Health in Times of Transition - Trends in Population Health and Health Policies in CIS Countries

Overall strategy

The general methodological approach of the project involves the combination of specific expertise in health care issues and social science methods. The health care experts, identify the key areas and issues of research as related to the state and dynamics of public health, such as diet, tobacco and alcohol consumption and access to and quality of health care. At the same time, social scientists provide sociological measurement tools and techniques (such as surveys), conduct fieldwork and conduct research into the formulation and implementation of public policy issues. Terms of reference for each research workpackage, research tools and reports shall be developed jointly or in close cooperation between health care and social science experts.

The overall scope and shape of the proposed cross-national and multidisciplinary project is based on the following principles:

• First, we identify the main research themes in HITT (=main analytical reports):
  1. Demography and health
  2. Society and health
  3. Economy and health
  4. Tobacco, alcohol and health
  5. Life style and health
  6. Public policies and health
• second, we consider a number of aspects, or views that allow us to analyse the core research themes from different perspectives (e.g. we explore subjective views, objective data and expert evaluations);
• and thirdly, we deploy a palette of research tools and methods to collect new empirical data and analyse them in innovative ways.

Objectives

• measure and explain prevalence and distribution of risk factors, health outcomes, and their social, cultural, and economic determinants;
• develop and implement validated community profiles to capture the opportunities and obstacles to leading a healthy lifestyle (in relation to diet, alcohol, smoking);
• assess health system performance, focussing on accessibility and quality of health services;
• quantify the cost of ill health through reduced labour supply and productivity;
• identify opportunities for and obstacles to policy change (alcohol and tobacco) in Russia:
• market analysis (alcohol & tobacco);
• regional analysis of alcohol -related mortality in Ukraine.

Main research themes (health determinants):

1. Demography and health
2. Society and health
3. Economy and health
4. Tobacco, alcohol and health
5. Life style and health
6. Public policies and health

Combining multiple elements:

• Individual attributes: including knowledge, attitudes, and practices in relation to the four health determinants, culture, beliefs, nationality, and socio-demographic and –economic status: Community attributes: assessment of the communities in which people live, and where they make decisions about how they lead their lives, focusing on the opportunities and constraints to leading a healthy lifestyle;
• Policy context, identification and critical analysis of existing policies and understanding how they can be changed.

Main research methods and tools:

• Household survey in 10 countries 
– probability sample of at least approximately 20,000 respondents, to examine the causes of ill health and the economic consequences of ill-health
• Stakeholder Analysis – interviews with key stakeholders to identify opportunities for and obstacles to change
• Econometric and demographic modelling 
– to collect validated background data on health and on trade in alcohol and tobacco
• Policy analysis 
– identification and critical analysis of existing policies

HITT-CIS will bring concrete benefits by influencing policy in ways that will support health by:

• disseminating findings within each country and to EU policymakers and international researchers;
• identifying policy implications based upon informed research.

Project duration

Planned duration of the project is 4 years (48 months), May 2009 to April 2013.

Geographical scope

A unique team with extensive expertise in health effects of transition will generate new knowledge on health determinants in 10 CIS countries: Russia, Belarus, Ukraine, Moldova, Kazakhstan, Uzbekistan, Kyrgyzstan, Armenia, Azerbaijan and Georgia.

Dissemination

The project is of great interest to academics as well as policy makers both in EU member states as well as in the 10 CIS countries. Therefore it is important to disseminate information to these different groups. Since methods of dissemination vary according to the group being targeted, each of these in turn will be indicated. The project team will disseminate the results of the proposed project to a variety of dissemination target groups:

• Members of the HITT-CIS consortium (extended project teams);
• Scientific and academic communities;
• Political and policy actors and stakeholders in national health systems;
• General and Interested Public, including NGO’s and civil society;
• European and global Public.

Further dissemination plans are:

• Publications
• Policy briefs
• Media coverage
• Face-to-Face dissemination to policy makers, academics and civil society
• Electronic dissemination – regularly up-dated information posted on the project website
• Close cooperation with the WHO’s European Observatory on Health Systems