Based on the order of the Ministry of Health of the Republic of Azerbaijan No. 119 dated September 1, 2008, starting from 2009, within the framework of the health reforms carried out in the country, the position of a family doctor for rural areas was established, and at the primary health care (PHC) level appeared health services based on the principle of family medicine. In November-December 2013, the Public Health and Reforms Center of the Ministry of Health (PHRC) conducted a study to assess and analyze the knowledge, attitudes, interests and capabilities of stakeholders at the district (Absheron, Sheki, Gakh, Aghdash, Ismayilli) and central levels involved in the primary healthcare reforms.

A similar study was conducted in 2008-2009 jointly by the PHRC and Abt Associated Inc., funded by the United States Agency for International Development (USAID). Re-conducting a similar study 4 years after the introduction of services based on the family medicine principle provides an opportunity for a comparative analysis of the knowledge, attitudes and interests of the central and district levels leaders with the results of the previous study, as well as for assessing the accessibility to these services, the level of knowledge and satisfaction of the population with these services.  

The study was aimed at exploring the vision and understanding of stakeholders on the following issues:

• The effectiveness of the existing PHC system;
• Introduction of family doctor practice and related reform of the existing PHC structure;
• Health financing mechanism and introduction of per capita payment at the PHC level;
• Strengthening the managerial and financial independence of PHC;
• The attitude of the population to the introduction of family medicine and satisfaction with the family doctor services.

The methodology for this study is based on a patient questionnaire developed by the “Quality in Family Medicine” Project at MacMaster University and stakeholder analysis recommendations taken from the “Collaborating for Healthcare Reform Guide, Policy Tools for Strengthening Health System Reforms". Thus, within the framework of the project, 3 survey tools were developed:

1. questionnaire for interviews with representatives of organizations at the central and district levels;
2. questionnaire for interviews with family doctors;
3. questionnaire for interviews with the population.

The survey instruments were piloted at the PHRC, and based on the results obtained, appropriate changes were made to these questionnaires. After preparing all the necessary tools for conducting the analysis, interviews with stakeholders began. The research team consisted of the staff of the PHRC.

The study included 59 interviews with heads of organizations at the central and district levels, 20 interviews with family doctors from the same districts, and 314 patients using the services of family doctors.

On April 25, 2014, the presentation of the final report of the study entitled “Stakeholder Analysis: Implementation of Family Medicine in Azerbaijan” took place at the PHRC. The event discussed the situation, development dynamics, achievements and problems since the introduction of family medicine in Azerbaijan.

The study showed that the majority of stakeholders note the urgency of laying the foundations of this process and expect the successful introduction of family medicine through the implementation of the next consistent activities and reforms in a number of areas.