Preliminary results of the implementation of the WHO programme on safe motherhood in Eastern Kazakhstan

Abstract

Background: Since 2008 Kazakhstan implements the WHO program on safe motherhood and child health with the activities related to safe pregnancy, family planning and safe abortion services, introduction of youth friendly clinics, support, promotion of breastfeeding, and integrated management of childhood diseases. Objectives: To assess the current status of selected routines recommended by the WHO in the maternity clinics in Eastern Kazakhstan. Methods: This cross-sectional study was performed in the town of Semey, the second largest city of Eastern Kazakhstan region. The 'Tool to assess the quality of hospital care for mothers and newborns,' developed by the WHO Regional Office for Europe was used to assess the status of the selected outcomes during 2011-2012, i.e. at least 3 years after the implementation of the programme began. Altogether, 546 women in postnatal wards in all maternity clinics of Semey comprised the sample. Results: The mean age of women was 27.4 years. Forty-two percent were primiparas. Mean birthweight was 3455.4 g. All 100 % of infants had 'skin to skin' contact with the mothers immediately after birth. Mean number of antenatal visits to family clinics was 8.6. Five hundred and four women (92.4 %) reported that they did not get full information related to the childbirth and 515 (94.4 %) women were not informed on the principles of optimal breastfeeding during prenatal care. Only 42.1 % of the respondents used contraceptives while the rest were not aware of contraception, never applied it and could not distinguish between different methods and devices. Nearly a third of the responders (29.8 %) had medical abortions prior to the index pregnancy. Only 9.6 % of respondents reported that they received post-partum counseling on contraception. Conclusions: Counseling on breastfeeding and postpartum contraception should be improved in clinics of Semey. The results should be generalized with due caution because Semey is a more favorable place for childbirth compared to most other towns in Eastern Kazakhstan. The reasons for slow implementation of the WHO programme on safe motherhood in the region will be discussed.