Safe Motherhood InitiativeSafe Motherhood Initiative
Georgia Safe Motherhood Initiative (SMI) project was funded by U.S. Agency for International Development (USAID) and implemented by Management Sciences for Health (MSH) in partnership with Curatio International Foundation, Program for Appropriate Technology (PATH), and Emory University. The duration of the project was September 2000 – January 2003.
The purpose of the SMI activity was to improve maternal and infant health in Georgia through strengthening of integrated maternal and perinatal health services. The project assessed the quality of perinatal services provided and began to support the transformation of the existing system of women’s care into a more integrated and effective one. This had to result in the delivery of continuous, high quality, and patient oriented services, and in increased women’s awareness of the importance of perinatal care for themselves and their child’s health. The project directed its activities toward the regional and local level. This strategy fully supported the Ministry of Labour, Health and Social Protection policy of strengthening primary health care.
Main components of the project:
Management and information system development;
Community Mobilization and Provider-Client Interactions;
Enhancement of maternal and perinatal clinical performance;
STD/Anemia Prevalence Study
Major Achievements:
Enhancement of maternal and perinatal clinical performance
SMI project supported development of the National Maternal and Perinatal Clinical Guidelines, which addressed clinical, as well as organizational issues of perinatal services. Twenty nine leading Georgian specialists in the field of Obstetrics/Gynecology, Pediatrics, and Health Care Managers worked over the course of nine months to produce this document. This team was supported by two US experts, who provided comments and valuable literature. Significant time and resources were devoted by the project to consensus building efforts that helped to inspire the thinking of national level experts and program managers to develop and agree on guidelines that call for new organization of perinatal services and that propose new approaches in clinical aspects of case management. The Guidelines were tailored to the Georgian reality, and they were evidence-based and, where applicable, comparable to International standards. The training materials were developed based on Maternal and Perinatal Clinical Guidelines. The package contains manuals both, for trainees and trainers. The training was designed to upgrade the knowledge and clinical skills of the Primary Health Care providers, including their acquisition of counseling skills in order to educate their clients on defined topics of Maternal/Infant health and care. Seventeen National experts from diverse fields (General Practitioners, Obstetricians, Pediatricians, and Counselors) worked on the development of the clinical training materials. A smaller number of experts was involved in actual provider training process in the project targeted areas. The target audience for the training was Obstetricians/Gynecologists, Pediatricians, Internists, Nurse/Midwifes. A total of hundred and ten members of the Primary Heath Care providing system benefited from this effort.
STD/Anemia prevalence study
Objectives of the study were:
Estimate the prevalence rates of five specific STDs and anemia in non-high risk sexually active women;
Provide essential data for monitoring trends and impact of STDs and anemia in order to carry out adequate policy development for the prevention and control programs;
Strengthen technical capacity of local epidemiological, laboratory, and clinical based study investigators.
The study was conducted by the local experts group, with technical support from CDC consultants. Laboratory tests were performed by local laboratories in Georgia. A total of thousand women were investigated.
First time since its independence (in 1991), Georgia obtained invaluable data on prevalence rates of STDs and anemia among non-high risk population, which enabled the country to consider the results of the research for the purpose of creating clinical guidelines, formulating policy, and updating clinical practice/protocol.
The SMI for Georgia paid significant attention to the health system components (financing, continuity of care, the workforce, community participation, and public health functions). From the beginning of the project, service deficiencies were identified and activities were planned for their resolution.
During the project implementation stage, the management approach ensured the empowerment of national/local governments, NGOs, professional groups, and communities. Continuing dialogue between the Georgian and US experts helped to tailor technical inputs to the specific needs of Georgians, rather than proposing ready-made solutions. The latter approach assured national ownership of the program results, which could serve as a guarantee for sustainability and replication to other areas.
The processes described above required significant staff attention and careful management of financial resources. Continuous on- the- ground presence of local project management helped ensure the attainment of the intended results.
r the CEE/CIS commissioned this Multi-Country Evaluation, as one of a series of such exercises, to a) document progress in reducing under-5 and infant mortality and morbidity and to generate lessons on how this was accomplished; b) inform programs aimed at scaling-up evidence-based and equity-focused interventions; and c) enable better partnering with national governments to advance the child health and rights agenda.