TY - JOUR T1 - International primary care snapshots: Armenia and South Africa JF - British Journal of General Practice JO - Br J Gen Pract SP - 308 LP - 309 DO - 10.3399/bjgp15X685381 VL - 65 IS - 635 AU - Marina Ohanyan AU - Armine Danielyan AU - Kevork Hopayian AU - Bob Mash Y1 - 2015/06/01 UR - http://bjgp.org/content/65/635/308.abstract N2 - Primary health care (PHC) has come a long way since Armenia gained independence in 1991. The former Soviet health service had to face the problems of transition to a market economy. A reform programme was launched in 1997 to move from the polyclinic system to family medicine (FM) with the programme aiming to create a strong and skilled PHC sector and a Basic Benefits Package for all citizens.Family medicine academic capacities were created in Yerevan State Medical University and the National Institute of Health. From 2000–2010 around 1500 polyclinic PHC doctors were retrained through 1-year conversion courses to become family physicians (FPs) in a race to build the workforce. The curriculum and training modules were created through the support of international experts and training courses in Western university clinics. Novel clinical teaching methods were introduced and clinical preceptors were trained countrywide to be involved in the retraining process, creating a cohort of modern-thinking professionals.The shift to FM has been uneven. In the cities, the old polyclinic system persists, perhaps because of the abundance and power of specialists and administrative staff. As in Soviet times, PHC in urban polyclinics is provided by therapeutists for adults and paediatricians for children working alongside specialists such as general surgeons, gynaecologists, and ENT specialists. The scope of the PHC practitioners work however, is severely constrained by the polyclinic specialists.In the villages progress towards FM has been more successful. FPs work in new-style ambulatories alongside specially-trained PHC nurses and midwives, providing comprehensive primary care to the population. Most FPs work in state-provided centres. Income consists of a basic allowance (scaled according to experience and qualifications), capitation and various bonuses such as hitting targets. Capitation is designed to encourage medium-sized lists typically between 1500–2000. Pay is low, about £200 per month. A British GP … ER -