Investing in better care during baby’s first days is saving lives in Kyrgyzstan

How health worker training and hospital improvements helped drastically reduce newborn mortality rates

By Sven G. Simonsen
Two babies in the resuscitation unit at Bishkek's National Centre for Motherhood and Childhood.
UNICEF Kyrgyzstan/2017/Vlad Ushakov
03 November 2017

Over the past decade, Kyrgyz children like Omurkal and Omurbek have had an increasingly better chance at surviving and thriving. Find out how UNICEF is supporting the Ministry of Health to help make a real difference in the number of child deaths in Kyrgyzstan.

BISHKEK, Kyrgyzstan, 3 November 2017  ̶  “She is the daughter I dreamed to have,” says Nargiza. “When I reach into the incubator, I touch her hands, her legs, to give her my love.”

Inside the incubator rests little Omurkal – Nargiza’s first child – who was born at 30 weeks. Nargiza has cancer. As her condition deteriorated and her hemoglobin level registered alarmingly low, the doctors performed a caesarian section.

That was two weeks ago.

A mother sees her baby in emergency care.
UNICEF Kyrgyzstan/2017/Vlad Ushakov
Nargiza comes every day to see her daughter Omurkal, who is still in emergency care after she was born prematurely two weeks ago.
Nargiza and Omurkal

Today, Omurkal may still be under watchful supervision in emergency care at Bishkek's National Centre for Motherhood and Childhood, but Nargiza sees her daughter improving.

“At first, she didn't cry, she didn't even have a voice,” says the new mother.

“But now I can hear her, and I recognize her voice,” she adds with a smile of love  ̶  and relief.

Nazira and Omurbek

In another room at the centre Nazira holds her son Omurbek. Like Omurkal, Omurbek was born two weeks ago, some 30 weeks into the pregnancy. He is Nazira’s third child. The family live in the western Talas region; Nazira was visiting the capital when her water broke.

She delivered at this hospital, and the boy was immediately put in CPAP – an assisted breathing machine specifically designed for small babies. Four days later, Omurbek could breathe on his own. The next day, the team began to feed him breastmilk with a probe.

Today, Omurbek rests calmly on Nazira's breast. Nazira seems relaxed and confident holding her baby, but she was worried when she arrived to deliver Omurbek so early. “I was [nervous], but then I saw other mothers with premature children who were doing fine, and I began to worry less. One of the children weighed just 900 g at birth, but put on another 300 g in a month – my boy was 1,280 g when he was born,” she says. 

As soon as Omurbek begins breastfeeding normally, mother and baby will go home.

Dr. Sagynbio Abdualieva checks on two babies
A doctor checks on two babies.
Dr. Sagynbio Abdualieva checks on two babies. She is head of the resuscitation unit at Bishkek's National Centre for Motherhood and Childhood.
Better chance of survival

Families like Nargiza’s and Nazira’s have benefited from a health system that offers prematurely born and severely sick children a significantly better chance of survival than it did 10 years ago.

Over the past decade, Kyrgyzstan has seen a steady decline in the rate of child mortality. During this time, UNICEF has worked with the Ministry of Health to upgrade the skills of health workers, modernize equipment and organize hospital processes and referral systems better.

Kyrgyzstan is one of 62 countries worldwide that reached the Millennium Development Goal of reducing child mortality by more than two thirds. In 2007, mortality among children under 5 in Kyrgyzstan was 36 per 1,000 live births. By 2015, it had dropped to 21. During the same time period, infant mortality dropped from 32 to 19 for every 1,000 births and newborn mortality decreased from 19 to 12 deaths per 1,000 live births.

Changes that work

Making improvements for children started with finding out more about the problem. In 2009, UNICEF completed a study to identify the main causes of child deaths in Kyrgyzstan, and the most effective ways to save children’s lives. UNICEF and the Ministry of Health used the findings as a guide to prepare a package of interventions. The Government of Japan was the main donor for this work.

The most important recommendation was to improve resuscitation of newborns, through training and equipment. Since 2015, almost 650 doctors, midwives and nurses have been trained on newborn child resuscitation and care.

Hospital staff have been trained as teams rather than individually to reach as many workers as possible. To ensure that the new skills are put to use monitoring specialists visit hospitals regularly.

Solving ‘big problems’

“We had big problems here before we started working with UNICEF,” says the Republican Infections Hospital’s Deputy Director Dr. Ainura Uzakbaeva.

“We didn’t have modern equipment, doctors were not trained to resuscitate children, staff were not trained for teamwork, and so on. Now our staff have better skills, and better equipment, and our services are more patient-oriented,” said Dr. Uzakbaeva.

UNICEF’s Regional Director for Europe and Central Asia, Afshan Khan recently visited the hospital, meeting with mothers and newborns and seeing the improvements in equipment and service delivery first hand.

“Kyrgyzstan has made significant progress in strengthening the delivery of maternal and newborn health care, which serves as a strong example to other countries in Central Asia. These strong results demonstrate that investments in the first 1,000 days of a child’s life are essential,” said Ms. Khan.


Learn more: Over the past 25 years, the world has made significant progress in saving young children’s lives. The rate of child mortality fell 62 per cent from 1990–2016, with under-five deaths dropping from 12.7 million to 5.6 million >>more