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IAAMRH Journal     Vol23  No.1      2004


TASKS AND ACTIVITIES OF THE (HUNGARIAN) NATIONAL INSTITUTE OF PRIMARY HEALTH CARE (NIPHC)

Ferenc Hajnal, Sándor Balogh*, Renáta Papp*, Gyula Füredi*
University of Szeged, Department of Family Medicine, NIPHC*

By law Hungary, i.e. the Republic of Hungary is an independent, democratic constitutional state with 4-yearly elected one-chambered parliament. The country is administered as 19 counties and the capital Budapest. The president of the Republic is elected by the Parliament. In fact, the country is governed by the government in which the health affairs are represented mostly by the Health Ministry, which is currently in charge with the social affairs, as well. In Hungary the health care is dominantly delivered as public service and practically the whole population is covered. The socalled Local Government Act, adopted in 1990, shifted the previous state ownership of the health care infrasructure, together with the responsibility to the local and municipal governments, for the management of health and social services. The frontline of the Hungarian health provision is the primary health care which has been developed during the whole twentieth century and now it is a widespread network of different services. So, it induced a nationwide welcome by the concerned professionals when the health government established, in 1998, the National Institute of Primary Health Care (NIPHC). This institute serves as baseline institution for the management, and scientific research in the field of primary health care, which are represented, among others, by the services in Hungary, as follows:
  • family physicians,
  • general pediatricians,
  • workers and offices of the school
  • and juvenile care,
  • (preventive) nurses of mother and child care, and
  • (nursing) home care.

The National Institute of Primary Health Care

Introduction

According to its Mission Statement the main objectives of the NIPHC, as follows:
  • provide professional knowledge and the necessary information for the daily practice of those employed in the services,
  • monitor the activities in the primary health care,
  • seeks for and update indicators for quality control, and
  • continously explore the needs and directions for professional development, and finally
  • help health policy makers in preparive work in decision-making. As far as the coordination of the fields of everyday primary care work is concerned, the main intentions of NIPHC are, as follows:
  • Take part in improving the general health condition of the population,
  • reduce the prevalence of diseases, and mortality rates,
  • improve poor life expectancy,
  • seek ways to optimize the functioning of the primary care service inside health care,
  • pay relentless attention to the ideal scope and integration in prevention, daily care, as well as rehabilitation in primary health setting.
Moreover, the NIPHC takes part to apply and support health law drafting by the next activities:
  • Assists applying directives and orders concerning primary care, issued by the competent ministry(s), so
  • closely cooperates with the National Institute of Public Health and Medical Officers (the Hungarian health authority) and
  • also with family physicians' peer-reviewers, by which keeps in touch with each primary care unit.

The NIPHC regional centres and the National Board of General Practice

Freshman doctors, including their education, have crucial part as far as the reinforcement and human resource supply for the primary care. The Hungarian medical faculties have crucial part either the graduate or postgraduate education of any medicals. In addition, the medical faculties with their family medicine departments are regional centres of either the education or health provision, mostly in secondary and tertiary care.

So, it is vital for the main leading stakeholders of the Hungarian primary health care, i.e. the NIPHC and the National Board of General Practice (NBGP to have close relationship with the family medicine departments at the medical faculties. So, the regional centers are organized practically around the family medicine departments

Therefore, the abovementioned third executive partner in the Hungarian primary health care is NBGP which is a body with 23, mostly elected, members from the general medical practice and appears as supreme professional partner and council for the Health Ministry in professional issues.

Public relations of the NIPHC

The management of the health care workers and units could not work without a constant and live information current. So, the NIPHC makes nonstop efforts in order to keep the necessary facilities and information channels in hands. It publishes updated information on actual issues of (general) medicine by:
  • Timely bulletins,
  • Monthly periodical ("Medicus Universalis"),
  • Notifying letters,
  • Web home page: www.OALI.hu.

The NIPHC's communication strategy includes: - Continuous development and aintenance of website/homepage,
  • Intranet network for collegiate GP supervisors (review peers),
  • Relentless PR activity for health consciousness of people with special sight to public health program(s). All these organs and information chanels are able, among other, to offer opportunities to implement the most advanced international guidelines and protocols in the primary care practices.

"The NIPHC umbrella" and the international affairs

Upon its mission, authorization, infrastructure and other resources NIPHC makes efforts too, to initiate and support the partnership between the Hungarian general practice corporates, as follows:
  • Scientific Association. of the Hungarian General Practitioners (founded in1967),
  • Association of the Researcher General Practitioners,
  • Association of General (district) Pediatricians,
  • General Practice Section of the Hungarian Medical Chamber,
  • Federation of General Practitioners in Free Practice,
  • Association of the Rural General Practitioners,
  • Scientific Association of the Rural General Practitioners,
  • Regional (county, city) General Practitioner Societies.

NIPHC employs its resources to build up and maintain friendly and operative liasons with foreign partner organisations and outstanding persons of education, professional policy making and practice concerning primary health care with special regard to the changes and challenges of the upcoming European integration. Moreover, the NIPHC makes constant efforts to develop regional partnership with the neighbouring Central and Eastern European organisations of the GPs.

Current activities of the NIPHC

The Institute continously organizes, coordinate and supports several events concerning its mission and the needs of primary health care workers, as follows:
  • Scientific conferences (either special or interdiscipliner),
  • Workshops and assembles for primary care workers and their partner with special interest, etc.
  • NIPHC also takes care of several project from the field of the primary care, as follows:
  • Special training for workers of peer review, upon the suggestion from the European Union of Specialists (UEMS),
  • Peer review manual, as part of this widespread enterprise,
  • Publications in special topics and issues concerning general practice and primary care,
  • Preparation of intercommunicative system of informatics,
  • Assesssment and promotion of the health of the primary care workers,
  • Research projects, concerning mostly the general practice competence,
  • Special projects of the current National Public Health Program.
  • CME courses and events, as follows (in Hungary CME is obligatory with a minimum requirement of 50 credit hours per years):
  • Independent and coordinated regional (family medicine chairs) organisation of interdisciplinary and special GP programs in the framework of obligatory CME.
  • Topics focused on the current public health project:
  • Screeening for cardiovascular risk,
  • tumours to be detected in early stage,
  • solutions for risky lifestyle like smoking and chemical abuse.
  • "friendly to the hearth" road show for primary care workers and activists,
  • Skill training for substance abuse and mental health.

As far as the assassment and promotion of the health of primary care workers project is concerned, this contains several subprojects, as follows:
  1. "lifestyle camps" mostly for paramedical workers in which the main subjects are the healthy food promotion, and the advicing for body exercise,
  2. Periodic offers for workers to
    • participate special health checkups organized by internal providers,
    • Skill trainings to raise responsibilty and sensitivity of own health, - Trainings as to how organize events to raise the health culture and knowledge among inhabitants, - Participate in training of gipsy helpers to improved poor health and social conditions of the deprived population.

Current research projects of the NIPHC
  • Studies on, and tools for fight, smoking habits,
  • Innovation in primary and secondary cardiovascular prevention in general practice,
  • comparative studies for morbidity, mortality and lifestyle in different regions and settlements,
  • Oncology eagerness and
  • Methods for quality assurance in the primary care.

In summary, the NIPHC is a government organisation which has nationwide network based on regional centers of health provision and education, closely works together with the health authority, and makes infrastructure for the General Practice Board. It also makes a resource centre for the different primary health workers, assists the work of the regional academic institutions, and undertakes part in several "vital" public health programs.

In our days its role in Hungary is indispensable, among the continuing health care and academic reforms, public health projects and in the process of joining the new, healthier united Europe, European health provision and care.

Hajnal Ferenc
E-mail: hajnalf@model.szote.u-szeged.hu

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