The longstanding Ukraine-Swiss partnership started in 1997 and aims at supporting health sector reform and modernisation of health services in the area of Maternal and Child Health. Various succeeding projects with a focus on strengthening maternal and child health services have been planned and implemented with the Ministry of Health and local partners in the regions of Rivne, Donetsk, Volyn, Ivano-Frankivsk, Crimea and Vinnytsia.
Objectives and Aims
The Ukrainian-Swiss Mother and Child Health Programme had been designed to contribute to national reform efforts such as improvement and decentralization of perinatal care, introduction of new modern approaches to medical care provision, quality improvement of services, increasing of managerial skills and introduction of modern ICT technologies. The programme was oriented on the integrated perinatal care what means that not only medical aspects are in the scope of the Programme activities but as well managerial, ICT, HTM issues which are closely connected to perinatal health. Whereas the earlier project phases concentrated on the tertiary care level, the overall programme gradually shifted focus to secondary and primary levels while strengthening the referral system as a whole.
Methods / Approaches
The programme targets essentially the health of mothers, newborns and infants up to one year of age within a safe motherhood framework. Thus it takes into account that modern concepts of maternal and child health include a broad spectrum of health related services. The provisions of quality clinical services for pregnancy and childbirth as well as neonatal and infant care are important components. Moreover, efficient and good quality perinatal services that meet the needs of Ukrainian people require a well defined and managed health system and the availability of modern ICT tools. All these aspects were taken into account throughout the various reform efforts of the Ukrainian Ministry of Health to which the programme contributed. The focus had been on two main targets: a) to improve quality and efficiency of perinatal services; b) to support MCH reform efforts via regulatory and organizational measures.
Working on regional and national levels, the project achieved significant changes in clinical practices and health outcomes. Aggressive obstetrical practices inherited from the Soviet times, were gradually giving way to clinical procedures based on minimal invasion principles. Partner delivery and rooming-in were introduced in maternities and old ‘routine’, but not evidence-based procedures were abolished. Targeted interventions led to a de-medicalization of care and patient centred procedures. For example, CPAP became the first choice routine practice in case of breathing problems of newborn and prenatal corticosteroids in threat of preterm delivery are now routinely used.
Further, four centers of simulation-based medical training were established in the partner regions of Vinnytsia, Volyn, Ivano-Frankivsk, and Crimea.
The collaboration project improved key health outcomes in MCH field in Ukraine. For example, in partner regions, infant mortality decreased in 1.5-2.5 times, and the percent of physiological deliveries increased twice. On a country level, Ukraine declared the achievement of MDG 4 and 5 in the end of 2013.
Target group: Health service providers and health managers on rayon, oblast and national levels. Primary beneficiaries: Men and women of reproductive age, couples (or single mothers) who are expecting children, newborns and infants. Secondary beneficiaries: obstetricians, neonatologists, paediatricians, anaesthesiologists, nurses, midwives, technicians, administrative staff, local authorities.
Further lines of action / next steps
The Swiss support to the Ukrainian partners ended beginning 2016. Collaborative links still exist between partner organisations and Swiss TPH. In particular, the Swiss TPH continues to contribute to the newly established, annual postgraduate education and strategic planning event for Ukrainian health care managers, the ‘Summer School on Health Care Systems Transformation. sph.ukma.edu.ua/school/litnya-shkola/summer-school-health-care-systems-transformation-eastern-europe/
Guidelines, electronic tools and films are available for download (in English, Ukrainian and Russian): motherandchild.org.ua/