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Making Pregnancy Safer in Uzbekistan

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Making Pregnancy Safer in Uzbekistan Making Pregnancy Safer, Beyond the numbers, Activities Report 2002-2008 The WHO Regional Office for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. Abstract Member States Upon request from the Ministry of Health of Uzbekistan, the WHO Regional Office for Albania Europe has carried out activities for mother and child health care in Uzbekistan since Andorra Armenia the 1990s in collaboration with a number of partners. The WHO Making Pregnancy Austria Safer programme has been implemented since 2002, through a series of policy Azerbaijan dialogues with the Ministry of Health and partners, and based on the sustained Belarus provision of technical expertise in key areas. In 2003, the Ministry of Health issued a Belgium Bosnia and Herzegovina comprehensive normative document (Prikaz) on mother and newborn care, with the Bulgaria support of United Nations agencies and intergovernmental and nongovernmental Croatia organizations: the first in a series of documents endorsing evidence-based practices Cyprus Czech Republic and WHO recommendations. Making Pregnancy Safer activities have included training Denmark workshops on improving maternal and neonatal health care, and assessment and Estonia follow-up after training to reinforce the skills acquired during courses in a number of Finland districts. Evidence-based care for mothers and newborn babies was introduced at a France Georgia 2003 workshop, and evidence-based guidelines for obstetric complications were Germany developed in the following years. In 2004 Uzbekistan participated in the first regional Greece workshop on Beyond the Numbers (BTN), a global tool developed by WHO for Hungary reviewing maternal deaths and complications to improve quality of care. A BTN national Iceland Ireland workshop in 2005 reviewed the various approaches and recommended that near-miss Israel case reviews (NMCR) and confidential enquiries into maternal deaths (CEMD) be Italy introduced to Uzbekistan. A technical BTN workshop on NMCR was held in June 2007, Making Pregnancy Safer Kazakhstan and a plan of action developed for pilot implementation. NMCRs started in 2007 in four Kyrgyzstan Latvia pilot maternity units, and international experts reviewed them in 2008. The lessons Lithuania learned were discussed at a workshop and the dissemination of NMCRs to other in Uzbekistan Luxembourg hospitals, and the introduction of CEMD at national level, was recommended. The Malta Monaco Ministry of Health is leading the collaborative efforts of several partners to implement, Netherlands disseminate and document the comprehensive strategic approach to improve maternal Norway and perinatal health, supported by WHO technical expertise. Poland Maternal mortality and Portugal Republic of Moldova Romania morbidity audit Russian Federation San Marino Serbia and Montenegro Slovakia Slovenia Activities Report Spain Sweden 2002-2008 Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan World Health Organization h Regional Office for Europe ne M s r Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark ái O í Tel.: +45 39 17 17 17. Fax: +45 39 17 18 18. E-mail: [email protected] e ia r á N Web site: www.euro.who.int i g D g i h ne M s ir á í e ia á N g D Making Pregnancy Safer in Uzbekistan Maternal mortality and morbidity audit Report of Activities: 2002–2008 MPS activities in Uzbekistan Maternal mortality and morbidity audit – 2002–2008 Making Pregnancy Safer: summary of activities, 2002–2008 Workshop on Evidence-Based Mother and Newborn Care, 10–14 November 2003 National workshop: Development of Guidelines for Emergency Obstetric and Pregnancy-induced Hypertension, 18–21 January 2005 National Workshop on “Beyond the Numbers”, 28 February-04 March 2005 Technical Workshop on “Beyond the Numbers”: Near-Miss Case Review, 12–15 June 2007 Piloting Near-Miss Case Reviews: international consultancy 4–10 November 2007 Near-Miss Case Reviews in pilot sites: follow-up 22–23 and 29–30 January 2008 Near-Miss Case Reviews: Workshop on Women’s Interview 17–18 April 2008 “Beyond the Numbers” Review and Scaling Up 12–23 May 2008 20/01/2009 ii MPS activities in Uzbekistan Maternal mortality and morbidity audit – 2002–2008 Abstract Upon request from the Ministry of Health of Uzbekistan, the WHO Regional Office for Europe has carried out activities for mother and child health care in Uzbekistan since the 1990s in collaboration with a number of partners. The WHO Making Pregnancy Safer programme has been implemented since 2002, through a series of policy dialogues with the Ministry of Health and partners, and based on the sustained provision of technical expertise in key areas. In 2003, the Ministry of Health issued a comprehensive normative document (Prikaz) on mother and newborn care, with the support of United Nations agencies and intergovernmental and nongovernmental organizations: the first in a series of documents endorsing evidence-based practices and WHO recommendations. Making Pregnancy Safer activities have included training workshops on improving maternal and neonatal health care, and assessment and follow-up after training to reinforce the skills acquired during courses in a number of districts. Evidence-based care for mothers and newborn babies was introduced at a 2003 workshop, and evidence-based guidelines for obstetric complications were developed in the following years. In 2004 Uzbekistan participated in the first regional workshop on Beyond the Numbers (BTN), a global tool developed by WHO for reviewing maternal deaths and complications to improve quality of care. A BTN national workshop in 2005 reviewed the various approaches and recommended that near-miss case reviews (NMCR) and confidential enquiries into maternal deaths (CEMD) be introduced to Uzbekistan. A technical BTN workshop on NMCR was held in June 2007, and a plan of action developed for pilot implementation. NMCRs started in 2007 in four pilot maternity units, and international experts reviewed them in 2008. The lessons learned were discussed at a workshop and the dissemination of NMCRs to other hospitals, and the introduction of CEMD at national level, was recommended. The Ministry of Health is leading the collaborative efforts of several partners to implement, disseminate and document the comprehensive strategic approach to improve maternal and perinatal health, supported by WHO technical expertise. Keywords PREGNANCY EVIDENCE-BASED MEDICINE PERINATAL CARE MATERNAL HEALTH UZBEKISTAN Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the WHO/Europe web site at http://www.euro.who.int/pubrequest. © World Health Organization 2008 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. 20/01/2009 i MPS activities in Uzbekistan Maternal mortality and morbidity audit – 2002–2008 Abbreviations AFT assessment and follow-up after training AGREE appraisal of guidelines for research and evaluation BCA biannual collaborative agreement BP blood pressure BTN beyond the numbers C/s Caesarean section CAH child and adolescent health CEMD Confidential Enquiry into Maternal Death CPS Country Policies and Systems (section of WHO Regional Office for Europe) EAPPC essential antenatal, perinatal and postpartum care EBM evidence-based medicine EBMN evidence-based mother and newborn ENC essential newborn care ENCBF essential newborn care and breastfeeding FCH family and community health GEM gender mainstreaming I/v intravenous IMPAC Integrated Management of Pregnancy and Childbirth MCH maternal and child
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