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NEW ERA FOR MOTHER AND INFANT HEALTH CARE PRACTICES IN UKRAINE

Kyiv – USAID Mission Director Earl Gast, Minister of Health of Ukraine Yuriy Polyachenko and TNK-BP Ukraine President Alexander Gorodetsky joined oblast health authorities and representatives of well-known international organizations on January 30, 2006, for the First National Dissemination Conference, which focused on international evidence-based maternal and infant health care technologies.  The purpose of the Conference was to introduce leading principles of effective perinatal practices and achievements of the Mother and Infant Health Project (MIHP) as well as to present a 2006-2110 national roll-out plan for most of the oblasts of Ukraine.

The roll-out in Ukraine of effective evidence-based maternal and infant health practices as developed by the World Health Organization became possible due to the outstanding successes of MIHP in eight pilot oblasts, including Volyn, Lviv, Poltava, Zhytomyr, Kyiv, Donetsk, Kirovohrad and Crimea. 

The new extended four-year project will be launched in partnership with TNK-BP Ukraine, a private company supporting this initiative. USAID is pursuing this new business model with many projects to collaborate with the private sector and leverage limited resources to gain the most impact in Ukraine. USAID and TNK-BP Ukraine recently signed a Memorandum of Understanding and Cooperation at a ceremony hosted by Ukraine’s Minister of Health Polyachenko. This begins the first multi-million dollar public-private partnership between USAID/Kyiv and a private company. It will also be the first partnership of such kind for TNK-BP Group, which is reinforcing corporate social responsibility model in its engagement with communities.” The parties committed themselves to working together to introduce effective, internationally accepted, evidence-based perinatal technologies for health providers and promoting effective curricula at health establishments in selected oblasts of Ukraine. USAID and TNK-BP will select the oblasts in cooperation with the Ministry of Health. USAID will contribute $6 million and TNK-BP Ukraine $1.2 million to this effort.  The project will begin in Luhansk oblast in early 2006.

John Snow, Inc, (JSI) a Boston-based organization dedicated to improving the health of individuals worldwide, will continue to implement MIHP in Ukraine. The project was first initiated in September 2002 in four oblasts of Ukraine, and has now expanded to eight pilot oblasts and 16 benefiting maternity hospitals. JSI provides training for health professionals and some life-saving equipment to facilitate effective evidence-based perinatal services. The project has already accounted for a 30% reduction in infant mortality, virtually eliminated hypothermia among newborns, and reduced child abandonment in all participating sites. In addition, while maternal mortality has been increasing in Ukraine, not a single maternal death has taken place in all 16 maternities supported by the project. Moreover, 15 health care authorities across the country have requested to participate in the project, and the Government of Ukraine issued a decree that successful MIHP practices be rolled-out nationally. 

USAID MISSION DIRECTOR LEARNS ABOUT SUCCESSFUL BIRTHING AND INFANT CARE EXPERIENCE AT DONETSK MATERNITY #3

November 17, 2005 Donetsk - Earl Gast , USAID Mission Director visited Donetsk Maternity N.3 on as a part of his working visit to Donetsk . During the visit , Earl Gast was b riefed about the successful implementation of effective evidence-based perinatal technologies and practices implemented by USAID Mother and Infant Health Project . He also toured individual delivery rooms and met with in-patient postpartum mothers and babies , and their relatives. Medical staff (midwives , nurses , OB/GYNs , neonatologists) explained new World Health Organization birth practices of perinatal care MIHP is implementing. These include: family deliveries , “warm chain” practices , the use of the partogram , rooming-in and free visits of relatives in post-partum department.

A USAID-funded four-year Mother and Infant Health Project (MIHP) is implemented in eight oblasts - Donetsk , Lutsk , Lviv , Crimean Republic , Kirovohrad , Zhytomyr , Poltava (city of Komsomolsk) and Kyiv. It aims t o improve the reproductive health conditions of Ukrainian women by introduction of effective perinatal technologies. The project is implemented by John Snow , Inc. (JSI) , in cooperation with Academy of Educational Development ( AED ).

MIHP aims to provide a full cycle of effective evidence-based antenatal , perinatal , postpartum and infant care in its pilot oblasts with further roll-out nation-wide. Through close cooperation with the Ukrainian Ministry of Health of Ukraine , the project will develop standards of care and clinical guidelines/protocols for maternal and infant health services and practices. The project also seeks to: 1) revise maternal and infant health curricula at the Institute of Higher Medical Education; 2) reinforce evidence-based practices of family medicine practitioners to become first-line contacts for timely diagnosis and referral of general mother to child HIV transmission; and 3) increase public awareness on healthy lifestyles by promoting improved maternal and infant health.

MIHP achievements in Donetsk Maternity Hospital N.3 since 2002 include: an increase in normal deliveries (from 22% to 68%); an increase in companion presence during birthing (from zero to 80%); a decrease in number of C-sections (from 37% to 17%); conversion of all delivery rooms into individual ones (from 0 in 2003 to 6 today); and a decrease of hypothermia (from 59% to 0%);

The results of a cost study survey conducted by MIHP this year show that Donetsk Maternity N.3 saved around $45 , 000 in 2005 after reduction of unnecessary (sometimes harmful) non-evidence-based medical interventions in birthing practices.

Lutsk Maternity Inspires Ukrainian Regions to Effective Birthing Practices

August 26, 2005    In July 2005 during the MIHP coordinators meeting in Kiev Dr. Nadezhda Zhilka, Deputy of MCH Department of the Ministry of Health of Ukraine was impressed by “Maternal and Infant Health Project” (MIHP) poster presentation sessions and the achievements of the Project sites that she requested some of the posters to be displayed at internal MOH general meeting conducted the following day. Presentation of MIHP results during the meeting at MOH was of great interest of all Ukrainian oblasts' MCH department heads that Dr. Nikolay Polishik, the Minister of Health of Ukraine decided to conduct an extended MOH meeting in Volyn Oblasts with tour in Lutsk maternity (one of the MIHP sites).

The meeting entitled “Innovative Technologies in Maternal and Infant Healthcare” was held on 26 August 2005 in Lutsk maternity and led by the Minister. There were all heads from 24 oblasts' Health Departments and heads of MCH departments as well as Sevastopol , Kiev and Autonomous Republic of Crimea. All participants were split in 3 groups for the tour in the maternity. Dr. Nina Zagrebelna, head of the maternity and MIHP local Coordinator while showing maternity premises answered numerous questions asked by the delegations. The visitors were impressed not only by the excellent data of the maternity but also by baby-father skin-to-skin contacts after C-section, counseling techniques of health care providers, free position of women during labor and delivery, family delivery, free visits of relatives to post-partum department etc…After the tour about the maternity was finished Dr. Mikhail Makarenko, The Chief Ob/Gyn of Kiev said to Dr. Zagrebelna: “To my amazement I didn't expect that all your staff is working in friendly, family-like atmosphere as one team where women and their relatives who come to deliver is a part of it. ”

After Lunch there was a meeting at Volyn State Administration where the Minister thanked USAID for giving opportunity to implement “Mother and Infant Health Project” and said: “I would expect every region of Ukraine to come close to the achievements of Lutsk maternity within 6-8 month”.

A week later the Minister issued an Order on the results of the visit of Lutsk maternity where he indicated that Maternal and Infant Healthcare is a priority in Ukraine and all innovative effective perinatal technologies should be implemented nation-wide. He also stated that the results of implementation of effective perinatal technologies in Volyn, Zhotomir and Donetsk oblasts are to be recognized as positive. Dr. Polischuk requested from all Heads of Oblasts' Health Departments to create the possibility to study the experience of Lutsk , Zhitomir and Donetsk maternities.

The delegation is visiting birth-preparation class in Lutsk outpatient women's clinic

Also in his Order the Minister stated: “Within years 2005-2006 to organize rooming-in, individual and family-centered delivery rooms in birth-giving inpatient clinics. The functioning of birth-giving clinics will not be considered expedient without such conditions. ” ( 26 Aug, 2005 , Lutsk ).