through the 

Community Leadership Development Program. 

During October and November, three groups comprising 

69 leaders from Russia and Uzbekistan visited 

Florida, Iowa and Minnesota. The Russian delegates 

came from 12 communities with active AIHA programs: 

13 from Orenburg, 18 from St. Petersburg, 

12 from Samara, and 14 from Saratov. Participants 

learned how to integrate medical services with social 

services provided by community organizations for 

comprehensive HIV/AIDS care. The Uzbek delegation 

to Minnesota saw TB treatment in prisons and 

laboratory diagnostics. The Uzbek delegation to 

Florida observed community health workers reaching 

underserved populations and preventive health 

services funded through dedicated sales taxes. These 

professionals are now part of the CLDP alumni network 

that is actively spearheading community action 

plans to promote health in their communities. 

Russian CLDP Alumni Lead Local 

Efforts to Improve Health 

AIHA sponsored a Russia-wide leadership meeting 

in Moscow for the Community Leadership 

Development Program/Russia alumni. At the May 

meeting, CLDP alumni reported on successful follow-on 

programs, including the formation of five 

regional networks of healthy communities representing 

25 cities, towns and districts in 

Chelyabinsk, Kurgan, Sakhalin, Samara and Tomsk 

oblasts. CLDP participants from Yuzhnouralsk 

gained wide support for a drug abuse and 

HIV/AIDS program, receiving city council 

approval and funding through 2005. Alumni from 

Novokuibyshevsk formed a healthy community 

program committee headed by the deputy mayor 

Through AIHA's CLDP exchanges, delegates get a first-hand 

look at community-based health programs in action. 

and decided to focus on prevention of HIV/AIDS 

and drug abuse in youth. Working with local agencies 

and NGOs, activities included distributing 

3,000 AIDS prevention booklets, holding a music 

festival, training school staff in prevention and 

conducting stakeholder roundtables. Samara 

alumni promoted healthy lifestyles among youth 

with three awareness and training projects. The 

“Take it with you!” project conducted 20 training 

courses on AIDS prevention in local schools in 

cooperation with the Center for Social 

Development and Information Foundation. 

Alumni and specialists from the Samara 

Pedagogical University trained 60 specialists from 

family medical centers to assist parents on the project, 

“Preserving children’s and adolescents’ health 

in the Samara region.” Alumni and members of the 

health and education departments sponsored the 

“Health-aware Teenagers” program, which trained 

30 physicians, 25 teachers and parents. 

Uzbek CLDP Alumni Convene for 

Follow-up Meeting 

In April, eight alumni of the first Uzbek Community 

Leadership Development Program delegation met in 

Tashkent along with representatives of the Tashkent 

State Medical Institutes, the Open World project, 

USAID and AIHA. Among other topics, the participants 

discussed relevant health programs and 

resources available in Uzbekistan, communityoriented 

interventions and delegates’ CLDP experiences. 

Alumni reported that since returning from 

the United States, they had initiated programs to 

expand services for drug abuse and HIV/AIDS, 

increase use of information technology, improve 

management of hospital beds and introduce healthy 

community principles in family medicine. 

Photo: Anne Maynard 


INFORMATION AND 

COMMUNICATION 

TECHNOLOGY 

“The LRC is a very 

important tool for 

changing the way 

people who work in 

healthcare think 

because it gives them 

an opportunity to 

learn to make the 

maximum use of 

existing information 

resources, both for 

themselves and for the 

people around them.” 

– Yuri Vorokhta, 

information coordinator 

for the Odessa State 

Medical University LRC 

AIHA’s Information and Communication Technology (ICT) programs 

focus on improving access to reliable health and medical information for 

health professionals worldwide, as well as developing the capacity for health 

professionals to interpret and apply this information using the principles of 

evidence-based practice. With greater access to information, physicians, 

nurses, educators, policymakers, and other health professionals are 

equipped with greater capability to improve the quality and effectiveness of 

the healthcare they deliver. AIHA’s ICT programs strive to both improve 

the availability of appropriate native-language health information resources 

and build upon the infrastructure and capacity of healthcare institutions to 

access and use these resources. 

Learning Resource Center Project Selected as Stockholm 

Challenge Finalist 

AIHA’s Learning Resource Center (LRC) Project was a finalist in the 2003- 

2004 Stockholm Challenge, a prestigious award for innovative ICT programs 

in international development. The Stockholm Challenge is a nonprofit 

initiative of the City of Stockholm that focuses on the benefits of ICT for 

people and society. The LRC Project was selected from a field of nearly 900 

entries from 107 countries. Finalists were invited to attend a conference and 

ceremony held in Stockholm in May. An international jury of 28 experts 

selected finalists in six categories – e-government, culture, health, education, 

e-business and environment – based on innovation, user need, accessibility 

and transferability. 

Sixteen New LRCs Established 

AIHA established 16 new Learning Resource Centers in the Caucasus, 

Central Asia, Kosovo and Russia to support AIHA partnerships in primary 

care, medical and nursing education, HIV/AIDS and reproductive health. 

These centers joined the network of 130 LRCs established in the region since 

1995. During 2004, the LRC project provided information and communication 

services to 75,000 health professionals and fulfilled 8,500 information 

requests. The LRCs trained 2,400 health professionals on the use of computers 

and the Internet and opened their doors to nearly 21,000 visitors. 


LRCs Contribute to Evidence-based 

Decision-making: An Example from 

Moldova 

Learning Resource Centers play an important role 

in improving healthcare quality by supporting evidence-based 

decision-making. In 2004, in an effort 

to overcome the old scourge of overmedication, the 

staff of the Cardiosurgery Center at the Republican 

Clinical Hospital in Chisinau, Moldova, evaluated 

patterns of drug usage for surgical and post-surgical 

prophylaxis. After reviewing the evidence-based 

literature, clinicians reduced the number of antibiotics 

used in routine surgical procedures from three 

to one. They standardized the culture and sensitivity 

tests for determining appropriate drug treatment 

for postoperative complications. In the six 

months following the implementation of the new 

procedure, the Center observed a noticeable 

decrease in the number of complications and a 

reduction in the average hospital length of stay. In 

addition to better patient care, the changes resulted 

in cost savings for the hospital. 

EurasiaHealth Knowledge Network 

Usage Doubles in 2004 

Use of the EurasiaHealth Knowledge Network, a 

Web-based clearinghouse of health and medical 

information in Russian and other Eurasian languages, 

more than doubled during 2004, from 

4,200 to 10,700 visits per month. The increase is 

due in part to the visibility generated by information 

bulletins EurasiaHealth began producing this 

year. These include the “Free Resources Bulletin” 

and the “Guide to Electronic Libraries,” which 

inform health professionals in developing countries 

how to obtain free books, CD-ROMs and 

access to on-line health and medical journals. 

Several Web sites and print journals reprinted 

issues of these bulletins. Activities of the specialized 

EurasiaHealth HIV/AIDS Knowledge Library 

are described in the section on HIV/AIDS. 

Evidence-based Medicine Distance 

Learning Course 

In April, AIHA conducted the first of three iterations 

of a new distance learning course on the 

basics of evidence-based medicine and critical 

appraisal of scientific literature. The course is 

designed to teach participants how to formulate 

“answerable” clinical questions, identify the best 

sources of evidence for each type of question, and 

appraise publications on validity, reliability and 

applicability. The four-week course was offered 

twice in Russian and once in English. Altogether, 

135 individuals from Eurasia and Africa attended 

the course. In the post-test self-assessments, participants 

showed increased knowledge in identifying 

relevant sources of evidence, devising search strategies, 

using critical appraisal tools and introducing 

evidence-based principles in their area of practice. 

Books, electronic databases and computer software are a part of the Standard Learning Resource Center Equipment and 

Resources package. 

Photo: Frances Greene 


ACTIVE PARTNERSHIPS 

AND PROJECTS 

Caucasus 

Armenia 

Armavir/Galveston, Texas 

Caucasus Partners: Armavir Regional Health Care Administration, Armavir 

Polyclinic 

US Partners: University of Texas Medical Branch at Galveston, Galveston 

Partnership for Better Living, JesseTree 

Gegarkunik/Providence, Rhode Island 

Caucasus Partners: Gegarkunik Regional Health Care Management 

Department, Sevan Polyclinic 

US Partners: National Perinatal Information Center, Care New England, 

Lifespan Health Systems 

Lori/Los Angeles, California 

Caucasus Partners: Lori Regional Health Care Administration, Vanadzor 

Polyclinic No. 5 

US Partner: University of California – Los Angeles Medical Center 

Lori/Milwaukee, Wisconsin 

Caucasus Partners: Lori Regional Health Care Administration, Vanadzor 

Polyclinic No. 5 

US Partner: Center for International Health 

Yerevan/Washington, DC 

Caucasus Partner: Armenian American Wellness Center 

US Partner: Armenian American Cultural Association 

Azerbaijan 

Baku/Houston, Texas 

Caucasus Partner: Mir Kasimov Republican Clinical Hospital 

US Partner: Baylor College of Medicine 

Baku/Portland, Oregon 

Caucasus Partner: Narimanov District Health Administration 

US Partner: Oregon Health Sciences University in Portland 


Baku/Richmond, Virginia 

Caucasus Partner: Binagadi District Health 

Administration 

US Partner: Virginia Commonwealth University 

Ganja/Livermore, California 

Caucasus Partner: Ganja City Health Administration 

US Partners: ValleyCare Health System, Alameda 

County Public Health Department 

Georgia 

Gori/Milwaukee, Wisconsin 

Caucasus Partner: Shida Kartli Regional Healthcare 

Administration Department 

US Partners: Center for International Health – 

Medical College of Wisconsin, University of 

Wisconsin Medical School – Milwaukee Clinical 

Campus, Marquette University College of Nursing, 

Marquette University School of Dentistry, 

City of Milwaukee Health Department, Planning 

Council for Health and Human Services, 

Sixteenth Street Community Health Center, 

Milwaukee County Division of Health Programs 

Guria/La Crosse, Wisconsin 

Caucasus Partner: Guria Regional Healthcare 

Administration Department 

US Partners: World Services of La Crosse, Inc., 

Gundersen Lutheran Medical Center, Franciscan 

Skemp Mayo Health System, Viterbo University, 

University of Wisconsin – La Crosse, Western 

Wisconsin Technical College, Health Science 

Consortium, City of La Crosse, La Crosse County 

Health Department 

Mtskheta/Milwaukee, Wisconsin 

Caucasus Partner: Mtskheta-Mtianeti Regional 

Health Administration 

US Partners: Center for International Health – 

Medical College of Wisconsin, University of 

Wisconsin Medical School – Milwaukee Clinical 

Campus, Marquette University College of Nursing, 

Marquette University School of Dentistry, 

City of Milwaukee Health Department, Planning 

Council for Health and Human Services, 

Sixteenth Street Community Health Center, 

Milwaukee County Division of Health Programs 

Tbilisi/Atlanta, Georgia 

Caucasus Partners: Central Children’s Hospital, 

Gudushauri National Medical Center 

US Partners: Partners for International Development, 

Emory University, Georgia State University, 

Georgia Institute of Technology, Grady 

Health System, Morehouse College 

Tbilisi/Scranton, Pennsylvania 

Caucasus Partner: National Health Management 

Center 

US Partner: University of Scranton 

Central Asia 

Kazakhstan 

Community-Oriented Primary Care: 

Social Integration Model 

CAR Sites: Family Group Practice No. 9, Family 

Group Practice No. 11 (Semipalitinsk); Family 

Group Practice No. 21 (Uralsk) 

Prevention of Mother-to-Child 

Transmission of HIV 

CAR Sites: Maternity Hospital No. 1 (Almaty); 

Oblast Maternity Hospital (Pavlodar); Maternity 

Hospital (Temirtau); Maternity Hospital No. 2 

(Karaganda) 

Turkmenistan 

Capacity Building for Primary Health 

Care and Health Management 

CAR Sites: Ministry of Health and Medical Industry, 

Family Medicine Training Center and 

Women’s Health at Health House No. 1, Family 

Medicine Training Center at the Research Center 

of Physiology, Health Management Training 

Center at Turkmen State Medical Institute 

Uzbekistan 

Tashkent/Lexington, Kentucky 

CAR Partners: Tashkent State Medical Institute 

No. 1, Tashkent State Medical Institute No. 2 

US Partner: University of Kentucky School of 

Public Health 


Regional 

Nursing Education and Leadership Development 

CAR Partners: Astana Nursing College, Almaty 

Nursing College (Kazakhstan); Bishkek Nursing 

College, Kyrgyz State Medical Academy Higher 

Nursing Education Department (Kyrgyzstan); 

Borovsky Nursing College of Tashkent, Republican 

Scientific Center for Emergency Medical Services, 

Bukhara State Medical Institute Higher Nursing 

Education Department (Uzbekistan) 

US Partner: University of Minnesota School of 

Nursing 

Undergraduate Medical Education 

CAR Partners: Kazakh State Medical Academy of 

Astana, West Kazakhstan Medical Academy of 

Aktobe (Kazakhstan); Kyrgyz State Medical 

Academy of Bishkek, Medical Department of 

Osh State University (Kyrgyzstan); Tajikistan 

Medical Institute of Dushanbe (Tajikistan); 

Tashkent State Medical Institute No. 1, Tashkent 

State Medical Institute No. 2 (Uzbekistan) 

US Partner: University of South Florida Health 

Sciences Center 

Nursing and Breast Health 

CAR Sites: Uralsk Nursing Association, Women’s 

Wellness Center of Almaty, Seminpalatinsk 

Nursing Association, Republican Nursing College 

of Almaty (Kazakhstan); Bishkek Nursing 

College, Post-Graduate Training Institute (Kyrgyzstan); 

Borovsky Nursing College of Tashkent, 

Women’s Wellness Center of Tashkent, Tashkent 

State Medical Institute No. 1, (Uzbekistan); Tajik 

Nursing Association (Tajikistan) 

Central & Eastern Europe 

Albania 

Lezha/Pittsburgh, Pennsylvania 

CEE Partner: Lezha Directorate of Primary Health 

Care 

US Partner: Magee-Womens Hospital of the University 

of Pittsburg Medical Center Health System 

Tirana/Bucharest, Romania 

CEE Partners: Institute of Public Health (Albania); 

National Institute for Health Research and 

Development (Romania) 

Tirana/Providence, Rhode Island 

CEE Partner: Maternity Hospital No. 1 

US Partners: National Perinatal Information Center, 

Women and Infants Hospital of Rhode Island 

Croatia 

HIV/AIDS Project 

CEE Site: Andrija Stampar School of Public Health 

Hungary 

Gyo″r/Pittsburgh, Pennsylvania 

CEE Partner: Gyo″r World Health Organization 

Healthy Cities Project 

US Partners: Magee-Womens Hospital of the University 

of Pittsburg Medical Center Health System, 

Family Health Council, University of Pittsburgh 

Graduate School of Public Health 

Pécs/Harrisburg, Pennsylvania 

CEE Partner: Hungarian Association of Healthy Cities 

US Partner: Institute for Healthy Communities 

Kosovo 

Gjakova/Hanover, New Hampshire 

CEE Partners: Gjakova Municipality, Gjakova 

Family Medicine Centers 

US Partner: Dartmouth Medical School 

Gjilan/Hanover, New Hampshire 

CEE Partners: Gjilan Municipality, Gjilan Main 

Family Medicine Center 

US Partner: Dartmouth Medical School 

Latvia 

Riga/Little Rock, Arkansas 

CEE Partner: WHO Collaborating Center for 

Research and Training in Management of Multidrug-Resistant 

Tuberculosis (State Center of 

Tuberculosis and Lung Diseases of Latvia) 

US Partner: University of Arkansas for Medical 

Sciences 

Romania 

Susan G. Komen Breast Cancer 

Foundation/USAID Radiology Project 

CEE Sites: Oncological Institute of Cluj, District 

University Hospital of Cluj, Oncological Institute 

of Bucharest, Fundeni Hospital of 

Bucharest, Renestera Foundation 


Russia 

Kurgan and Shchuche/Appleton, Wisconsin 

Russian Partners: Kurgan Oblast Administration, 

Shchuche District Administration, Central District 

Hospital of Shchuche, Kurgan City Maternity 

Hospital 

US Partners: ThedaCare (including Appleton 

Medical Center and Theda Clark Hospitals), Fox 

Cities-Kurgan Sister Cities, Physicians for Social 

Responsibility, Lawrence University, University 

of Wisconsin Family Practice Residency Program 

and Family Living Program, Chamber of 

Commerce, American Red Cross of Appleton 

Sakhalin/Houston, Texas 

Russian Partners: Sakhalin Oblast Health Department, 

Korsakov Central District Hospital, 

Sakhalin Department of Healthcare, City Health 

Administration of Nogliki-Okha, City Health 

Administration of Kholmsk, City Health 

Administration of Yuzhno-Sakhalinsk, City 

Health Administration of Korsakov 

US Partner: Baylor College of Medicine 

Sarov/Los Alamos, New Mexico 

Russian Partners: Sarov City Duma, Office of the 

Mayor, Medical-Sanitary Unit No. 50 

US Partners: County of Los Alamos, Los Alamos 

Medical Center, Los Alamos National Laboratory, 

State of New Mexico Department of Health, 

University of New Mexico School of Medicine, 

Los Alamos School District 

Stavropol and Samara/Des Moines, Iowa 

Russian Partners: Samara Oblast Department of 

Health, Stavropol Krai Department of Health 

US Partners: Iowa Hospital Education and 

Research Foundation, Central Iowa Health System, 

Iowa Department of Public Health, 

Planned Parenthood of Greater Iowa, University 

of Osteopathic Medical and Health Sciences, 

Iowa Sister States, Iowa Council for International 

Understanding, Consortium of Iowa Community 

Colleges 

Tomsk/Bemidji, Minnesota 

Russian Partner: Tomsk Oblast Health 


US Partners: North Country Health Services, 

Bemidji State University, Beltrami Area Service 

Collaborative, Cass Lake Heath Service Indian 

Hospital, Bemidji MeritCare, Beltrami County 

Nursing Service, Headwaters Regional Development 

Commission, Rural Physician Associate 

Program 

Volgograd/Little Rock, Arkansas 

Russian Partners: Volgograd State Medical University, 

Volgograd City Health Department, Volzhskiy 

Health Center 

US Partners: University of Arkansas for Medical 

Sciences, Arkansas Department of Health, 

Lowell Medical Center, Area Health Education 

Centers – Northeast Family Medicine Center, 

Mid-Delta Community Health Center, Arkansas 

Academy of Family Physicians 

Orenburg/New York, New York 

Russian Partner: Orenburg Oblast AIDS Center 

US Partners: Elmhurst Hospital Center, Mount 

Sinai School of Medicine, New York City Department 

of Health’s HIV Surveillance Unit, AIDS 

Institute – AIDS Center of Queens County 

Samara/Providence, Rhode Island 

Russian Partners: Samara Oblast Ministry of 

Health, Togliatti City Health Department, Samara 

Oblast AIDS Center, Togliatti City AIDS Center 

US Partners: National Perinatal Information Center, 

Care New England Health System, Stanley 

Street Treatment and Resources, Lifespan, 

Rhode Island Department of Health 

Saratov/Bemidji, Minnesota 

Russian Partners: Saratov Oblast AIDS Center, 

Engels City Health Department 

US Partners: Northern Rivers HIV/AIDS Consortium 

(North Country Health Services, Bemidji 

State University, Minnesota Department of 

Health’s Section for STDs and HIV, Beltrami 

Area Service Collaborative, Indian Health Service, 

Rural AIDS Action Network, New York 

City’s Metropolitan Hospital) 


St. Petersburg/New Haven, Connecticut 

Russian Partners: St. Petersburg City AIDS Control 

Center, St. Petersburg Health Committee, 

Botkin Clinical Hospital 

US Partners: Yale University School of Medicine, 

Yale University School of Nursing, Yale Center 

for Interdisciplinary Research on AIDS, Yale 

AIDS Care Program, Yale-New Haven Hospital, 

Nathan Smith Clinic, Connecticut Department 

of Public Health, Hispanos Unidos 

Moscow Oblast – Dubna/La Crosse, Wisconsin 

Russian Partners: Moscow Oblast Health Administration, 

Dubna City Health Administration 

US Partners: World Services of LaCrosse, Gundersen 

Lutheran Medical Center, Franciscan 

Healthcare System, Sister Cities 

WEST NIS 

Moldova 

Comprehensive TB Control Project 

WNIS Partners: Ministry of Health, Ministry of 

Justice; State Medical and Pharmaceutical 

University “Nicolae Testemitanu” 

Lativian Partner: State Center of Tuberculosis and 

Lung Diseases 

US Partner: University of Arkansas for Medical Sciences 

Ukraine 

Donetsk/Pittsburgh, Pennsylvania 

WNIS Partners: Donetsk Oblast Health Administration, 

Polyclinic No. 1, City Hospital No. 25, 

Kramatorsk Central City Hospital 

US Partners: Magee Womancare International, 

Allegheny County Health Department, United 

Mine Workers of America, University of 

Pittsburgh Graduate School of Public Health, 

University of Pittsburgh Medical Center 

Department of Family Medicine and Clinical 

Epidemiology 

Kharkiv/La Crosse, Wisconsin 

WNIS Partners: Kharkiv Oblast Health Administration, 

Kharkiv Student Polyclinic, Chuguev 

Rayon Hospital 

US Partners: World Services of LaCrosse, Gundersen 

Lutheran Medical Center, Mayo Health System 

– Franciscan Skemp Healthcare, University 

of Wisconsin – La Crosse, Western Wisconsin 

Technical College, Viterbo University 

Kiev/Philadelphia, Pennsylvania 

WNIS Partners: Kiev City Health Administration, 

Darnitsky District Central Polyclinic, Darnitsky 

District Family Medicine Center, Kiev Postgraduate 

Medical Academy 

US Partners: Temple University, Widener University, 

Crozer-Keystone Health System, Health Federation 

of Philadelphia 

L’viv/Cleveland, Ohio 

WNIS Partners: L’viv Oblast Health Administration, 

L’viv City Polyclinic No. 5, Zhovkva 

Rayon Hospital 

US Partners: Cleveland International Program 

Federation for Community Planning, Cuyahoga 

County Board of Health, Case Western Reserve 

University, Cleveland State University, Cleveland 

Clinic Foundation, Ohio Department of Health, 

Center for Health Affairs, Fairview Center for 

Family Medicine, Cuyahoga County Board of 

Mental Health, Heartland Behavioral Health, 

Ohio Department of Mental Health, Case Western 

Reserve University School of Nursing, Free 

Clinic of Cleveland 

Odessa/Boulder, Colorado 

WNIS Partners: Odessa State Medical University, 

Odessa Seaport Occupational Polyclinic, 

Odessa City Council, Odessa Oblast Health 


US Partners: Boulder Community Hospital, University 

of Colorado School of Medicine, Boulder 

County Health Department, Beacon Clinic, 

Boulder County Healthy Communities Initiative 

Uzhgorod/Corvallis, Oregon 

WNIS Partners: Zakarpatska Oblast Hospital, 

Central Velykoberesnyanska Rayon Hospital, 

Zakarpatska Oblast Health Administration 

US Partners: Corvallis Sister Cities Association, 

Oregon Health Sciences University, Corvallis 

Family Medicine, Western Oregon University, 

Benton County Health Department, Good 

Samaritan Hospital, Corvallis Clinic, Oregon 

State University, Benton County Community 

Outreach 


THE YEAR 

IN NUMBERS 

52 = Active partnerships and projects 

27 = Partnerships that graduated 

7 = New partnerships established 

17 = Countries where AIHA had partnerships and projects 

28 = US cities involved in AIHA partnerships 

188 = US partner volunteers who traveled on overseas exchanges 

345 = Person exchange trips 

46 = Training manuals/materials developed and/or translated 

27+ = Model primary healthcare centers opened and operational 

through AIHA partnerships 

32 = Active Women’s Wellness Centers 

17 = Active Neonatal Resuscitation Training Centers 

$16.2 million = Overall 2004 budget 

$8.4+ million = Value of in-kind contributions by US partners in 2004 

$184+ million = Overall budget since 1992 

$234+ million = Value of in-kind contributions by US partners since 1992 


PARTNER PROFILES 

Ramize Ibrahimi has been a nurse at Gjilan 

Health House in Kosovo for many years and has 

participated in health development activities sponsored 

by a variety of international organizations, 

including the World Health Organization. Despite 

her participation in numerous training courses, 

workshops, and conferences offered by these 

organizations, she lacked the self-confidence to 

openly express her opinions – especially in front of 

the physicians and other medical professionals she 

interacted with. “I just always felt like I was in a 

lower position than those I was with,” Ramize says, 

explaining that in Kosovo nurses have traditionally 

been viewed as subordinate to the will and dictates 

of physicians, not as equal partners in the provision 

of medical care. 

When AIHA’s Gjilan/Hanover (New Hampshire) 

partnership was established in October 2001, 

Ramize was asked to lead several working groups 

tasked with health education programs, clinical 

practice guidelines for nurses, and community 

education and outreach. Drawing on the expertise 

and support of her partners at Dartmouth Medical 

School, Ramize conducted training courses for 

nurses working in family medicine clinics 

throughout Gjilan and its environs. She also spearheaded 

efforts to develop community education 

materials on hypertension, conducted outreach 

and awareness activities throughout the community, 

and even spoke out about the subject on local 

radio programs urging listeners to pay heed to the 

early warning signs of high blood pressure and ask 

their healthcare provider about screening tests. 

Ramize credits her participation in the partnership 

not only with giving her important new skills as a 

nurse and a health educator, but also with giving 

her confidence in her own abilities and the 

courage to voice her opinions. “By the time our 

partnership entered its second year, I had developed 

enough courage and self-confidence to freely 

express my opinions and share my ideas during 

training courses and other meetings,” she says. “I 

am no longer scared to speak out, to voice my 

opinions.” 

Primary care nurse Ramize Ibrahimi gained knowledge, practical 

skills and self-confidence from her involvement in AHIA’s 

Gijilan/Hanover partnership. 

Although the partnership with Dartmouth ended 

in 2003, Ramize has continued her work as the 

head nurse for patient education at Gjilan Health 

House. Empowered by her newfound self-assurance, 

she is now applying her considerable talents 

and the knowledge she gained through her partnership 

experience to the task of providing better 

health education to the people of Gjilan. In addition 

to developing an annual plan for communitybased 

diabetes education, Ramize has been invited 

by the Ministry of Health, the Association for 

Health Education and Promotion, and the 

Institute of Public Health to serve on a number of 

national advisory groups addressing topics ranging 

from reproductive health and family medicine 

to health promotion activities throughout Kosovo. 

Perhaps most importantly, she now serves as a 

strong voice representing all Kosovar nurses striving 

to enhance the role they play in providing quality 

clinical and patient education services to the people 

in their communities. 

Photo: Violeta Shala 


PARTNER PROFILES 

Dr. Steve Rith-Najarian has been practicing 

family medicine in and around Bemidji, 

Minnesota, since 1986 when he became a commissioned 

officer in the US Public Health Service’s 

Indian Health Service and was assigned to provide 

care to Native Americans living on the Red Lake 

Reservation. In addition to primary care and epidemiology, 

some of his professional interests 

include the prevention and management of diabetes, 

hypertension and other chronic ailments. 

“Just as patients with chronic illness have to examine 

their lifestyle choices, we have to examine 

choices we make in the organization of our clinical 

practice,” he says, explaining that 

this connection is one that all too 

clearly underscores the close relationship 

between continuous 

quality improvement and effective 

public health programs. 

A keen interest in this link played 

an important role in Steve’s decision 

to participate in a primary 

healthcare partnership that AIHA 

established between a coalition of 

health-related institutions in 

Bemidji and the Russian city of 

Tomsk in 2000 and a subsequent 

alliance formed in 2004 between 

the northern Minnesota town 

and Saratov, Russia, to address 

the latter community’s growing 

HIV/AIDS epidemic. 

From the beginning, both partnerships – like all 

twinning alliances AIHA creates – focused on peerto-peer 

exchanges of knowledge, information and 

hands-on practical skills. One thing that became 

apparent early on was that the American and Russian 

healthcare providers shared the common goal of 

providing the best possible care for their patients. 

Family practitioner Steve Rith-Najarian 

says he learned as much from his Russian 

partners as they have learned from him. 

“Our partners are eager to embrace the public 

health model and adopt the principles of continuous 

quality improvement to make positive changes 

within their own community’s health systems,” 

Steve says, noting that it is an inspiration to work 

together with his Russian counterparts to develop 

and implement exciting new programs and services. 

“It’s important to point out that I’ve learned as 

much or more through my affiliation with these 

partnerships as I’ve shared, and this makes my 

job at home a lot easier,” he continues. “At the 

end of each exchange, I feel a sense of professional 

growth and personal enrichment that 

make the commitment of time and energy well 

worth the effort.” 

Photo: Courtesy of Steve Rith-Najarian 

For Steve and the other US healthcare 

providers and allied professionals 

involved with the partnerships, 

their work not only broadens their 

horizons by introducing them to 

other people, cultures and different 

ways of doing things, it also 

strengthens their sense of community 

at home. “We’ve all learned 

many valuable lessons from our 

partnership experience, not the least 

of which is to be more open and 

flexible. Our shared experience has 

opened the door to collaboration 

among people and organizations 

here that previously had no connection 

just as it has enhanced existing 

relationships,” he says. 

On an international level, the partnerships 

go a long way toward improving understanding 

and goodwill on both sides, he explains, 

concluding, “America has historically had a tendency 

to be relatively ethnocentric, which can create 

wide cultural barriers. Partnerships break 

down these barriers allowing us to get past our 

real or perceived differences and make lasting 

connections based on our commonalities and 

shared goals of making real improvements in 

patient care.” 


FUNDERS AND 

STRATEGIC PARTNERS 

Funders 

United States Agency for International Development (USAID) 

US Department of Health and Human Services/Health Resources and 

Services Administration (HHS/HRSA) 

US Library of Congress/Open World Learning Center 

Susan G. Komen Breast Cancer Foundation 

World Health Organization (WHO) 

The Global Fund to Fight AIDS, Tuberculosis and Malaria 

Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) 

Strategic Partners 

Abt Associates 

AIDS Foundation East-West (AFEW) 

AIDS Healthcare Foundation - Global Immunity (AHF-GI) 

American College of Radiology 

American Nurses Association (ANA) 

Association for Professionals in Infection Control and Epidemiology 

Association of Academic Health Centers (AHC) 

Association of American Medical Colleges (AAMC) 

Association of Nurses in AIDS Care (ANAC) 


Association of University Programs in Health 

Administration (AUPHA) 

Beth Israel Deaconess Medical Center/Division of 

International Disaster and Emergency Medicine 

Carelift International 

Columbia University School of Social Work 

Connect plus e.V. - Competence Transfer for 

AIDS Prevention and Self-help 

Deutsche Gesellschaft für Technische Zusammenarbeit 

(GTZ) 

Development Gateway 

François-Xavier Bagnoud (FXB) Center at the University 

of Medicine and Dentistry of New Jersey 

Futures Group 

International Association of Physicians in AIDS 

Care (IAPAC) 

International Training and Education Center on 

HIV (I-TECH) 

Liaison Committee on Medical Education (LCME) 

March of Dimes 

Médecins sans Frontières (Holland)/Ukraine 

Medical Advocates for Social Justice (MASJ) 

Medical Center of St. Petersburg 

New York State Department of Health/AIDS 

Institute 

Open Society Institute (OSI) - International 

Palliative Care Initiative 

Sisters Together and Reaching (STAR), 

Baltimore, MD 

Southern Ukraine AIDS Education Center 

(SUAEC) 

UNAIDS 

UNICEF 

University of Nebraska Medical Center 

School of Nursing 

University Research Corp. (URC) 

US Centers for Disease Control and Prevention 

(CDC) 

Volunteer Services Overseas (VSO) 


BOARD OF DIRECTORS 

AND STAFF 

Board of Directors 

Donald W. Fisher, PhD (Chairman) 

President and Chief Executive Officer 

American Medical Group Association 

Roger J. Bulger, MD (Secretary) 

President 

Association of Academic Health Centers 

Sheila A. Ryan, PhD, RN, FAAN (Treasurer) 

Professor; Charlotte Peck Lienemann and Alumni Distinguished Chair 

Director, International Nursing Education Programs 

University of Nebraska Medical Center 

College of Nursing 

Dennis P. Andrulis, PhD, MPH 

Associate Dean for Research and Director 

Center for Health Equality 

Drexel University School of Public Health 

Daniel P. Bourque, MBA (past Chairman of the Board) 

Group Senior Vice President, System Operations 

VHA Inc. 

Henry A. Fernandez, Esq 

Attorney at Law 

Larry S. Gage, Esq (past Chairman of the Board) 

President 

National Association of Public Hospitals and Health Systems 

Partner, Powell Goldstein, LLP 

Louis W. Sullivan, MD 

President Emeritus 

Morehouse School of Medicine 

Alan Weinstein, MBA 

Healthcare Consultant 


AIHA Staff 

Headquarters 

Washington, DC 

James P. Smith 

Barbara Brocker 

Donna Anderson 

Sara Barnes 

Timur Bazikov 

Alesha Breedlove 

Jason Brown 

Matthew Burton 

John Capati 

Irina Carnevale 

Eun-Joo Chang 

Evangeline Crawford 

Richard Custer 

Keisha Dennis 

Laura Faulconer 

Emily Fedullo 

Chase Gray 

Frances Greene 

Cheryl Halcrow 

Teresita Herradura 

Irina Ibraghimova 

Zandra Isaac 

Inna Jurkevich 

Irina Kapitonova 

Emily Korff 

Maureen Lomo 

Susan Luck 

Muna Massaquoi 

Sinem Mustafa 

Hau Nguyen 

Margo Nowakowski 

Keith Pearson 

Ntfombi Penner 

Susan Pobywajlo 

Melissa Rawlings 

Anjuli Saharia 

Amy Sanborn 

Kate Schecter 

Natasha Schweiger 

Zoya Shabarova 

Executive Director 

Associate Executive 

Director/CFO 

Victor Stanilevskiy 

Delia Stirling 

Mark Storey 

Ramesh Suri (Omega World Travel) 

Kathryn Utan 

Ngoc Vu 

James Willis 

Gosia Wolfe 

Sara Wright 

Jack Yau 

Carole Zimmerman 

Field Offices 

Caucasus 

Nata Avaliani Regional Director 

Marika Abesadze 

Gia Chigoyev 

Anatoly Daniyarov 

Julietta Eminova 

Elena Godziashvili 

Lela Kvachantiradze 

Aleko Makharashvili 

Jeyhoun Mamedov 

Lali Mchedlishvili 

Mehdi Mehdiyev 

Nika Menteshashvili 

Zaza Varsimashvili 

Central Asia 

Zhamilya Nugmanova 

Gulnar Akhmetova 

Bauyrzhan Amirov 

Maya Annaberdiyeva 

Kairat Davletov 

Kair Doldin 

Pavel Gulyaev 

Assel Terlikbayeva 

Viktoria Volgina 

Saltanat Yageubaeva 

Zhaniya Zhaikbaeva 

Regional Director 


Central and Eastern Europe 

Violeta Shala 

Dusko Jagodic 

Moldova 

Viorel Soltan Project Director 

Valeriu Crudu 

Tatiana Dumbrava 

Sergiu Gherman 

Andrei Pruteanu 

Slava Rodideal 

Irina Zatusevski 

Russia 

Arsen Kubataev Regional Director 

Marina Ayvazyan 

Stela Bivol 

Leonid Baichitsman 

Ludmila Bogdanova 

Ekaterina Dyakonova 

Nancy Frazier 

Yuri Gavryushin 

Sergie Lavrushin 

Ksenia Nykolaeva 

Oksana Pinchuk 

Elena Pokrovskaya 

Sergie Popovski 

Polina Safronova 

Irina Shumilova 

Ukraine 

Maria Bodnar 

Olena Dolotova 

Vira Illiash 

Olga Kostyuk 

Grigoriy Naumovets 

Natalia Nizova 

Andriy Styopkin 

Svetlana Sviridenko 

Grigoriy Tyapkin 

Photo: Frances Greene 

Washington, DC Staff

Annual Program Report 2004 - American International Health Alliance

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