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Mortality of children under five in families in the poorest wealth quintile, compared to the richest.
Giving hope for life
Improvement of Mother and Child Health Services in Uzbekistan
Madina's baby was born premature and underweight, with little chance of survival. "They gave me the hope," – she smiled tearfully, recalling how the nurse, trained during a project-supported training for post-birth care personnel worked skillfully for her infant child's life. "My child had an opportunity to live and they helped make this happen."
Madina’s child is just one of the many other newborns saved in the past few years across Uzbekistan thanks largely to the "Improvement of Mother and Child Health Services" (IMCHS) Phase II project, a joint effort by the Ministry of Health, the EU Delegation to Uzbekistan and UNICEF.
"This project was an instrumental part of the nation’s effort to reduce maternal and child mortality," – said Robert Fuderich, UNICEF Representative to Uzbekistan. "It supported the ongoing health system reforms in Uzbekistan, and introduced scalable and cost-effective solutions for ensuring equitable access to health services for mothers and children in urban and rural areas alike; and bringing these services closer to the international standards."
IMCHSPhase II, implemented in two phases – 2008-2011 and 2012-2015, also sought to strengthen healthcare institutions and to assist in capacity-building among medical providers in order to enhance maternal and child care.
"We are confident that our joint actions aimed at strengthening the mother and child healthcare system are in line with the highest international standards, enhancing the skills of health professionals and improving parenting skills through the community-based approach,” – said Yuri Sterk, Ambassador, Head of the EU Delegation to Uzbekistan.
As one of its primary project goals, IMCHS Phase II provided technical support to the Ministry of Health in the development and revision of major national documents regulating provision of quality health services to mothers and children, including decrees, clinical guidelines and standards.
"The joint Improvement of Mother and Child Health Services in Uzbekistan PhaseIIproject, is an example of productive cooperation and strong partnership between the Ministry of Health, the European Union, UNICEF and World Health Organization," - said LazizTuychiev, Deputy Minister of Health. "The successful implementation of the first and then second phases of the project is yet another proof of high efficiency of the state policy implemented by Uzbekistan from the first days of independence, with top priority given to the bringing up of a healthy and harmoniously developed generation."
Important milestones towards a larger goal
Among the project's key accomplishments was its participation and support for the Ministry of Health in the development of the “State Programme for the Strengthening and Development of the System of Protection of the Reproductive Health of the Population, the Health of Women, Children and Adolescents in Uzbekistan for the years 2014–2018”, adopted by the Presidential decree in September 2014. It now constitutes the framework for reforms in the mother and child health care sector, including international collaboration.
The project team also provided technical support to the health authorities in the development of the national concept and strategic action plan for quality improvement in the mother and child health sector for the next five years (2016-2020).
More than 17,000 health professionals have been trained in newborn and child survival packages through a network of twelve training centers set up by the project throughout the country; today 54 per cent of the country's maternities correctly apply newborn survival packages recommended by World Health Organization and UNICEF - 40.5 per cent up from 13.5 per cent in 2013.
Two resource centers – one at the Republican Perinatal Center and the other one at the Republican Pediatric Center – have been established to serve as a repository for the critically important information collected throughout the project (technical reports, working tools, training materials etc.). This will help sustain the results achieved by the project and make future work easier.
Reaching out to the communities
As part of the IMCHS II project, the Participatory Learning and Action (PLA) approach was piloted in the selected urban and rural communities of Namangan region and the Republic of Karakalpakstan, in the period of 2013-2015.
The PLA methodology encourages and empowers communities to start assessing health and well-being needs of mothers and children aged 0 to 5 years old, gain necessary knowledge, plan action for improvement that is relevant in their local context, and regularly monitor the progress of applying the positive practices, through establishment of the community-based monitoring groups.
A 2015 study by UNICEF showed the following improvements, compared with the figures for 2013, in five essential behaviours encouraged in families for the wellbeing of children:
- The average number of mothers and caregivers recognizing the danger signs of childhood illnesses improved from 31 per cent to 52 per cent;
- The proportion of mothers who exclusively breastfeed their children aged zero to six months old increased from 39 per cent to 50 per cent;
- The proportion of children aged six months to 23 months consuming four or more groups of food improved from 66.5 per cent to 70.4 per cent;
- The proportion of children aged zero to five years old whose hands are being washed at critical times during the day increased from 35 to 47 per cent; and
- The average time spent for the stimulation and development of a child aged under five years old increased from two hours to 5.9 hours a day.