Capacity building of anesthesia and intensive

care services in obstetricsDinara Mambetalieva,National MCH Center

Bishkek - 2015

Safe Motherhood PrinciplesHuman life is pricelessSafe Motherhood is a human rightAll women have guaranteed access to

Emergency Obstetric Care (EmOC)Ensured skilled attendance at delivery

(Mother-Baby Package: Implementing safe motherhood in countries. Practical guide.

WHO Geneva, 1996).

JUSTIFICATION:High rates of maternal mortality in KRNon-adequate and delayed Emergency Obstetric CareAbsence of effective and evidence based technologies and

practices in provision of EmOC

APPROACH:Innovative idea using experience and knowledge of

Uzbekistan due to common history, culture, language and common challenges in health system

Development of clinical and practical skills and team approach

Improvement of continuous medical education in Emergency Obstetrics

Main activitiesAssessment of clinical and organizational bottlenecks in

EmOC jointly with Uzbek colleaguesStudy Tours to Uzbekistan and LithuaniaDevelopment, approval and introduction of the 1st Clinical

protocol on anesthesia and intensive care in EmOCDevelopment of 5-day training module on EmOC in for

continuous education and retrainingClinical and practical training at national level jointly with

regional and international experts (more than 200 doctors trained)

On-the-job training and mentoring at oblast level

Results (1)Care of critical conditions in

obstetrics (pre-eclampsy, hemorrhage, sepsis) is according to approved clinical protocol;

Wide application of spinal anesthesia in obstetrics;

Team of national trainers and supervisor/mentors on EmOC is built, cascade trainings

Commitment and contribution of managers of health organizations on EmOC (equipment, training, provision of drugs) is increased

Results (2)EmOC training module is integrated in continuous

medical education (KSMIRCE);Training Center under National MCH Center is

established and equipped with dummies and training equipment;

Regional experience and international expertise has increased the role and the status of anesthesiologists and intensive care doctors of Kyrgyzstan;

ChallengesFurther capacity building of the professional

association of anesthesiologists and intensive care doctors in KR (organizational development, task share in training and mentoring, regional exchange)

Institutionalization of EmOC programmes (ToT, equipping of Simulation Labs, motivation)

National System of Monitoring and Mentoring in EmOC (human and financial resources/potentials)

Future perspectives Introduction of training programmes and provision of

master-classes on EmOC for anesthesiologists, intensive care and obstetric doctors at national level

Active involvement of the professional association of anesthesiologists and intensive care doctors in development of:

- New clinical guidelines and adaptation of EmOC standards for tertiary level of care;

- Quality management system using monitoring and mentoring tools;

- Standards for referral of pregnant women under critical condition to the Perinatal Center

Thank you!