In order to improve the health of pregnant women, mothers, and children and to achieve the Millennium Development Goals, MCH is of major concern for Kyrgyz Health Reforms and one of the four key priority areas of the current reform programme.
To improve perinatal and paediatric emergency services, a 10-year perinatal care programme was introduced for the period 2008-2017. The programme is based on the introduction of a system of regionalisation of perinatal care.
In the framework of German Financial Cooperation with the Kyrgyz Republic the German Government has provided support to the enhancement of Mother and Child Health (MCH) since 1995. After completion of three consecutive phases of the programme focused on the improvement of MCH services at rayon hospitals countrywide, a new program (“MCH IV+V”) was launched in January 2014 to establish a tertiary level Perinatal Centre as part of the National Centre for Motherhood and Childhood (NCMC) in Bishkek.
To ensure that quality health care is provided at each level of care and to optimise the capacity of the service facilities at each level, the German Ministry for Economic Cooperation and Development via the KfW Development Bank has committed funds for a the following activities
- Establishment of a second perinatal tertiary care centre in Osh in the South
- Upgrading of secondary level perinatal and paediatric services in four Northern oblasts
- Upgrading of the National Centre for Motherhood and Childhood building
Scope of Work
m4h had been engaged to conduct the feasibility study by exploring the following areas:
- Assessing the current situation of perinatal and emergency paediatric services in the Northern oblasts of Chui, Issykul, Naryn and Talas, and for the perinatal centre in Bishkek considering existing capabilities of the health system and health facility network;
- Developing an integrated referral concept for secondary-level perinatal and paediatric emergency care that considers the referral system within the oblasts as well as the referral system between oblasts and the central tertiary level at the NCMC in Bishkek.
- Developing a Master Plan and Hospital Development Plans (HDPs) for secondary-level perinatal and paediatric emergency care services in the target Northern oblasts of Chui, Issykul, Naryn and Talas, centred around the oblast capitals and encompassing the service demand within the whole oblast; propose support measures for capacity building to improve the referral system, service quality, facility management, as well as hospital hygiene and waste management.
- Developing a Master Plan for infrastructure development and service provision for the old block of the tertiary-level NCMC in Bishkek not covered under the ongoing ‘MCH IV and V’ programme: civil works for construction and rehabilitation, procurement of medical and non-medical equipment.
Likely requisites for successful referral systems include; a referral strategy informed by the assessment of population needs and health system capabilities, an adequately resourced referral facility, active collaboration with referral levels and across sectors, formalised communication and transport arrangements, setting specific protocols for referrer and receiver, affordable service costs, provider performance accountability and capacity to monitor effectiveness and overlying all these a strong policy support.