Armenia : Healthcare Quality Improvement Program

Health / Health sector development and reform

The program aims to improve the quality of health care as stipulated in the Government Program, 2021-2026, Health Sector Strategy 2023-2026, the UHI Concept Paper, and the Quality of Care Strategy 2022-2026.

The proposed RBL program is aligned with the following impact: personal and public health improved. The outcome of the RBL program will be quality of health care improved, measured by (i) amenable deaths for chronic conditions reduced; (ii) in-hospital mortality for acute myocardial infarction reduced; and (iii) hospitalization rate for ambulatory care sensitive conditions reduced. The program will have the following outputs: (i) infrastructure and equipment to provide quality health services improved; (ii) capacity and organization for quality of care strengthened; and (iii) quality improvement interventions and monitoring institutionalized.

Disbursement-linked indicators (DLIs) may include (i) amenable deaths for chronic conditions reduced; (ii) in-hospital mortality for acute myocardial infarction reduced; (iii) health facilities upgraded or constructed and equipped with consideration of climate-resilience and gender responsiveness; (iv) institutional structure and leadership, including for female leaders, for quality of care strengthened; (v) availability of qualified health workers improved; (vi) gender- and climate-responsive quality of care standards and improvement tools piloted in selected number of marzes (regional administrative entities) and approved for nationwide scale-up; and (vii) health facilities reporting quality indicator data on time.

With the roll-out of universal health insurance in Armenia, the demand and utilization of health services are expected to increase due to enhanced affordability of services. Along with enhancing affordability of health services for the population, the improvement of health care quality is high on the government's reform agenda. The provision of comprehensive health care coverage will require simultaneous improvements in quality of care to lead to improved health outcomes. Improving the quality of care will need support across structural elements of quality (infrastructure, equipment, and human resources) to improve service availability, enhance the quality of care processes and monitoring to measure performance and outcomes. The key to sustaining quality improvement interventions is to ensure sufficient institutionalization, budget, measurement, and accountability. The proposed results-based lending (RBL) will support quality of care implementation as part of the reform agenda.

The RBL program is aligned with Asian Development Bank (ADB)'s Strategy 2030 operational priority (OP) 1 (addressing remaining poverty and reducing inequalities), OP2 (by improving gender-responsiveness of health services), OP3 (by promoting climate change adaptation and mitigation measures), and OP6 (by strengthening governance and institutional capacity in the health sector); and ADB's Strategy 2030 Health Sector Directional Guide.

Personal and public health improved

Quality of care improved

Infrastructure and equipment to provide quality health services improved

Capacity and organization for quality of care strengthened

Quality improvement interventions and monitoring institutionalized