Primary Healthcare Reform Initiative

Recent reports from the WHO and World Bank have reaffirmed the importance of primary care as the most cost-effective method to advance population health in low- and middle-income countries. Also, reports on the state of Armenian healthcare by the WHO, the Primary Healthcare Practice Initiative (PHCPI), and the World Bank note the lack of a functioning primary care system in Armenia and recommend its rehabilitation. Like many former Soviet Union countries and countries with similarly centralized governments, investments in healthcare in Armenia were targeted at hospitals and specialists, and primary care was neglected.

The Armenian Ministry of Health (MoH) developed a Primary Healthcare Reform (PHCR) Taskforce in 2021 to analyze the primary care system in Armenia and how to enact fundamental change. The Chobanian & Avedisian School of Medicine is uniquely positioned to help with this initiative, since the Department of Family Medicine Global Health Collaborative (DFM GHC) has enacted fundamental primary care reform in southeast Asia, most notably in Vietnam, but also in Cambodia, Laos and Myanmar. The DFM GHC has also helped established a functional medical system in Lesotho in Africa.

The BU-AMP is currently coordinating with the Armenian MoH, the Health Network for Armenia (HENAR), DFM GHC, and other institutions in Armenia to identify initiatives that will guide the development of a fully functional primary care system in Armenia over the next 10-15 years.

Man in suitjacket standing at podium at front of room beside powerpoint slides — Jeff Markuns (Director, department of Family Medicine Global Health Collaborative), speaking at the HFA launch

In the spring of 2024, the BU-AMP, in partnership with the HENAR Foundation, the Health for Armenia Foundation, the Armenian Ministry of Health (MoH), Yerevan State Medical University (YSMU) and the Armenian National Institute of Health (ANIH)—helped launch a rural family medicine fellowship titled the Healthcare Leadership Program (HLP). The program was started with a twofold purpose: to improve healthcare access and quality in Armenia’s underserved rural communities, and to create a strong movement of medical professionals who will continue to reform the Armenian healthcare system in the future.

Group of people participating in a workshop in a modern room with big glass windows and large whiteboard and orange sofas — Henry Louis (HFA program director) and Aram Kaligian (director, BU-AMP) leading a HFA Healthcare Academy workshop

In March 2024, nine core faculty members were recruited from the outskirts of Armenia and began a Training-of-Faculty program to prepare them for the incoming HLP fellows. In June, eight recently-graduated Family Medicine physicians began the two-year HLP training program, beginning with a six-week intensive Healthcare Training Academy, followed by weekly lectures and workshops. Then, in October 2024, the HLP fellows began their biweekly clinical rotations at these select faculty practices to improve their clinical skills with hands-on patient care. A second cohort of HLP fellows has already been recruited and began the program in the fall of 2025.

Progress is also underway to lay the groundwork to reform the two Family Medicine residency programs in Armenia to be much more clinically- and competency-based. The BU-AMP is collaborating with HENAR, which already has experience on the ground in Armenia when, in partnership with Children’s Hospital of Los Angeles, they developed a new, three-year Pediatric residency program in 2023.