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Top Priority in Uzbekistan: Healthy Generation
Doctors point out the improving health of the population and predict further growth of the indicators. An Uzbekistan Today reporter attempted to find out the truth about the statements.
A lot to work on
The positive dynamics was largely ensured by the national model of mother and child health protection ‘Healthy mother implies a healthy child’s. It covers all aspects of raising a healthy generation, ranging from shaping of the medical culture in the society, especially among young people, promotion of physical culture and sports, to the establishment of the cutting-edge specialized medical centers.
The results are obvious: maternal and infant mortality in Uzbekistan has fallen by more than three times for the years of independence, and the number of newborns with abnormalities has decreased by 1.3 times. Currently, 92% of children meet World Health Organization standards in their physical data.
Over the past decade, the incidence of acute infectious diseases among children aged 6-15 has decreased by 34.4%, pneumonia – by 49.7%, bronchitis - by 32.8%, scoliosis - by 32.7%. Some infectious diseases, like polio, have been even eradicated.
Doctors have been consistently implementing the national program the Year of Mother and Child Health and other previously approved social programs that contribute to the further improvement of mother and child protection. The work is divided into five major directions. The policy prioritizes the provision of a broad and equitable access to quality health services on strengthening of reproductive health of the population, protection of mother, child and adolescent health at all levels of healthcare, improvement of quality of medical and social rehabilitation of children with disabilities, improvement of health of children and adolescents with disabilities, and creation of appropriate conditions for their functional participation in the life of the society.
The capacity of health work power has been strengthened with the emphasis on specialists of rural medical centers, family clinics and district associations. The infrastructure of qualified, specialized and high-tech health care for mothers, children and adolescents has been developing as well.
The involvement of the population in the initiatives and programs on improvement of mother, newborn, child and adolescent care, promotion of advantages of healthy lifestyles, healthy and happy family is another important aspect.
Healthcare information systems have been streamlined. The authorities have ensured the coordination, monitoring and evaluation of inter-agency cooperation and action in strengthening reproductive health, especially with regard to mothers and children.
Available for everyone
The Ministry of Health has summed up the regular month’s rally in March under the motto ‘No One Left Behind!’ The campaign covered more than 200,000 residents with medical examination. Doctors of rural health units and family clinics, in collaboration with their colleagues from regional and national health facilities diagnosed, consulted, and referred to treatment. Women and children made up more than a half of the examined.
Monthly weeks for targeted rehabilitation of women of childbearing age, children and adolescents have been contributing in the recovery and reduction of incidence in women of childbearing age. The campaigns involve the leading specialists of national and regional institutions. More than 1 million mothers and children have received qualified medical assistance under the initiative since 2014.
A system of targeted health examinations promotes the effectiveness of the weeks. People consult with doctors at all stages of their life. Premarriage ranks among the most important phases. It allows the future spouses to plan their family, taking into account the health status of each of them, and undergo treatment if needed.
The program of the Year of Mother and Child Health attaches importance to the improvement of quality of coverage of the intending spouses with medical examination. It is planned to monitor the diagnosis of infectious and viral diseases, including tuberculosis, AIDS and STI pathologies.
The check-ups also pursue another goal. They provide the physicians with a reliable picture of the state of health of the population and help to plan preventive measures. The fight against the diseases caused by deficientcy of trace elements in the environment has been underway in Uzbekistan. Sales of table salt without iodine enrichment are prohibited, and the most consumed type of flour is enriched with iron and folic acid. Pregnant women in rural areas are provided with multivitamins, as funded by the national budget. It is expected that the program will cover over 400,000 women in 2016.
A major campaign on prevention of noncommunicable diseases has unfolded under the Health-3 project. Experts hope to achieve the goals through promoting of an active lifestyle and balanced diet. The project is piloted in settlements of Kashkadarya and Ferghana regions. Following the recommendations of doctors, residents and authorities will try to change their lifestyles, making it more favorable for the prevention and reduction of morbidity.
Vaccination has proved reliable in protecting against infectious diseases. According to the national calendar, 98% of children are vaccinated from 11 infections. The calendar is constantly expanding. For the past two years it was added with vaccines against rotavirus and pneumococcal disease. The introduction of a human papillomavirus vaccine has been scheduled for 2016. There are other programs too. A children’s de-worming project was launched a year ago, envisaging targeted examinations of children and free provision of related medications.
The care for pregnant women has been streamlined, as proved even by TV programs. TV channels produce programs under the national program the Year of Mother and Child Health, raising and discussing the relevant mother and child related issues like compliance with the recommended nutrition, quality and caloric food, promotion of regular sports among the youths, and particularly girls.
In partnership with physicians, journalists produce series of programs to advocate simple ways of improving maternal and child health. They tell about sanitary and hygienic norms and standards of healthy nutrition for pregnant women to follow as a pledge of a healthy baby. They clarify the basic principles and the usefulness of breast-feeding, and the need for immunizations.
The Ministry of Health has created a unified interactive web-portal promoting healthy lifestyles, introducing to reproductive, family, parent, child and adolescent health. The Institute of Health and Medical Statistics, in conjunction with mobile operators, has launched a project, which offers the subscribers of cellular networks to sign up to SMS messages with recommendations of doctors on healthy lifestyles. A subscriber can choose a topic to his interest.
The Namangan region is piloting a project on the introduction of home pregnancy card this year. The full data on the progress of pregnancy, as well as important information on prevention of complications will be registered in a specialized booklet. Experts anticipate that this practice would further reduce maternal and child mortality, and will be further expanded throughout the country.
At the screening center
The national budget allocates huge finds to strengthen the mother and child protection. The healthcare system has launched new areas of operation, including the service of mother and child screening.
Today, all pregnant women are covered by medical examination and ultrasound diagnosis yet from the early stages of pregnancy at the place of residence. In case of identified deviance, a patient is forwarded for in-depth examination at the screening centers.
A screening center was established in Karakalpakstan fourteen years ago. The effective performance of the innovation in Uzbekistan has entailed the decision on the establishment of similar institutions across the country. Along with the Republican Mother and Child Screening Center in Tashkent, they were established in all regions except for Tashkent region. Equipment is ready for installation, and the preparatory works in the building are nearing the completion.
Advanced diagnostic technologies in the mother and child screening system have significantly expanded the range of detectable diseases. For example, being the latest innovation in the global medical diagnostics, a tandem mass spectrometry method has been introduced in Uzbekistan for the last two years. A child’s blood stain can be examined for 46 metabolic disorders. The technology helps to clarify diagnoses in the heaviest patients of newborn departments of regional children's diversified centers and hospitals.
Early detection of deviations and pathologies allows doctors to take prompt preventive measures. It is worth noting that all the newborns registered in screening centers, receive free clinical nutrition.
All means for correction
Up-to-date and effective service of mother and child health protection is impossible without new medical technologies. This work was undertaken by the Republican Specialized Research Medical Center of Obstetrics and Gynecology, and the Republican Perinatal Center. As part of the State Health Reformation Program, adopted in 1997, maternity hospitals were the first to be equipped with up-to-date equipment. Regional perinatal hospitals were established under maternity hospitals to assist women with pregnancy complications.
Neonatal surgery is another new service for the country to save the newborn lives. Just a decade ago, such operations were performed only at the Republican Perinatal Center. Neonatal surgery departments have been opened at regional children's diversified centers in the Republic of Karakalpakstan, Andijan, Kashkadarya and Samarkand regions over the past two years.
In the current year, the Ministry of Health continues the introduction of advanced technologies of neonatal resuscitation. In conformity with international standards, Uzbekistan has started practicing the use of vitamin K for the prevention of hemorrhagic disease in newborns, which leads to increased risk of bleeding. The measure has empowered doctors to overcome the disease in almost all cases. The use of surfactant is another innovation. The medicine is essential for the prevention of respiratory distress syndrome in premature infants. Its pilot introduction will be carried out in a perinatal center in Tashkent.
At the present stage, the priority is given to the development of pediatric services. The reconstruction and overhaul of buildings of the Republican Specialized Research Medical Center of Pediatrics, Hospital of Tashkent Pediatric Medical Institute, regional children's diversified medical centers and children's departments of district medical associations is nearing the completion. The equipping is currently in progress. In the first instance, the high-tech equipment was installed in newborn departments at neonatal regional centers, which receive the newborns with poor health that are referred from perinatal centers. They are equipped with devices for the care of children with low weight and pathologies, pulmotors, and other facilities.
The Republican Specialized Research Medical Center of Pediatrics opened a department for children with congenital and acquired diseases of upper respiratory tract. The department performs cochlear implant surgeries, which rehabilitate hearing in children with certain forms of hearing loss. Doctors have treated more than 200 children.
Pediatric surgery has been entering the new level. Doctors are less likely to resort to the classic methods of vast incisions of soft tissue. Endovisual surgeries will soon be introduced in all regional children's diversified medical centers. A minimum of complications and a relatively small time of recovery rank among the major advantages of such operations.
The Ministry of Health has been working on new projects on introduction of high-performance technologies in the system of mother and child protection. 2016 marks the launch of the construction of the new children’s medical center of the fourth generation, which will treat children with the most severe diseases. It also announced the intention to build a high-tech medical facility for women in the coming years.