Inadequate medical care
Infant and maternal mortality rates in Ukraine are higher than in other eastern European countries. Ukraine is seeking to modernise its healthcare services but there is a lack of skills and expertise among health service providers and outdated practices continue to be applied. Hospitals also suffer from a shortage of equipment and medicines and too little continuity of care. Not enough emphasis is placed on prevention and patient education, and some people living in rural areas do not even have access to a hospital. The project to promote mother and child health encompasses 71 municipalities in Ukraine. In response to the current conflict, internally displaced families are also being integrated in the programme.
Perinatal offers and information services
A working group comprising Ukrainian and international specialists have developed new clinical practice guidelines based on scientific evidence to replace the previous centralised approach of the Ministry of Health. Newly-introduced management tools ensure that perinatal health services have improved. New standards for medical infrastructure have also been developed with most partner facilities now complying with modern perinatal norms.
Hospitals are being reorganised to allow easy access to the operating theatre from the delivery room. Considerable care is taken to provide the right equipment and ensure hygiene regulations are met. Antibiotics are given more frequently after Caesarean sections and an increasing number of newborns receive resuscitation and ventilation support. Priority is given to patients' well-being and less invasive clinical procedures are used.
An additional focus is on training for health service providers. For example, medical mannequins can be used to illustrate and practice delivery procedures.
Information services are also important. Specialists advise mothers on diet, exercise and breastfeeding. During their first antenatal consultations, all women receive a brochure on what to expect during pregnancy and later, they are given more information about the delivery itself. Partners are encouraged to take part during the delivery.
After her first child was born in the maternity department of the Gorokhiv central rayon hospital in Volyn, Yulia Vasylyk swore never to have another one. But that has changed. "We’ve got two boys. We just need a girl now.”
The Gorokhiv central rayon hospital was one of the first to take part in the programme to promote mother and child health in Ukraine in 2005. As a result, perinatal mortality in the Gorokhiv rayon decreased from 8.8% in 2004 to 3% in 2009.