Contact

SCIH

Project Leader
Manfred Zahorka

Project Associate

Joëlle Schwarz

 

CRED Foundation

Project Support Office

Bucharest, RO

www.cred.ro

Project coordinator

Nicu Fota

 

Country Map

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Capitalisation

Key interventions, documentation and lessons learned from RoNeonat, 2002-2007

Romania

Swiss Neonatology Project (RoNeonat)

Project Description

 

RoNeonat is a Neonatology/Perinatology project of the Romanian Ministry of Public Health spanning the years 2002-2007 and funded by the Swiss Agency for Development and Cooperation (SDC) . SDC mandated the Swiss TPH with its Centre for International Health (SCIH) to support project implementation through technical assistance and to manage the Swiss contribution. Phase I did the preparatory work in terms of assessment (training needs, equipment, etc.) and establishing a medico-legal framework (new life birth definition based on WHO criteria, regionalisation of neonatal services, others) for the project. During phase II major investment in medical equipment and infrastructure rehabilitation (Romanian contribution) were done together with capacity building and technical assistance in the medical, managerial and communication field. Phase III started in October 2005 to consolidate previous experiences and to support national roll-out in collaboration with the World Bank funded National Health Sector Reform Program (HSRP). 

 

CRED Foundation

 

With the SDC mandate for the implementation of RoNeonat, the Swiss TPH founded a Romanian NGO as a legal entity for the provision of continuous managerial and project implementation services to its Romanian partners. The CRED Foundation -“Centre for Health Sector Development” - is based in Bucharest and coordinates the local implementation and technical assistance provided. It can rely on in house experience in public health, project planning and management, health economy and financing, procurement, hospital management including health technology management and Quality management. Additionally it has access to a variety of networks on national (professional associations, experts) and international levels (amongst others through SCIH networks). CRED is an active member of the Guideline International Network – GIN and works towards its ISO certification as an institution providing high quality expertise.   

Location

Phase I and II

 

Following the preparatory work of phase I, phase II provided technical assistance in the area of Neonatology, Perinatology, quality of care and health communication strategies at the national level. Additionally it created implementation models in two health regions namely Iaisi and Targu Mures, where it created the necessary infrastructure (infrastructure rehabilitation through the Romanian and medical equipment through the Swiss contribution), provided capacity building and management support and contributed to health sector reform measures to improve the quality of services. Additionally, it started a communications strategy to improve professional communication as well as to inform clients about available services and their access.

 

Phase III


The last phase supported the national HSRP for the national roll-out of the experiences gathered through the RoNeonat project. For that purpose, the project supported the creation of 7 “Centres of Excellence” in neonatology with training centres for nationwide capacity building in Sibiu, Timisoara, Cluj, Bucharest (Polizu and Giulesti) Iasi and Târgu Mures. Most project content had been tested in one or more of the seven centres and are then been promoted for nationwide use (e.g. Clinical Practice Guidelines -CPGs, Quality Management, Follow-up services for premature newborns and others).

Background and Approach

Although significant improvements in Romanian health indicators were made since the 1990s, neonatal, post-neonatal and infant mortality rates remain high in regional comparison and continue to give rise to concern.

RoNeonat addressed its objective to “Modernise the Romanian Neonatology System” at various levels including

  • infrastructure rehabilitation and adaptation to modern standards;
  • quality improvement of the care provided through capacity building, Clinical Practice Guidelines, the introduction of complementary services (neonatal transport, post NICU follow-up of premature newborns), the improvement of professional communication and continuous medical education through Information and Communication Technology (ICT) and knowledge management;
  • improvement of access to high quality service through health promotion, referral and transport systems;
  • client orientation and improvement of institutional quality through Quality Management Systems, financial management mechanisms, the analysis and review of interface problems through interdisciplinary collaboration across all levels of care;
  • the generation of “Centres of Excellence” as crystallisation points for the dissemination of modern and high quality approaches.

 

For a description of the above components of RoNeonat and the comprehensive approach chosen to meet the objectives, click here.

Partners and Collaborators

  • Ministry of Public Health Romania
  • Institute of Mother and Child Health, Romania
  • National Health Insurance House, Romania
  • Romanian College of Physicians
  • Romanian Professional Associations of Obstetrics and Neonatology
  • World Health Organisation – Cooperation Office, Romania
  • United Nations Population Fund (UNFPA), Romania
  • World Bank Romania
  • Swiss Hospitals (University hospitals in Basel, Geneva, Bern, Lausanne and Zurich as well as the cantonal hospitals in Luzern, Aarau and Schwyz
  • Medical Service of the health insurers (MDK) in Alzey/Germany for Quality Management in Health
  • Verein Outcome Zurich for Quality Management in Health

Funding Agencies

Swiss Agency for Development and Cooperation (SDC)

Objectives

RoNeonat aims to reduce the neonatal mortality in Romania through the modernisation of the neonatology system. 

Outputs

  • Training of Romanian medical staff both nationally and internationally in the fields of neonatology, obstetrics and gynaecology
  • Improvement of health technology management at facility level
  • Development and promotion of clinical practice guidelines in neonatology and obstetrics. CRED is now a member of the Guidelines International Network
  • Improvements to the referral system for newborns and enhancement of collaboration and communication between different levels of care
  • Technical backstopping to implement a system for the follow-up of newborns undergoing intensive care
  • Greater public awareness on issues of safe motherhood and care for the newborn and promoting the new services through media campaigns
  • Support for the Romanian Health Sector Reform Programme

Timeframe

Phase I        Sep 2002 – Jan 2002
Phase II       Feb 2003 – Sep 2005

Phase III      Oct 2005 – Dec 2007

Financial Volume

 € 5'700'000 / CHF 9'000'000

Current status

RoNeonat will conclude at the end of 2007.

 

A CD-Rom with the key interventions, documentation and lessons learned from RoNeonat has been produced end of 2007, and its content is also available on our server at www.swisstph.ch/scih-cd/roneonat

 

CRED - Centre for Health Sector Development - is a fully fledged Romanian NGO providing expertise in the following areas:

  • Project Management
  • Quality Improvement in Health Care
  • Health Technology Management
  • Monitoring and Evaluating Services
  • Professional Networking and Training
  • Capacity Building in Health

 

Website: www.cred.ro