|© UNICEF video/2009|
|This 26-year-old mother is encouraged to keep her newborn with her after delivery to encourage immediate breastfeeding. Such practises are new to Kyrgyzstan's maternity wards.|
This year, UNICEF’s flagship report, ‘The State of the World’s Children’ – launched on 15 January – addresses the need to close one of the greatest health divides between industrialized and developing countries: maternal mortality. Here is one in a series of related stories.
By Guy Degen
BISHKEK, Kyrgyzstan, 15 January 2009 – In a small delivery room at Kyrgyzstan's National Maternal and Child Health Centre, Nargiza Umuralieva is in labour, awaiting the birth of her second child. Her sister Jibek is there for help and support. She quietly massages Nargiza's hand.
The 23-year-old can choose any position for delivery, from the traditional Kyrgyz method of standing with a cotton rope for support to using a large, inflatable rubber ball. Partner-assisted and free-position deliveries are new birth practices in Kyrgyzstan, only recently introduced in hospitals.
'More like a mother'
Across Kyrgyzstan, better hygiene, skin-to-skin contact immediately after birth and exclusive breast feeding are becoming standard practices. These are just some of the ways hospitals and clinics certified by UNICEF as 'baby friendly' are providing a continuum of care for mothers and newborns.
Aizat Tailobaeva, 26, who has just delivered her second child across the hall from Nargiza, says the modern birth practices make her feel more like a mother.
“This delivery was different. The doctor put my son directly on my chest after birth. Within half an hour he was seeking my breast to feed,” she explains. This is in stark contrast to Aizat’s first delivery, when the nurse took her baby to a different ward immediately after birth.
Today, about one-third of newborns in this country are exclusively breastfed for the first six months of their lives. A higher percentage, close to half, are breastfed and given complementary food as well. About 50 per cent of of Kyrgyzstan's maternity homes are certified as 'baby-friendly hospitals' with UNICEF support, which has led to improvements in baby feeding practices.
Preventing maternal mortality
Retaining trained health professionals in Kyrgyzstan presents a challenge. Many doctors and nurses seek better salaries in Russia or neighbouring Kazakhstan.
Though most mothers in Kyrgyzstan deliver their children at a hospital or clinic, maternal mortality rates remain high. Poor nutrition is a leading cause of birth complications. Around 34 per cent of pregnant mothers suffer from anaemia.
UNICEF Representative Tim Schaffter said UNICEF is working with health authorities to introduce cost-effective ways to reduce both maternal and infant mortality.
“We know most maternal deaths are preventable. We know most deaths of newborn children are preventable,” says Mr. Schaffter. “For children, simple techniques to improve sanitation and hygiene to prevent infection, simple techniques to promote breastfeeding [lead to] an amazing reduction in child illness and death.”
Holistic care for mother and child
Preventable death is a tragedy in every community. The head of maternal heath at the National Maternal and Child Health Centre, Dr. Guldan Duishenbaeva, is confident that new equipment and training of health professionals is making a difference.
“Doctors in Kyrgyzstan realize the advantages of new technologies. We are training a lot of doctors and nurses to be able to treat mothers and families,” says Dr. Duishenbaeva.
New health policies are now allowing for pregnant women to receive free medical care throughout their pregnancy, and for their children to get care up to the age of five. Gradually, Kyrgyzstan's health system is developing the capacity to provide a more holistic approach to maternal and infant care.
The State of the World’s Children 2009
SOWC 2009 report launched
Report on maternal and newborn health
'Baby-friendly' practices for Kyrgyz mothers