Innovative method to improve parental care in Georgia
By UNICEF Georgia
The Georgian government, with support from UNICEF, is using simple technology to promote early childhood health and development – helping to further reduce child mortality in the country.
Through the “positive parenting” initiative, key messages are automatically distributed by SMS to mothers of all registered newborns in Georgia, providing useful or even vital information on issues such as nutrition, vaccination, symptoms of illness, developmental benchmarks and good childcare practice. Since the initiative was launched at the beginning of 2011 by Georgia’s Civil Registry and Ministry of Labour, Health and Social Affairs, together with UNICEF, more than 66,000 mothers or other caregivers have received a total of almost 1.6 million text messages on their mobile phones.
“These messages are really very helpful, certainly for me and lots of other women whom I know,” says Keti Gomelauri, a 36 year-old mother living in Tbilisi. Like almost any working mother, Keti has many jobs to juggle. With two daughters, 11 year-old Tata and Lizi, aged just six months, a full-time job and a home to run, it is a challenge sometimes to remember everything that needs to be done in a normal day. So when Keti receives an SMS on her phone, reminding her that Lizi’s next vaccination is due, it almost comes as a relief. “These messages can be timely reminders for busy mums. In some cases they might be the only source of child healthcare information that a mother has. The overall lack of adequate information on this issue has been very problematic in Georgia, but this is slowly starting to change,” she says.
Keti knows what she is talking about – not least since she helped to develop the “positive parenting” initiative through her job at the Civil Registry Agency. “There is no real culture of prevention when it comes to health issues in this country, and that goes for well-off people in urban areas as much as people in remote villages, “says Keti. “Just as they do for themselves, parents are likely to bring their children to the doctor only when they have an obvious illness. When it comes to a child’s psychological, emotional and social development, there is generally a very low level of understanding. So increasing parents’ responsibility in this domain is very important,” she adds. “The fact that the majority of households in all parts of Georgia own at least one mobile phone makes this the obvious channel of communication.”
The carefully formulated messages are derived from the Parent-Baby Book, developed by the Ministry of Labour, Health and Social Affairs with UNICEF support, within the Early Childhood Development National Action Plan. This book serves as a child’s personal health and development record up to the age of six, as well as being a useful information resource. Distribution of the book is currently underway through health care providers across the country, and is available in Georgian, Russian, Armenian and Azeri in minority areas. “Simplified, much more visual versions of the book have also been produced, especially in the second languages,” says Keti, “This way we can be sure the content is understood. The messages are also adapted accordingly in the different languages,” she adds.
The “positive parenting” project is just one initiative among many in the ongoing reform of the Georgian health system, which is oriented towards market-based strategies to drive improved efficiency and effectiveness, and improved health outcomes for the Georgian population. While there is a general push towards privatization of health care facilities and health insurance, there is a significant state-financed health insurance programme that includes free neonatal and emergency care, free in-patient care for children aged 0-3, and a comprehensive package of health services for children from the most vulnerable families. Specific efforts are being made to strengthen the perinatal and neonatal health system, including through the implementation of World Health Organisation approaches and standards.
In the past decade, substantial progress has already been made in reducing child deaths in Georgia. Since 1999, the mortality rate of children of children under the age of five has dropped by two-thirds – from 45 deaths per 1,000 live births to 16 in 2010. Infant mortality reduced during the same period from 42 to 14 deaths per 1,000 live births.
Yet still too many children under the age of five are dying of preventable causes – including a growing number within the first 28 days after birth – such as infections, pneumonia, diarrhoea and complications arising from premature birth. Many deaths are associated with under-nutrition, and are closely linked with the mother’s health during pregnancy.
According to Keti, the aim of the “positive parenting” initiative is however to go beyond reducing child mortality, and to help children in Georgia develop to their full potential. “No matter how much we think we know as parents, there are always things we could do better. It’s surprising too how much we forget,” she says.
Maia Kukava, mother of an18-month old boy, Saba, and who also works in Tbilisi, agrees enthusiastically. “This SMS information service has been helpful in many ways. For example, it was thanks to this that I realised my son had a problem when he still didn’t have any teeth at the age of eight months. It turned out he had a calcium deficiency. I’ve also received useful advice about playing music for my baby, and other stimulating activities,” says Maia.
As she watches Saba joyfully kicking a soft ball around the living room, she concludes with a smile, “Whatever helps to ensure that our children are healthy and happy must be a good thing.”