“Knock-knock. Geniuses are being born here.”: Effective Perinatal Care in Batken
“This will be my fourth child in this maternity house,” says Chinara. “I’ve always liked it here, but it’s better now, because it has become even more warm and comfortable. Like home.”
We are in the maternity department of Kyzyl Kiya town hospital. The town, on the road from Osh to Batken, is not large. The maternity department is also small, but more than 3000 babies are born here every year. “Ten years ago we had 1600 births,” says Lyudmila Suglina, head of the maternity department, “but now the number has grown and it’s still growing, because women don’t just come here from the town to give birth, but from all the nearby districts as well.”
The aim of the programme is to provide healthcare staff with more effective ways to care for women and children, and to create the best possible conditions in maternity facilities for both women and newborns.
This includes equipment for individual birth rooms, where the woman in labour can always be accompanied by a partner. The room should be clean, warm and comfortable, and everything should also be ready for the baby – a warm little baby changing table and the necessary equipment for if the infant requires urgent assistance in resuscitation.
The woman can give birth in any position comfortable for her. However, immediately after the birth, the infant is placed on the mother’s tummy. From the first minutes of life, the child receives breast milk, and will not part from the mother – they will move from the birthing room together into an equally warm postnatal ward.
It all seems so simple. However, everyone who works in this difficult field of medicine understands that the path to this simplicity was long and hard. Medicine as a whole is the most conservative of social services, and in order to change practice in healthcare institutions, it is essential to gradually but steadfastly change the attitudes of health care workers, the majority of whom received Soviet education and are committed to old Soviet methods.
Specialists note that infant and maternal mortality in the country is not only influenced by economic, social and cultural factors, public health and the demographic situation, but also by the behavioural skills of both mothers and doctors.
Since 2005, UNICEF has supported Ministry of Health initiatives to reduce maternal and child mortality. Important research is being carried out, tendencies being tracked, the causes of mortality analysed and the results used to develop a programme to reform medical service provision.
The crucial National Strategy for Perinatal Care developed with UNICEF support and approved by the Kyrgyz Government in 2008 has as a key aim the provision of better access and better quality of medical services for mothers and infants.
In the framework of the joint UN programme, doctors and healthcare personnel are being trained on how to provide effective assistance to pregnant women and babies, while maternity facilities are being provided with simple and effective instruments, including Ambu bags, “nests” for newborns, and also techniques for neonatal assistance. All the pilot maternity houses apply the “don’t touch me with dirty hands” rule.
It is astonishing that conservative medics actually make jokes about the transition to the new approach. In Kyzyl Kiya maternity department we are amused by the notice “Knock-knock. Geniuses are being born here.” on the doors of the labour ward. Putting yourself in the place of a pregnant woman, you can only imagine what an amazing feeling it is if her still-unborn child is called a genius. It is also a powerful motivation to follow all the instructions of the doctors before, during and after birth, to take responsibility for the child’s development and to take pride in bringing a new person into the world.
Cooperation between maternity institutions and the authorities is also gradually improving. Abubakir Imarov, the first deputy Governor of Batken Province, knows first-hand the needs and requirements of the district hospital. With six children and one grandchild, he realises how important it is for the place where future citizens first see the world to have clean water and everything necessary for safe birth. One example to be emulated is the fact that a neonatologist invited from Bishkek has been granted a flat by Batken Provincial Administration. “In the near future, we will be 100 per cent staffed with qualified neonatologists, said Mahbuba Huseinova, head of the maternity department, proudly. “This will significantly reduce infant mortality.”
Media Liaison Officer UNICEF in Kyrgyzstan