Making Pregnancy Safer in Uzbekistan. Maternal mortality and morbidity audit. Activity report, 2002–2008
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.