Perinatal Health in Kyrgyzstan
Title: Promotion of Perinatal Health in Kyrgyzstan
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Lead executing agency: Ministry of Health of the Kyrgyz Republic
Overall term: 2018 to 2020
While Kyrgyzstan has experienced success since 1990 in reducing deaths among children under five, neonatal deaths have fallen at a slower rate and maternal deaths have hardly declined. Kyrgyzstan has the highest maternal mortality rate in the World Health Organization European region, and many of them could be prevented. Lack of standards and poorly regulated referral practices mean that high-risk pregnancies are not detected in time, referred to the correct level of care, or adequately treated. In rural areas, family practitioners are few in number, insufficiently skilled for pregnancy care, and often difficult to reach.
The quality of integrated care services for pregnant women and newborns in the five pilot regions has improved.
As a new development partner in the health sector, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH brings a systemic and multi-level approach to policy advice and capacity building in line with the National Health Strategy 2019-2030: ‘Healthy Person – Prosperous Country’.
Together with the Ministry of Health we work at the national level with Mandatory Health Insurance Fund (MHIF) and the E-Health Center and at the regional level with 13 health facilities in Bishkek, Chuy, Issyk-Kul, Naryn and Osh. We build the expertise of health workers, improve the quality of services for pregnant women and newborns, and strengthen referral pathways for them.
The technical cooperation project is one module in a larger German-supported health sector programme in Kyrgyzstan including financial cooperation measures implemented by the KfW Development Bank.
Building expertise: We support the development and introduction of transparent, competence-based human resource planning, management and recruitment tools for the new National Perinatal Center in Bishkek. The Center will serve as the first national level institution of perinatal care. GIZ measures complement the financial support for infrastructure and equipment of the National Perinatal Center provided by KfW.
The project is adapting the Safe Delivery App developed by the Danish Maternity Foundation to the Kyrgyz context. The app is an aid for skilled birth attendants to manage complications during pregnancy and childbirth.
Improving quality: To improve the quality of care to women before, during and after delivery, we are helping to establish and guide the work of quality improvement committees at 13 healthcare facilities in the five regions. Two qualified mentors support facility-based teams to identify obstacles and to develop quality improvement plans to address gaps.
In cooperation with the MHIF we work to steer funding and incentives to support the quality improvement plans of healthcare facilities. With the E-Health Center we work to improve the quality of data used to monitor perinatal and obstetric services.
Patient-centred care: To bring the referral system to the standards required by an integrated patient-centred system, we support regional working groups. In one district of the Osh region we are working with local authorities and healthcare facilities to pilot a case management-based approach to high-risk pregnancies. Also, the project is supporting the development of training materials for family practitioners for management of pregnancy.