CHRONEX-RD has the purpose to improve economic performance of the border area between Romania, Moldova and Ukraine in a sustainable manner. CHRONEX-RD will contribute to the diversification of the panel of activities in the field of public health by stimulating the transnational cooperation between key entities focused on research and development, academic institutions with expertise in education and health care practice. This will positively impact other economic sectors (labour market, pharmaceutical industry, services, etc.). Furthermore, the implementation of this project is ideally framed to improve the competitiveness of the above-mentioned sectors and, thus the competitiveness of the regional economy. In this way, this project promotes the inactivity and creativity of Research and Development in health care and public health to make the transnational area more attractive for foreign direct investments in pharmaceutical and health technology industries.
The accomplishment of the general and specific objectives of this project will generate cross-border social and economic development. CHRONEX-RD will improve health services through utilisation of the research outcomes, development of a research network connected to the education and health systems in the 3 countries and process engagement of health technologies’ and pharmaceutical industries. CHRONEX-RD will synergistically interconnect the regional infrastructure resources for research and chronic health care by linking disparate entities into a cross-border multidisciplinary network embedded into the community. Therefore, CHRONEX-RD will equally engage individuals from the active workforce and those entering the labour market. New jobs will be created directly by the projected activities and indirectly by developing a professional training core in the network. Thus, the job market will be expanded by attracting upstream and downstream funding from the private sector, in areas related to the scope of the project, as well as public funding in the form of grants, stemming from the expertise accumulated through research activities. The pharmaceutical industry and private foreign companies will benefit from a wider and consolidated base of recruitment for clinical studies, solid scientific output rapidly amenable to application into practice, while the research institutions will gain broader access and increase their capacity to attract research funding.
Sectorial impact of CHRONEX-RD in the cross-border area:
- Improvement of the quality of health services in the region and better access to advanced medical services through multidisciplinary integrated health care, and consolidation of the expertise in the biomedical field. This will lead to healthier individuals and thus increased workforce capacity. This will promote economic growth through retrieval of lost work capacity from chronic illness by rehabilitation of patients with chronic diseases or prevention of work capacity loss through medical interventions and prevention.
- Development of institutional management through capacity building will increase the capacity to attract extramural international funding by better expertise in accessing complex funding schemes. According to World Health Organization (WHO), the integration of the institutional capacities dealing with chronic diseases leads to lower health care costs.
- Improvement of the efficiency of research activities – a powerful base for research and education for the medical universities will provide better regional training opportunities for the young population.
- Synergistic research efforts using multidisciplinary approaches will lead to improved scientific productivity and yield marketable and competitive results.
- Increased regional economic competitiveness by implementation of performance-generating networks employing highly skilled workforce and giving rise to increased demand for related services.
- Positive externalities by creating a fertile environment for the development of pharmaceutical and health technology industries as well as for private medical services.
- Promotion of cultural diversity through cross-border educational and research exchanges could lead to dissemination of good medical practices and public attitudes towards chronic disease.
- Creation of a model of success for the development of other countries in the region (in the former soviet territories).
Emphasising public policies in cross-border area
In Romania, CHRONEX-RD This proposal supports the main priority of the National Development Plan 2007-2013 of increased economic competitiveness and development of the economy based on knowledge and health, as part of the larger human resources focus. The project
proposes to develop research infrastructure, which exactly follows the country’s targets to develop the knowledge society and to allocate up to 2% of GDP for research programs, as outlined in the National Research and Development Plan. At regional level, the Development Strategy of North-East Region focuses on the “development of research infrastructure, technology transfer and information society”. In addition, this project contributes to the “Adaptation of human resources to the labour market” as outlined in this strategy. Regarding health policies, this project aims to bring together regional capacities, which is in concordance with the decentralization policy of the health system as outlined in the Law 95/2006 Healthcare Reform: the entities with responsibilities in the field of public health can freely associate in order to improve the services offered to the population.
In the Republic of Moldova, CHRONEX-RD This project supports the priorities of the Code of Science and Innovation that stipulates in arts. 56 and 57 to promote social and
economic development through stimulation and valorisation of scientific potential”; “integration of research and innovation into economic and social development; consolidation of the interaction between science and education”; “adaptation of science and innovation to the needs of the society”; “promotion of partnerships between science, education, manufacture and finances”. This project target the same areas outlined in the National Health Policy of the Republic of Moldova focusing on the control of CDs via consolidation of health system capacities for early detection, appropriate treatment and monitoring. Improvement of the health system targets human resources management and utilization of post-graduate continuing medical education, just as this project proposes. CDs are strategic targets for an efficient health system as implementation of quality management systems in health care is tantamount for the accomplishment of this goal.
In Ukraine, This project aims to fulfil the needs for development of health care in Ukraine, which is in a process of reform of the Health system while ONMedU is a key stakeholder in this reform. The program “Health of Nation” of the Ministry of Health Care prioritizes reorganization of Primary Health Care and effective forecasting and planning of training of medical specialists. Our project proposal fits within the development strategies of Ukraine and ONMedU implemented by the Ukrainian government: The creation of the Primary Health Care centre: Economic Reform Program for 2010-2014, “Plan for the implementation of the reform of medical support”, “Experiment in the pilot regions”. The Basic Laws of Ukraine about public health to improve health care systems.
Impact of CHRONEX-RD on partner universities
CHRONEX-RD initiated by “Grigore T. Popa” University of Medicine and Pharmacy will be linked to the research infrastructure and programmes of this institution and together with the Biomedical Research Centre and the Ethics and Health Policy Centre will constitute a pole of competitiveness in health care and public policies, perfectly placed to bring economic and social benefits both to the North-East region of Romania and the cross-border region. Furthermore, the network of academic institutions with expertise in CDs’ research will provide a strong platform of interaction with the private health service providers as well as with pharmaceutical and health technologies businesses. Some of the largest drug manufactures in the region are located in Iasi and Odessa. Taking into consideration the capacity for multidisciplinary research and the quality of the human resources involved, as well as the optimal environment and the substantial infrastructure, this project has all the premises to reach and implement the highest standards of excellence in research in the region and to become a key player in international research.
Impact of CHRONEX-RD on target groups and final beneficiaries
The project will create significant opportunities for researchers and medical personnel in the cross-border region:
30 Researchers (10 for each region/city – Iași, Chișinău, Odessa) directly working on advanced
research projects coordinated by the Research biomedical core of CHRONEX-RD. The education component of the network will implement specific training programmes involving both lectures and hands-on training for advanced research and the management of research and development activities. Selection criteria: For all three countries local standards of excellence in research (scientific productivity, master degree as minimum requirements, commitment to research, etc. Each university will proceed its own selection.
60 family doctors (20 practices in each region) – will benefit from training in community research management and will constitute the primary and community medicine research core. Their practices will also benefit from the implementation of the quality management system for CDs care. In addition, 15 persons (out of these 60) – will be trained as trainers in research management, chronic disease management and quality assurance in practice and research in primary and community health care. Selection criteria: Outstanding in medical practice (clinical performance and infrastructure and equipment), commitment to research, background in research and level of expertise in chronic diseases. Whenever possible adequate geographic distribution of their practices will be sought out in order to increase the level of generalisation at the proportional level of research data of the future projects.
300 medical practitioners (doctors in different stages of training or practice (residents, specialists), PhD students in medical sciences) will benefit from training in the management of chronic diseases. Selection criteria: Professional involvement in CD care, multidisciplinary skills, commitment to integrated medical practice, availability to travel and time for training.
Final beneficiaries (1). Chronically-ill patients in the care of health care professionals in the target groups; (2) Health technology and pharmaceutical businesses; (3) Public health practitioners and policy makers in the region; (4) Health managers (as end users of the quality management system).
b) needs and constraints of each target group and final beneficiaries
Researchers (including those from community research network) Needs: Professional Development in research -Stimulating and fertile environment; Access to research grants; Research partnerships; Mobility for research; multidisciplinary cooperation; Acceptance of research in the community at large; Quality management system. Constraints: Restricted personal and career development opportunities; Lack of research infrastructure (especially for Moldova and Ukraine); Poor access to research funding due to lack of expertise; Poor cross border cooperation; Lack of multi-centric, international research infrastructure; Lack of integrated biomedical, clinical and public health research; Actual research and health care not embedded in the community;
Health practitioners’ Needs: Professional development – ; Availability of proper infrastructure; To provide quality health care services (a significant load on the average medical practitioners activity; Individualisation of care according with patient’s needs; Services based on scientific evidence and cooperation among clinicians to improve the care of chronically ill patients. Constraints: Inadequate chronic care management – The actual system is mainly designed for acute rather than chronic care; Lack of formal partnerships in multidisciplinary care; Actual system is based on “one size fits all” approaches; Poor multidisciplinary integrated care.
For final beneficiaries Patients: Need: Improved quality of life. Improved capacity of work- Constraints: >50% of chronically ill patients never receive the care they need; Lack of access to multidisciplinary coordinated care.
Business and industry: Needs: Access to research base, access to research pool of patients, high quality of research outcomes. Constraints: Lack of access to research settings with procedures and regulation compliance and quality insurance systems. Policy makers and public health practitioners: Needs: Scientific Evidence based health policies; increased capacity to design health care services policies in accordance with patients’ needs – Constraints: Lack of infrastructure to conduct cross-border public health research; poor regional health services research. Health managers: Need: Evidence based management and good managerial practices – Constraints: Lack of quality management system.
As shown in the section 1.3 this project will integrate in a synergic manner researchers, regions, institutions, infrastructure, multidisciplinary expertise and levels of action (research, clinical practices and education). Putting together through a comprehensive network all components involved in an area of medical science connected also to public health intervention this project will bridge the knowledge – practice gap in the management of chronic disease and therefore remove the above mentioned constraints.
c) Participatory process ensuring participation of target groups and final beneficiaries
This project will increase researchers’ motivation by opening new professional opportunities. In addition, the engagement of the target groups with project’s activities will be promoted by involvement of the professional bodies and associations in the structure of the consortium and in the selection of the target groups. In addition, this project will pay special attention to community engagement with the project in several ways. First, patient associations will be invited to participate in the consortium. Second, the project will organize forums which will put together patient associations, health technology and pharmaceutics businesses, policy makers and university representatives to identify scientific, health care and policy interventions focused on patients’ and communities’ health needs. Special techniques for team building and community engagement will be applied. Third, the project procedures will establish communication channels and communication policies within all the institutions in the network. Specific community engagement techniques will be used.