Final report : EPIQ [environmental policy and institutional strengthening indefinite quantity contract] Slovakia -- environmental health component

No contract period is specified. As was the case with the environment component, the health component built on previous work undertaken by the USAID- funded Central and Eastern Europe Environmental Economics and Policy (C4EP) Cooperative Agreement. The main focus of activity under both C4EP and EPIQ was local capacity-building through the development and delivery of high-level courses in the areas of environmental and occupational health. Under C4EP, much of the training was directed at physicians and other health professionals working within the government health care system. During the final phase of C4EP, the Slovak government enacted legislation requiring private firms to take responsibility for providing occupational and environmental health services to their employees. As a result, the focus of training under the EPIQ project expanded to include private physicians, and the project established strong links with the Private Physicians" Association. Private physicians became a well-represented group at the training courses and, as a result, the project was able to build a bridge between public and private practitioners. As a new government was elected in Slovakia during the course of the EPIQ project, Ministry of Health officials expressed an interest in having the EPIQ team become involved in the general reform of the health care delivery system. Subsequently, a number of discussions were held on this issue and the feasibility of such participation was evaluated. Because of the serious financial constraints faced by the Slovak health care system, there was particular interest in assessing various types of cost containment. However, given the time remaining available under both the EPIQ task order and USAID"s presence in Slovakia, USAID decided not to expand the mandate of the EPIQ team, and the focus of the health component remained on capacity building. (Author abstract, modified)