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Maternal and child healthcare: quality matters

TASHKENT, Uzbekistan, 16 April 2010. – Maternity clinics in eight regions will now be able to continuously assess their day-to-day actions to make them more effective. The new tool at their disposal - called “The Quality of Hospital Care for Mothers and Newborn Babies” - will now help them track progress on using effective perinatal technologies.

This assessment tool has been originally developed by WHO and brings international standards for maternal and child healthcare to more than 20 countries. With WHO’s technical support, the Ministry of Health of Uzbekistan has recently adapted it to the country situation. With UNICEF’s assistance, the tool has been introduced in three maternity hospitals of Tashkent, Samarkand and Djizzak and a pilot team of assessors trained.

The quality assessment tool consists of check lists and questionnaires that cover the key areas of hospital care for mothers and newborns in an integrated manner. Various information gathering techniques help assess a maternity hospital against different performance indicators. Conditions in delivery rooms and maternity wards, equipment and drug availability, organization of services and case management, treatment methods, patients’ feedback – there are many factors that come into play to assess the overall quality of care at a given hospital. Scoring is done on a three point scale. The highest score – 3 is an indication that this facility meets required standards, while 2 means there is a need for improvement.

“This tool is very much action oriented and calls for our attention to the areas that need strengthening. It also encourages our staff to think, reflect, and act upon, as they get engaged in a continuous process of self-assessment,” says Adelina Lyubchich, director of the Republican Perinatal Centre in Tashkent. Her facility was evaluated among the first just two months ago and received 2.6. “It was a real learning experience. As soon as we got the final report, we reviewed its findings and drew a long “to-do list”. By using the quality assessment tool, we get a clear idea what needs to be improved and how.”

Introduction of the Continuous Quality Improvement (CQI) system in Uzbekistan is an integral part of the “Improvement of Mother and Child Health Services” Project, which is implemented by the Ministry of Health with UNICEF’s technical support and funding from EU.

The project focuses on long-term interventions, such as adoption of international standards and clinical guidelines, training of medical professionals, so that the health sector could introduce and sustain positive changes over time. The quality improvement assessment tool is thus one of the essential means to monitor the project’s impact and ensure that health facilities and their staff follow new policies and standards on maternal and child care.