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The IntraHealth International-led Tajikistan Health & Nutrition Activity (THNA) has achieved a major landmark in the country’s approach to improving the quality of its maternal health care. THNA’s in-depth assessments of 14 hospital maternity wards and six primary care centers mark the first significant assessment of hospitals in the country.
Tajikistan is the poorest country in central Asia, and health care for pregnant women, mothers, and newborns is inadequate. Using an assessment protocol established by the World Health Organization, THNA experts and specialists from Tajikistan's Scientific Research Institute of Obstetrics, Gynecology (SRIOG) worked to:
With field work in May and analysis in June, the team was challenged to reconcile significant discrepancies between the real and the reported situation. Official reports, it appears, are "optimized to meet the national requirements"—for example, facilities reported that 100% of newborns received all four elements of essential care, in compliance with the national requirement, but interviews with clients and medical personnel during the assessment revealed that this is not the case.
Working in teams of six, the assessors observed clinical procedures, interviewed staff and clients, audited records, and inventoried equipment for a complete picture of maternity care operations.
On aggregate, the findings are bleak. As a group, the maternity wards are chronically understaffed, underequipped, short on most medical supplies, and suffer from poor quality control and managerial oversight. In brief:
That said, the health facility staff members are generally motivated to learn and eager to work with THNA to enhance their knowledge and skills.
THNA will use this assessment to identify the specific assistance required at each facility. This assessment is the starting point for long-term support and will form the baseline for facility progress over the coming four years.
By Jon Thiele. The Feed the Future Tajikistan Health and Nutrition Activity is funded by the US Agency for International Development.
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