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Programme of improvements assures quality in mother and child health across Uzbekistan

By Rob McBride

NAMANGAN, Uzbekistan, 26 October 2010 – In the delivery room at the regional hospital here in Namangan one day this past summer, Tukhtabaeva Margubu’s labour with her first child was already well along. Her expression alternated between understandable anxiety and pain from the contractions.

VIDEO: UNICEF correspondent Rob McBride reports on a programme of improvements in mother-and-child health introduced by the Uzbek Ministry of Health, the European Commission and UNICEF.  Watch in RealPlayer


But the voice of the experienced midwife was soothing and the atmosphere in this bright and well-equipped room was designed to reassure and comfort. The biggest help, perhaps, was having Margubu’s husband Muminov Akmal present – something that would have been unthinkable in the past.

Under the guidance of the midwife, he was shown how to massage his wife’s back as a way of helping her through labour and delivery.

Support for mothers

“Having partners present helps make the mothers calmer,” explained one of the midwives, Sadrinova Soxiba. Herself a mother of six, Ms. Soxiba has delivered thousands of babies and has witnessed great changes in her 30-year career.

© UNICEF video
Tukhlabaeva Margubu and her newborn baby in Namangan, Uzbekistan.

“In previous times, we used to provide all women with the same bedsheets and nightgowns,” she went on, “But as well as new techniques, we allow women to bring in their own bedding and clothes, to feel more at home.”

Perinatal services at the Namangan Children’s Multi-Profile Medical Centre, and at other hospitals throughout the country, have benefited from the programme of improvements introduced by the Uzbek Ministry of Health, the European Commission and UNICEF.

The need for change was obvious. Although practically all births in Uzbekistan were being attended by medical professionals, a significant proportion of infant deaths were occurring during the neonatal period. Thanks to the training of thousands of health workers in new techniques, lives are being saved.

Sustainable improvements

What’s more, these changes are sustainable due to the recruitment of several hundred trainers, who can guarantee continuity of the new techniques introduced. And the improvements are being guaranteed, thanks to a quality assurance system run by specialists trained in monitoring the performance of medical institutions around the country.

© UNICEF video
Health worker holds a child at the Children’s Multi-Profile Medical Centre in Namangan, Uzbekistan.

Azimova Dilbar is a senior neonatologist and quality assessor whose job is to help monitor performance.

“Our assessments are based on World Health Organization standards of quality assurance, which are then analyzed and presented to the health facilities with plans for improvements to very specific deadlines,” she said.

Perhaps the biggest guarantee of this programme having a long-term impact is its adoption by the Uzbek Government at a national policy level. “The goals of this project have now been embraced by a government policy aimed at strengthening human capacity to improve health care to mothers and children throughout Uzbekistan,” explained Diloram Akhmedova, Chief of the Department on Mother and Child Health.

UNICEF team involved

Two years into the project, the UNICEF team involved in its implementation is in an extremely satisfying position.

© UNICEF video
Uzbek health workers being trained at the Namangan Children’s Multi-Profile Medical Centre.

“You can see there have been impressive results in the skills of the health professionals,” said UNICEF Health Manager Dr. Hari Krishna Banskota, “and it is quite equitable, because this has been expanded to the most rural areas of Uzbekistan.”

In the delivery room back at the hospital in Namangan, a few minutes after giving birth, the beaming smile on Tukhtabaeva Margubu’s face was proof of the changes that have taken place. “I’m very lucky to have such a great midwife, and to have my husband here with me,” she said, looking tired but clearly elated.

Snuggled against her body was tiny Yusuf, Uzbekistan’s newest citizen at that moment, enjoying a better start in life because of changes in mother-and-child medicine that should benefit his children, as well, in years to come.



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