142nd APHA Annual Meeting and Exposition

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303416
Implementing perinatal care regionalization program to improve maternal and newborn health outcomes in Georgia

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Ekaterine Pestvenidze, MD, MS , USAID SUSTAIN Project, John Snow Inc., Tbilisi, Georgia
Maternal and infant morbidity and mortality represent major public health issue worldwide. Regionalization of perinatal care system emerged in last decades as an ideal model of health care delivery to decrease perinatal morbidity and mortality.  USAID funded JSI SUSTAIN project in collaboration with Ministry of Health initiated perinatal care regionalization program in Georgia with aim to improve poor maternal-infant health outcomes through establishing risk-appropriate care.

The program implementation process went through three major steps:

  • Developing criteria for level I, II, III obstetric and neonatal care;
  • Assessment of capacity of currently operating facilities according to developed indicators of levels of care;
  • Assigning levels of care to each facility based on their individual capacity.

All 96 facilities providing neonatal and obstetric care throughout the country went through detailed assessment process. The results documented inappropriate provision of perinatal care services in the country.  Out of 96 operational facilities, 55 (57%) correspond to level I care, 16 (16%) to level II care, 3(3%) to level III care, while 19 (20%) are below any levels of care.  75% of level II facilities are accumulated in capital of Georgia, while in the rest of the country level I facilities with very limited capacity are predominant. The assessment process also revealed inadequate distribution of human and technical resources, deficiencies in transportation and referral system.

Based on assessment results adequate recommendations were provided to the Ministry of Health and optimal model of perinatal care regionalization had been developed and proposed to the Minister for implementation.

Learning Areas:

Program planning
Provision of health care to the public

Learning Objectives:
Describe the steps for implementing the perinatal care regionalization program. Discuss the nationwide assessment of perinatal care facilities as a strategy for identifying the capacity and assigning the levels of care to the facilities accordingly

Keyword(s): Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a senior technical expert, MD, MPH, Deputy Chief of Party and activity manager I was directly involved in planning and implementing the perinatal care regionalization program in the country. In close collaboration with Ministry of Health I worked on defining the levels of perinatal care, planned and supervised implementation of nationwide assessment of perinatal care facilities and assigning the levels of care to the facilities based on their individual capacity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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