Assessment of Selected Best Practices for Maternal and Newborn Care in Albania, Armenia, Georgia, and Russia

This report describes the results of a four-country assessment, funded by the US Agency for International Development (USAID), of high-impact maternal and newborn childbirth practices in the Europe and Eurasia (E&E) region. Conducted between October 2010 and August 2011 in 42 maternities in Albania, Armenia, Georgia, and Russia, the assessment examined the quality of high-impact childbirth and early post-partum maternal-newborn practices in sampled facilities, including the status of cross-cutting health system functions and provider and client attitudes, knowledge, and self-reported practices. The study provides a multi-perspective look at the quality of maternal- newborn care currently provided and as perceived by clients, with an eye toward assessing areas of strength and areas needing improvement.

The assessment found evidence for solid coverage of many best practices in the sampled maternities. Measured results are undoubtedly in part attributable to high stakeholder investment in the region, including by USAID, and most importantly are reflected in the decreasing maternal and neonatal mortality rates. However, despite the narrowing of the maternal and newborn mortality gap between E&E countries and their richer neighbors, the persistently higher rates of maternal and newborn mortality in the region demonstrate a need to hold and expand the gains, with a focus on areas of demonstrated service delivery weakness for high-burden conditions. Moreover, the legacy of highly specialized and medicalized care even for routine, uncomplicated deliveries remains strong in the region yet represents a care model that is unlikely to be cost-effective over the long-term.

Recommendations in the final section of this report focus on closing the gap between known best practices and observed practices for high mortality and morbidity maternal and neonatal conditions. Based on assessment findings, we provide specific recommendations to improve care in five areas: 1) labor, delivery, and immediate post-partum care; 2) early post-partum care; 3) complications care; 4) client-centered best practices; and 5) health system recommendations to improve care delivery.  
Report Author(s): 
Hill K | Chitashvili T | Trevitt J | Panajyan G | Korotkova A
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