Perinatal Care Referral System Study

Donor organization: 
GIZ (German Agency for International Cooperation)
Start of Project: 
End of Project: 
Value of service: 
€ 776,880
Partner Organisations: 
Description of Project: 

The module “Promoting perinatal health in Kyrgyzstan” is part of the German Development Cooperation Programme “Health in Kyrgyzstan” and aims to improve access to basic health services based on international standards and financed on a sustainable basis for all population groups and genders, especially in rural areas.
The consortium EPOS Health Management and Evaplan had been awarded the contract for implementation of the assignment “Promoting Perinatal Health: Improvement of the management processes of the clinical services”.

The objective of the intervention is to improve the quality of services for integrated care for pregnant women and new-borns in the 5 pilot regions. To achieve its objective the programme works in three fields of activity:
Human resources development and planning,
Quality management, and
Strengthening the integration of perinatal care systems.
The services rendered by the consortium correspond to output 2: “Management, processes or support processes of selected facilities in the 5 pilot programme regions have been improved”.

Although quality is high on the political agenda, there is no dedicated structure within the Ministry of Health (MoH) to lead this agenda, as the quality unit was closed during reorganization of the MoH in 2017 and quality assumed under the responsibility of the Department of Health Care Organization and Drug Licensing. There are also plans to create a national quality centre.
While almost all components for an effective national programme for quality management in perinatal care are present in Kyrgyzstan, they are still fragmented, with little coordination, feedback and learning across the system.  Quality is driven by top-down command, external inspection and mandatory committees at the facility level; rather than being inherent in the work of clinical teams or embedded in training and continuing professional development. Thus, while formal mechanisms are in place, the lack of coordination and cooperation leads to missing learning opportunities inherent in quality improvement (QI) process.

Description of Services: 

The consortium provides two pools of specialized short-term experts, and a manager for managing these pools and to organize and facilitate two major workshops.
The following services are provided:
Demand-driven support to quality improvement processes in health care organisations
Development of clinical skills related to quality improvement objectives in obstetric and perinatal care
in order to improve the management and processes of 13 second-level health facilities in the 5 programme regions Bishkek, Chuy, Issyk-Kul, Naryn and Osh.

Key activities are:
Developing a demand driven quality improvement approach, with standard indicators for perinatal/ obstetric quality assurance, with stocktaking and conceptual work.
Establishing quality committees in health care organisations and supporting the preparation of QI plans; providing capacity development of staff to ensure quality improvement in perinatal/obstetric care based on international standards (including LNOB principles) and corresponding indicators.
Support the implementation of QI plans and strengthening the performance of quality improvement units through technical advice, on-the-job training, mentoring and coaching
Contributing to the development of a national quality approach to perinatal care based on the stocktaking exercise and lessons learned from implementation.

Project Volume: 
€ 996,000