PM Pashinyan Inquires About Changes in State Order System

Prime Minister Nikol Pashinyan visited the Ministry of Health to discuss the 2023 activity report of the agency. Reports were presented by Health Minister Anahit Avanesyan and deputy ministers.

First, the work carried out in the healthcare sector was presented. This year, the implementation of systemically significant programs in the healthcare sector has continued. A draft law for the introduction of one of the key reforms, the comprehensive health insurance system, has been developed. Expert groups have been formed, and a price survey has been conducted, based on which the main service package and cost calculations have been formulated. The ultimate goal of the reform is to improve access to essential medical services, enhance the level of financial protection, and reduce the burden of mortality and morbidity. The project has been submitted to the government of Armenia after revisions.

Prime Minister Pashinyan expressed interest in what changes have been made in the state order system. “Previously, we had the practice that the ministry distributed funds, effectively at its discretion. Is this practice now completely out, meaning are the funds allocated based on a logical offer and following the patient?” Pashinyan inquired. In response, Anahit Avanesyan confirmed this and added that now the funds follow the patient.

In response, the Prime Minister noted: “We are saying that a. there should be no ministerial orders regarding limits and b. there should be healthcare centers that do not have state orders. In other words, the practice of linking state orders to healthcare centers is being eliminated. Anyone who wants to provide services can do so. In this context, I have instructed the minister to ensure the mobility of waiting lists. A person is a beneficiary, their status as a beneficiary is recorded, and they see that a particular medical center can provide their service, for example, within 15 days, and they agree. In the next stage, they see that there is a healthcare institution that can provide the same service within a week. The person should have the freedom to move from that list to there, and automatically be removed from the other list. This means we are following the person, not the healthcare institution, to make this mobility more effective. I believe this will serve as an additional incentive to improve the quality of service delivery for healthcare centers.”

To develop human resources in the healthcare sector, a licensing system for doctors has been introduced. An independent ethics committee composed of experts has been established to examine violations of ethical standards by healthcare workers in medical centers.

A registry of healthcare professionals has been created, aimed at having a comprehensive database of healthcare professionals operating in Armenia. A rapid response medical team has been established that will provide medical assistance both within our country and while conducting international humanitarian missions outside Armenia.

In the first nine months of 2023, a free treatment program for patients with viral Hepatitis C has served 826 patients, of whom 649 have received treatment, while the others are undergoing treatment. In 2024, it is planned to include 1,440 patients in the program.

This year, measures to improve reproductive, maternal, and child health have been implemented. A pilot program for prenatal screening has been introduced in the Gyumri Medical Center for all pregnant women in the region, which will improve the situation of prenatal diagnostics. The “Saint Gregory the Illuminator” Medical Center has established the future “Center for Fetal Medicine,” and construction work for an in vitro fertilization center has begun. A newborn screening program for adrenal genital syndrome has been developed, which will be introduced in early 2024 in Yerevan and subsequently cover all regions. Through screening, newborns with congenital adrenal hyperplasia will be identified, significantly reducing neonatal mortality due to early detection of severe forms before adrenal crisis develops.

In 2023, the maternal mortality rate has halved, as has the stillbirth rate, which, since 2020, had stabilized at around 16-19 per mille (600-850 cases) and now does not exceed 11.2. As of November 30, 2023, the number of births has increased compared to the same period last year (32,926, an increase of 336). Overcoming infertility remains one of the country's key objectives and is simultaneously one of the programs with exceedingly high demand among the population. Considering all this, due to a significant increase in funding allocated to the program since January 2023, the groups of beneficiaries have been unprecedentedly expanded. Since the start of the program until November 30, 368 children have been born, among whom 54 are from families of fallen servicemen. The listed measures aim at achieving the targets set by the sectoral strategies.

Addressing the issue of reproductive health, Nikol Pashinyan mentioned, “Are we in agreement with our age policy that we are pursuing the right policy because there are numerous cases, especially I receive letters and applications? The issues regarding age restrictions are particularly acute in families of fallen servicemen. Are we in agreement that our policies are precise?” Health Minister Anahit Avanesyan noted that the relevant legislative initiative has already been sent to the National Assembly. “We are changing two thresholds—raising the age for assisted reproductive technology from 53 to 55 for the ECO and from 35 to 38 for surrogate mothers,” the minister said.