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Improving day care for children

JOMBOY, Samarkand region, 10 May 2010. – “It’s a challenging but fulfilling job. I’m always among people and keep in close touch with families. I feel important and useful as I’m helping their kids grow healthy,” says Muborak Tursunkulova, 38, patronage nurse from the "Tut" village medical point.

She is one of the primary health workers from Samarkand region, who went to five-day training on mother and child care last year. It was organized by the Samarkand Multi-Profile Medical Centre with UNICEF support.

Muborak has been working for the "Tut" medical point since its opening in 2005. It serves five villages where almost six thousand people live. Children under the age of 14 make up one third of the local population. Out of that, more than 500 are children under five.

In the mornings she helps a paediatrician receive patients. Then she goes to families with children. There are 74 families which she sees at least once a week or more often if needed.

“Many families have become accustomed to my visits and wait for me,” smiles Muborak.

Bridging the gap

Village medical points, commonly known as SVPs, are a new type of facilities that have been established in Uzbekistan within a large scale health reform. Scattered all over the country, the 3,000 SVPs are meant to bring proper and affordable medical care closer to rural populations.
In recent years, the Government also made strides to staff and furnish the SVPs with modern equipment. Yet, would-be patients continued to head towards big district clinics instead of using services available at a door step. Building trust of the communities they served turned out to be a more difficult task. It required more than just funding. Better skilled and knowledgeable health workers would make a real difference.

Capacity building of medical staff at all levels, including SVPs, is one of the ways UNICEF is helping the Government of Uzbekistan to improve the quality of mother and child healthcare. Last year, several thousand maternal and child health workers were trained within the project on Improvement of Mother and Child Health Services funded by EU and implemented by the Ministry of Health and UNICEF.

New knowledge, new skills

The new setup of primary care also put additional responsibilities to patronage nurses like Muborak. They are not just doctors’ assistants who help monitor the status and living conditions of pregnant women or children and can provide timely medical assistance. Educating families to prevent and detect childhood illnesses at an early stage has become an important part of their job

Muborak shows the handbook "If you want your child to be healthy" that she received after last year’s training.

“With this manual, it is much easier now to guide families on the issues concerning child development or health. I also give them a mother’s card where they can find useful information and basic tips on childcare. For example, mothers often didn’t not know what to do if their child got diarrhea. Some might even decide to put him or her on a diet or stop giving fruits – believing that will only worsen the situation,” recalls Murobak.

The family of Sojida Jumanova is one of the families that patronage nurse Muborak Tursunkulova visits regularly. With two small children - Sevinch, 4, and Nazarbek, 18 months, Sojida is one of the mothers who is benefiting  from accessible  primary care..

© UNICEF Uzbekistan/2010/Pirozzi

Muborak also says before some young mothers used to complaint about the inconveniences they faced when breastfeeding a baby. Now they know that they just need to properly place a child.

“People are becoming more careful of the health of their children. I see that mothers I had talked to followed my advice: the number of diarrhea cases in our territory is decreasing,” she adds.

“Muborak-opa is a very nice and energetic person. I’ve learned a lot from her, especially on child nutrition, though completed a medical college,” says Sojida Jumanova, 26. She lives in the same village where the “Tut” health point is located. With two small children - Sevinch, 4, and Nazarbek, 18 months, she is one of the mothers who have benefited from improved primary care. “Now we shouldn’t go far away from home and the whole family can be served in one place”.