How a birth registry helps women and children in Georgia

An electronic maternal and child health management information system strengthens the maternal and child health care system in Georgia

Inge Snip for UNICEF Georgia
UNICEF/GEO-2017/Blagonravova

25 February 2020

Picture this: a woman finds out she is pregnant and visits an antenatal care provider of her choice. After the pregnancy is confirmed by the clinic, she is told to go to the Social Service Agency to pick up the paper voucher that would cover antenatal care related costs throughout the pregnancy period. With this voucher she can start her journey at any antenatal care provider recommended by the State Antenatal Care Program.

There is one problem: an expecting mother can visit multiple different care providers during her pregnancy, but her pregnancy related health information does not follow her from provider to provider. This means that the trustworthiness of the pregnancy anamnesis largely depends on the woman’s education level and health awareness, she is the one who has to explain her situation to the new doctor.  

This leaves a lot of room to miss crucial information, with sometimes deadly outcomes for mother and child, or even both. This is one of the factors contributing to Georgia’s high maternal and infant mortality. The country’s infant mortality rate — the number of babies who die before turning 1 year old — is higher than the EU average with 8.1 deaths per 1,000 births in 2018. And for mothers, the chances of dying during pregnancy or childbirth, are also worrying, with 27.4 deaths per 100,000 live births.

 

UNICEF/GEO-2017/Blagonravova

That is why Georgia’s government asked UNICEF to support in establishing a real-time reliable data collection system that could ensure continuity of care.

The birth registry system was created in parallel to USAID supporting the government in setting up 30 different E-health modules to improve governmental control of state subsidized health care programmes, to increase transparency of healthcare financing, to decrease fraud rate, and to create space for real-time monitoring.

But, there was no dedicated system for maternal and child health. And that is where the birth registry came in.

The real-time electronic health management information system, tracking every mother and newborn through pregnancy and delivery, was launched in 2016. Its use is threefold: it tracks the health condition of mother and child, it helps doctors access — with the approval of the mother — the patient’s medical history, and it collects country-wide reliable data to be used in policymaking.

The system was created with the help from Norwegian technical experts, who brought their expertise from the Norwegian birth registry. They ensured that the team in Georgia created the right requirements for the right variables and supported the establishment of the registrar’s office in charge of safeguarding the data’s quality.

Now, as soon as an expecting mother visits a prenatal care clinic, a notification of the confirmed pregnancy is immediately registered in the system. The social service agency is then pinged, to ensure she will receive the financial support she is entitled to.

UNICEF/GEO-2017/Blagonravova

Although the e-health system is still quite new, the team of analysts at the birth registry have initiated real-time analyses to study the situation of maternal and newborn health and support the government in making sound decisions which could increase the survival and health of both mother and child.

“The government can now closely monitor mothers and children’s health, which was not possible before. This registry serves as a basis for both proper oversight and the governance of the perinatal services. And with that, the lives of mothers and children will be better protected.”, says UNICEF Representative in Georgia Dr Ghassan Khalil.

But that is not all. There are a few more plans for the near future to help both mother and child with the data collected through the registry. One is to share hospital quality related information, meaning that expecting mothers would be able to look at the different facilities and choose the one right for her and her situation. It would also incentivize doctors and facilities to improve their services.

“Expecting mothers will have a proper instrument to assess the quality of care and can make informed decisions.”

says UNICEF Health Specialist Ms Tako Ugulava

The other is to instantly notify primary health care clinics about an ‘incoming baby,’ as soon as the mother and baby leave the maternity hospital to facilitate their postnatal care. Through UNICEFs supported “0-6 Child Growth and Development Surveillance Electronic Module,” they will gain direct access to mother’s pregnancy and delivery anamnesis after she gives them consent to do so.

Only a few years ago, expecting mothers were tasked with ensuring that doctors were fully aware of their situation and had to wait in line at the ministry to receive their vouchers, doctors were left in the dark on sometimes crucial health information, and the government was forced to create maternal policies based on scattered and unreliable data. Now, with the birth registry, everyone involved in safeguarding the lives of mother and child are able to actually do so. And with that, both expecting mothers and their babies actually have a fair chance at secure, healthy, and stress-free care.