Maternal and child health as government policy priority

Improvement of maternal and child health, and of family in general, in accordance with the Healthy Mother - Healthy Child principle, is one of the priorities inherent in the current national program of the Year of Family. Since it started to be implemented, numerous universal measures to bolster reproductive health have been raised to a qualitatively new level. There are also new initiatives underway designed to prove instrumental in consolidating the nation\'s gene pool.

In the course of development

The national organization of maternal and child healthcare has undergone significant changes and transformation since 1998, the year when the government program on reforming the healthcare system was introduced. The previously ineffective health facilities were replaced with new modern medical institutions, catering to the requirements of our times. These new ones then have regularly been upgraded. They are the premises where various effective measures are executed on a constant basis. As a result, during the years of independence, the country’s maternal and infant mortality was reduced nearly threefold. The number of children born with congenital abnormalities has also been diminishing. All this is the major outcome of the efforts being undertaken by the Ministry of Health of Uzbekistan in cooperation with the World Health Organization, UNICEF, UNFPA, Fund Forum, the Social Initiatives Support Fund, Mehr Nuri Fund, the Women\'s Council Republican Public Association, the Soghlom Avlod Uchun (For Healthy Generation) Foundation and many other public and international organizations.

A set of measures aimed at boosting maternal and child healthcare and uplifting its effects is being implemented nowadays as part of the Year of Family program. Thus, the Republican Mother and Child Screening Center has been devising a new method for diagnosing hereditary diseases - the tandem mass spectrometer. The technology enables doctors to reveal with high accuracy several genetic diseases through analyzing newborn’s dry bloodstain. The strategic program to combat helminthiasis among children is being developed too. The children who have been in contact with an infected person are provided with anti-tuberculosis drugs in order to prevent the tuberculosis.

The traditional and popular medical actions have risen to a new level of organization and implementation. Talks about healthy eating become more frequent. It is needed to reduce the consumption of fatty food and to increase fruits and vegetables in daily diet. Experimental program School Milk, in which students receive free milk, covers 44 secondary schools. Medical examinations of people living in remote settlements became better and more regular. The program has been continuing to select children with various heavy diseases for being treated abroad. Those children whose diseases are still incurable in the country receive free treatment in foreign clinics. Programs designed to improve the health of children in local health centers and camps are reinforcing. Many children health centers and camps have been repaired and reconstructed during this year.

Without any doubt, every one of the fifteen measures prescribed in the state program the Year of Family, and designed to improve maternal and child health, helps to achieve the principal goals of the national healthcare system, namely, to fortify the nation\'s gene pool and foster a comprehensively advanced generation. In what quality has the national system of reproductive health entered this critical period of its development? The UT have attempted to look for answers to this question.

Family as a social institution

Over the past 10-15 years, the system of institutions of maternal and child health reached new heights on absolutely all spheres of medical service. It is remarkable that the transformation of medical institutions is not just about changing the signboards, but mainly about dramatic changes in the organization of their activities, thereby improving the efficiency and quality of health care.

The institutions of primary care, where patients feeling unwell normally go to consult a doctor, were moved to general practice. The term general practice is a synonym of the worldwide called notion family medicine. Primary medical service of rural areas was the first to move to this principle of work. The program plans to bring cities’ clinics to general practice in 2015. In general practice there is no division of the specialists on the pediatricians and therapists; children and adults are treated by a general practitioner. And that is right. At least from the point of view, that the health of all family members is interconnected and thereby it is impossible to organize an effective medical cure when there is no complete picture of family’s health. General practitioners are also working to promote the healthy lifestyle among the population, and propagate knowledge on parturition and upbringing a healthy baby.

The country has established a network of screening and perinatal centers. These institutions work together to provide assistance to the families with high risk of having an infant with abnormalities. Today, there are screening centers in every region except the Tashkent region and the capital itself. The population, there, is serviced by the Republican Screening Center. Every year, thousands of families get quality medical care in the centers, including diagnosis and preventive treatment. Perinatal centers are the obstetric centers that are specializing in providing medical services to women that have pregnancies with abnormality or bear a high risk of having children with poor health. The perinatal centers have strong resuscitation departments, so the chances of the favorable outcome even in the most difficult cases are increased many times.

The project Boosting the Health of Mothers and Children implemented by the Ministry of Health in cooperation with the Asian Development Bank has made an invaluable contribution to the development of obstetric institutions. Over the past years, under this project, the country\'s all maternity hospitals have upgraded themselves with modern medical equipment that allows them to provide medical assistance which corresponds to the recommendations of the World Health Organization.

Today, all the efforts on strengthening the material-technical base of the system of protecting motherhood and childhood are aimed at the development of the Republican Specialized Scientific-Practical Medical Centers of Obstetrics, Gynecology and Pediatrics, created in 2008, and on further development of the regional diversified children\'s medical centers. They should raise specialized high-tech based medical service in maternal and child health as well as in the reproductive health to a qualitatively new level. Construction is going on today at the territory of many of these medical institutions. New medical equipment is being bought for them.

Priority to prevention

A popular wisdom goes that prevention is preferable to treatment. The notion that child\'s health begins from the healthy parents is also accurate, to be sure. These postulates explain why the preventive measures in the country aimed at strengthening the reproductive health, maternal and child health are comprehensive in scope.

Implementation of practical measures is going on simultaneously with promoting healthy lifestyles, the foundations of creating a healthy and strong family, and making healthy children.

For several years the country has a good tradition to hold monthly health weeks for the women of childbearing age, children and adolescent girls. These events make it so the doctors come to the inhabitants of rural areas to conduct medical examinations on the ground, instead of peoples counseling to the senior staff at the regional and national hospitals. The recent examinations have expanded the target audience and now they already cover the entire population. The health weeks became a good addition to the compulsory medical examination of students of secondary schools and those who is going to marry. This allows doctors to detect diseases at early stages. Such state of things greatly improves the treatment results.

Particular attention is paid to women\'s health. In recent years, the country has deployed large-scale activities to combat women\'s cancers, which are among the first causes of death of our mothers, wives and sisters. Fund Forum’s marathon has become a traditional event. Funds raised in the framework of the campaign are being spent on examination and treatment of the woman. It is also important that the action helps to ensure that women pay more attention to their health. Republican Specialized Center of Obstetrics and Gynecology, in cooperation with the international organization League of doctors, launched a range of measures to combat cervical cancer. The set of measures includes the vaccination of adolescent girls and preventive examinations of women at specifically opened screening centers of cervical cancer.

The implemented set of measures on nutrition improvement and measures to prevent micronutrient deficiency among the population also contributed to the reduction of morbidity and birth of sick children.

Today, all pregnant women from rural areas get multivitamin complexes. 1,410,100 US dollars was spent this year alone, on saturating the market with the fortified flour and the iodized salt.

Another $80,000 went to the program of vitamin A supplementation of children under 5.

National immunization schedule is an integral part of the national system of maternal and child health. The country has created all conditions so every child can receive protection through vaccination against vaccine-preventable diseases according to this calendar.

Ministry of Health seeks to ensure through extensive outreach the full coverage of children with the immunization procedures.

Scientific reinforcement

The domestic system of maternal and child health has sufficiently strong scientific base. It develops new methods of diagnostics and treatment; it adapts them to local conditions and introduces advanced developments of foreign scientists. This year, the Committee for Coordination of Science and Technology announced 203 topics which will be researched by the leading specialists of the institutions of the Ministry of Health during the upcoming years. The studies are paid by the state budget. More than 12 billion were provided on these projects.

Nearly one quarter of them is aimed at solving problems directly related to improving the health quality of mothers and children.

Virtually all research topics of the coming years are aimed at finding new efficient methods for prevention, early diagnosis and treatment of diseases. By this way the Ministry of Health explains the great attention paid in the country to the problems of mothers and children health. Since health begins from the moment of conception.

For example, the Department of ENT-Diseases of Tashkent Medical Academy under the leadership of PhD in Medical Sciences Gafhar Haydarova, implements a project aimed at the introduction of early diagnosis of hearing impairment among newborn infants. The scientists plan to introduce into the domestic practice the technologies that make possible the detection of hearing impairment among infants on the third day after their birth. Early detection of hearing impairment means that you can choose the most progressive treatment strategy and enables to reduce the number of new cases of disability among children. Under the project, all the newborns in the maternity complex at Tashkent Medical Academy are being surveyed by this new technique. These researches will give estimates and recommendations that will allow doctors to implement this method into a broader national health care practice.

According to the Ministry of Health, in tackling topical issues related to the improvement of the technologies used in maternal and child health service, beside the specialists of the Tashkent Medical Academy the specialists from other medical institution are engaged too. It is talked about the specialists of Tashkent Pediatric Medical Institute and its Nukus branch, Republican Scientific Practical Center of Medical and Pediatric Surgery and its Samarqand branch, National Research and Practical Medical Center of Obstetrics and Gynecology, National Rehabilitation Center for Children with Abnormalities of the Locomotor System, Tashkent Institute of Advanced Medical Studies and National Center for Reproductive Health. (Source: “Uzbekistan Today” newspaper)