Background

The Healthcare Strategy approved by the Municipal Council of Stara Zagora on 15 July 1998 aims to meet the forthcoming changes and to outline the future of healthcare in the municipality. The strategy is focused on the issues and problems of critical significance. The main aim is to create conditions and prerequisites for improving health and increasing the life of population in the municipality. The main priorities are:
1. Improving public health;
2. Optimizing the structure and funding of the healthcare insititutions;
3. Increasing the qualifications of the medical personnel;
4. Gradual attainment of higher social status of the medical society.

Practice

The accomplishments to present comply with several main objectives:

1. Improving public health

A working group is set up to develop a Municipal Plan on Health and Environment. In cooperation with the police, NGOs and the municipal healthcare administration a program focused on reducing traffic traumas for children is started. A number of materials entitled Risk Free Holiday are produced. Improving the kinetic status of children is among the priority tasks of the healthcare administration, as well as the enhancement of the medical control over children involved in sports with the aim of decreasing traumas.

As a result of the cooperative work of teachers, police and NGOs a series of seminars are conducted with students, entitled Fight with Toxicomanias . The Municipality is included in the national network Schools Promoting Health : five educational institutions are doing prevention work jointly with the children s medical rehabilitation center in the Stara Zagora spa resort to protect and improve children s health.

Improving the hygiene of the settlements is closely related with solving the landfill issues. An incinerator is constructed in the yard of the medical complex, serving all medical insitutions. Jointly with the Hygiene and Epidemiology Institute an Occupational Medicine project is implemented, supported by the PHARE Program, which will lead to improving the working conditions and protecting employees from occupational diseases.

The municipal healthcare administration together with pre-hospital treatment practitioners and the Hygiene and Epidemiology Insititute implement the CINDY Program of the European Community for the asserting a healthy life style. Together with Roma NGOs, the Family Planning Center and HEI, the Strengthening of Women s Sexual and Reproductive Health program is developed. Together with Open Society Foundation and ADAPTA 21, activities are conducted for supporting families with children with deviant behaviour.

2. Optimising the structure and financing of health insitutions

The Municipality places a strong emphasis on pre-hospital treatment in the municipal healthcare structure. Two polyclinics are transferred into independent medical centers. The decentralization of dental surgeries at stomatological polyclinics with the aim of bringing dental services closer to the citizens has begun. In April 1999 a new healthcare service is opened in the village of Dalboki. People suffering form heart and vessel diseases do not pay for their treatment. A project was developed for the primary healthcare in the municipality, with which the healthcare administration applied before the World Bank for funding of medical practices.

3. Enhancing doctors and nurses qualification

The Municipality cooperates with the Medical Faculty of the Technical University in Stara Zagora for the start of post-graduate courses in General Medicine. On the initiative of the Stara Zagora Municipality a meeting was organised with municipal healthcare administrations of other eight big cities to familiarise them with the process of applying for a general medical course. In 1998 a training center in the field of Information, Economics and Management in Healthcare is set up and conditions are created for training managers in healthcare with a view of implementing an efficient and cost effective management.

Results

Continuous education of medical staff through collegiums, seminars, and courses leading to an increased motivation of doctors in rural regions to take active part in the healthcare reform.

All municipal health institutions create conditions and fund training of medical personnel in general medicine.

Opening of a Health Information Center in the Municipality lobby.

Creating a Chemical Therapy Day Stationary to the Oncological Center in Stara Zagora.