Mother and Child Health
Providing healthcare, proper nutrition, protection from violence and early learning and stimulation
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The Challenge
Georgia has reached its Millennium Development Goal for under-five child mortality; however, the infant mortality rate (IMR) with 11.4per 1,000 live births (IGME 2017) remains high and still amounts to twice the EU average. Inequities between rural and urban areas persist. Challenges remain with high maternal mortality rates (MMR) with 36deaths per 100,000 live births (MMEIG 2015). Low quality ante, perinatal and post-partum services contribute significantly to the high IMR and MMR.
Approximately half a million Georgian citizens, mainly women and children, suffer some form of malnutrition.
Significant numbers of pregnant women and children in Georgia suffer from anemia, stunting and other micronutrient deficiencies including folic acid deficiency contributing to high infant mortality, deficits in cognitive development of children and disabilities.
The Solution
We work with the Government of Georgia to strengthen quality of health services during pregnancy, delivery and post-delivery. This includes improved capacity of health providers, effective reorganization of the service delivery system and establishment of reliable management information system as a basis for evidence-based policy making.
With our support Georgia is moving towards regionalization ofperinatal health care which is an important step towards strengthening the maternal and child health care system. It envisagesgranting of levels of care (I-III levels) to maternities in Georgia as per the predefined requirements for each level in terms of human resources, infrastructure, equipment, laboratory and diagnostic services. The perinatal care regionalization concept demands that every maternity facility must meet the required standards.
We provided essential technical assistance for the establishment of the electronic maternal and child health management information system of Georgia, the so-called Birth Registry.
The electronic module registers and tracks every pregnant woman in the country through the entire pregnancy and delivery periods and includes information on newborns.
UNICEF support is continuing to ensure the quality of data; to equip the system with an “analytical engine” and as a result, to safeguard the relevance and appropriateness of Government decisions.
For the continuity of maternal and child health care we supported the development of an electronic child growth and development monitoring module and ensured its linkage with the Birth Registry.
The module collects routine, real-time data onchildren aged 0-6 years, assesses a child’s development trajectory, and reflects data related to child nutrition, as well as information on child neglect and abuse.
Primary health care doctors and/or nurses are tasked to enter pre-defined data into handheld electronic devices. This data then flows into the web-based data management system. The module also incorporates child age-specific messages for medical personnel, reminding them of the health topics to be discussed with parents/care-givers, as well as age-specific text messages for mothers. It includes a simple tool that allows primary health care professionals to evaluate a family’s economic conditions and help vulnerable families obtain state allowances. The module also tracks maternal health and well-being during the postnatal period and reflects all potential factors for the timely detection of maternal health complications. This instrument is thought to strengthen the primary health care system in Georgia, in particular the baby check-up component and support services for families with young children.
We have also supported the development of an electronic immunization module. The moduleencompasses vaccine and safety injection stock management, an SMS engine, as well as a parents’ page. The immunization module is equipped with an analytical module that enables immunization data analysis and visualization in real time.
These e-health modules will be linked with the e-social modules that are also developed with UNICEF support and aim at effective data processing and analysis of children’s developmental issues in Georgia.
E-Management Information System for social services reflects all business processes related to social services for children and their families
This system is operated by the Social Service Agencies (at central and regional levels), health and social service providers (day care centres, small group homes, rehabilitation centres, etc.), as well as state contracted social workers.
We also support the Government in strengthening policies and interventions that address and improve the nutritional status of pregnant women, mothers and children .In particular, UNICEF’s technical support and close collaboration with the Government and the United States Center for Disease Control (US CDC) resulted in the establishment of the National Nutrition Monitoring and Surveillance System which is able to systematically collect and analyze trends in a defined set of nutritional status indicators in a population. This system is functional in four regions of Georgia. Relevant data is provided by the eight sentinel sites (two clinics per region). We continue to strengthen the local analytical capacity in outlining follow up policy recommendations.
Finally, we advocate for folic acid and iron supplementation, enforcement of mandatory wheat flour fortification and for increased exclusive breastfeeding rates in Georgia.