Mother and Child Health Programme

Seeking of ICT specialists

Swiss-Ukrainian MCH Programme is seeking specialists for collaboration in the field of ICT in health institutions from partner Oblasts (Vinnytsya, Volyn, Ivano-Frankivsk and Crimea). Details are provided in Ukrainian.
 

Increasing access to up to date medical information

On December 22, 2011 the National Scientific Medical Library hosted a gathering of key stakeholders involved in the reform of perinatal care services in Ukraine. The event was organized by Mother and Child Health Program (MCHP) to present and share a series of training modules on select topics in obstetrics and neonatology as well as the use of telemedicine in clinical practice. The training materials were developed and published in the previous project phase and distributed among the four partner regions of Ukraine – Crimea, Ivano-Frankivsk, Vinnytsya and Volyn.
This time the project’s publications were donated to the Institute of Reproductive Health which is comprised of four departments of obstetrics and gynecology of the National Medical Academy of Post Graduate Education, the Academy’s Department of Neonatology and the Department of Medical Information. “The Project responds to the needs of the Ministry of Health and the medical schools but what is much more important, it responds to the needs of medical practitioners who are keen on learning”, said Professor Yuri Voronenko, the Rector of National Medical Academy of Post Graduate Education.
“Among many projects it is this very Programme that made the most significant contribution in the development of maternal child health services in Ukraine, said Professor Nina Goida, Vice Rector of NMAPE. Its importance and impact is enormous. The principles of regionalization of services was introduced in Ukraine thanks to the Swiss Programme ” added Nina Goida.
The National Project “New Life” also received MCHP publications . The “New Life” Project was launched as a Presidential initiative in 2010 with the goal to set up a network of 27 perinatal centers in Ukraine to provide high quality tertiary level care. The donation of books is another step within the overall framework of collaboration between MCHP and “New Life” Project. “We strive to become a reliable partner because we understand what we gain from joining efforts with other projects, said Victor Sirman, the Head of the “New Life” Project. “We need up to date approaches, tools and practices which international projects bring to Ukraine. We have already worked with Swiss Mother and Child Health Programme to introduce OpenMedis. Today I can say that every perinatal center to be opened will have and will use this tool for equipment maintenance and procurement. And we know that the renovated walls and equipped rooms are not a cure themselves, we need skilled health care providers to treat patients that is why we are very pleased to receive these books from the MCHP”, wrapped up his speech Dr. Sirman.
Mother and Child Health Project is also joining the efforts with the National Scientific Medical Library to distribute the Programme’s publications within the network of medical libraries across Ukraine.

MCH Programme's publications

Communication before official part

Books handover to New Life Project
 

Pictures of the Conference "Multiple pregnancy"

“Technical support”

Before opening the Conference

In between sessions

Presentation by I. Matvienko

Presentation by I. Blickstein

Answers to questions during master-class provided by MCHP trainers

Conference on Multiple Pregnancy

On December 15-16, 2011 an international conference on Multiple Pregnancy was held at Kyiv National Academy of Post Graduate Education (NMAPE).
The Conference was organized by the NMAPE, Ministry of Health of Ukraine and Swiss-Ukrainian Mother and Child Health Programme (MCHP). Conference agenda was designed based mainly upon the training module on Multiple Pregnancy developed by the working group within MCHP in the previous project phase. Among the conference presenters were perinatal practitioners from Ukraine, Belgium, Germany and Israel. In their presentations the speakers shared the latest advances in diagnostics and management of uncomplicated and complicated multiple pregnancy, addressed the issues of neonatal care and postnatal outcomes. The Conference participants were also very glad to receive e-module on Multiple Pregnancy developed by MCHP working group in the previous phase.
Nearly 200 perinatal practitioners and medical faculty from all regions of Ukraine gathered in Kyiv to attend the conference. For the first time in Ukraine the on-line conference participation was also made possible. Due to collaborative effort of Mother and Child Health Programme and Kyiv National Academy of Post Graduate Education over 500 people from 91 locations received on-line access to the conference. Some participated individually while several Medical Universities organized on-line group sessions, for example, 117 participants in Odessa, 104 in Donetsk and 30 in Dnipropetrovsk.
The feedback from both “live” and on-line participants was very positive. “This has been the best Conference of this kind. And the idea of on-line participation was absolutely fantastic!, said Yevhenii Petrenko, an obstetrician from Dnipropetrovsk.
“Great that the Conference was dedicated to multiple pregnancy. We are getting more and more of these cases but there is no clinical protocol. At this conference I learned a lot and what is really important – I can use it in my practice. I’m so glad that I’m here!” said one of the Conference participants during the coffee break. (Чудово, що конференція присвячена саме темі багатоплодової вагітності. Маємо в практиці все більше таких жінок, але клінічного протоколу з цього питання нема. А на цій конференцій отримав надзвичайно багато нових і, головне, практичних знань. Дуже радий, що приїхав!)
“The Conference content is very interesting. Even though we participated in the training on Multiple Pregnancy during the previous project phase, the conference format provided additional information and also offered an opportunity to network with the colleagues. I’m very grateful to the Maternal Child Health Project for supporting my participation in the conference”, said Larissa Zadvornykh-Sashko, an obstetrician/gynecologist from Ratno central rayon hospital, Volyn region.

Pictures of the Conference you may find here...

Ukrainian-Swiss MCH Programme’s publications contribute to the development of post-diploma education of the Ukrainian health professionals

eLearning manuals such as: “Normal delivery”, “Multiple pregnancy”, “ CPAP as method of newborn's respiratory support” which were developed during the previous Programme phase are very popular among Ukrainian doctors.
Due to MoH of Ukraine recommendations these manuals are widely used in post-diploma education institutions.
Coordinator of the working group on the development of eLearning manuals was Mr. V. Krasnov, associate professor of medical informatics department, National Medical Academy of Post-Diploma Education named after P.Shupyk.
On December 2, 2011 Mr. V. Krasnov defended his doctoral thesis on the following topic: “Development of information display system of the knowledge transfer processes in post-diploma education”. One of the main resolved tasks in his work was “development of methodological basis for eLearning manuals in post-diploma education”. Mr. V. Krasnov was awarded the degree of Doctor of Medical Science.

Thus, scientific and organizational and methodological basis has been created in Ukraine which would allow significantly improving the quality of eLearning manuals development.
On behalf of the Programme we sincerely congratulate Mr. V. Krasnov with his award and hope for future collaboration in the field of constant professional development of doctors.
 

Upcoming events of the Ukraine-Swiss MCH Programme:

• Clinical trainings in Ivano Frankivsk (November 28-30, 2011) and Vinnytsya (December 7-9, 2011)
• National Conference on Multiple Pregnancy (Kyiv, December 15-16, 2011)
• Infection Control Training in Ivano-Frankivsk (January 30 – February 1, 2012)
• Training for Regional Monitoring Teams (January/February 2012)

 

First online session of the Programme’s event

On November 22, 2011 in the frames of MCH Programme the Master class on local protocols development took place in Symferopol, Crimea.
Master-class for heads of departments (obstetricians and neonatologists) of Crimean health facilities was held by prof. D. Dobryanskiy. At the same time due to Programme’s collaboration with National Medical Academy of Post-Diploma Education there was held an internet-based master-class broadcast. Health professionals from other regions distantly joined the master-class. Among of them there were representatives from Volyn (Lutsk Maternity hospital, Ratno central rayon hospital, Horokhiv central rayon hospital and Kovel maternity hospital), Vinnytsya (Kalynivka central rayon hospital and Mohyliv-Podilskiy territorial medical center) and Ivano-Frankivsk perinatal center.
The Programme is planning to use online broadcasting in its further training sessions.
 

Workshop on concepts and management tools brought together head physicians from central rayon and city hospitals

A workshop for head physicians from 71 rayon and city hospitals who joined the project in Phase II was held on November 21-25, 2011.
Simferopol hosted Crimean and a number of Vinnytsa participants. Ivano Frankivsk, Volyn and the other half of Vinnitsa rayons and cities gathered in Ivano-Frankivsk. The 1st Day of the workshop provided and overview of management tools and instruments developed by the MCHP in the previous phase, outlined key components of Perinatal Services regionalization, presented Perinatal Service Package and addressed the issue of development & implementation of the local protocols. The 2nd Day introduced modern management principles and management models, emphasized the leadership principles and focused on process and outcome measurement. The 3rd Day was dedicated to ICT tools such as iPath telemedicine platform in clinical practice, perinatal registry & OpenMedis.
Also, within the workshop in Simferopol three other important events took place:

• Presentation of MCHP at Crimean workshop for authorities and donors (21st of November).
• Master class for Crimean doctors on how to develop local clinical protocols (22nd of November).
• Signage of MoU with MCHP by head physicians (22nd of November).

 

Presentation of Prof. D. Dobryanskiy,
Symferopol, November 21, 2011.

Head of healthcare department of Ivano-Frankivsk Regional State Administration
joined the workshop, Ivano-Frankivsk, November 23, 2011.

Group work, Symferopol, November 22, 2011.

Manfred Zahorka, SCIH expert is answering the questions of participants,
Symferopol, November 22, 2011.

Regional teams meeting

MCHP Coordination Board meeting was held on November 9-10, 2011.
Four Regional teams who form the core members of the Board met in Kyiv to finalize Regional Plans and review the implementation status of the regional activities. The meeting was opened by Svitlana Ostashko, Head of Maternal Child Department of the Ministry of Health of Ukraine and Guido Beltrani, Director of Swiss Cooperation Office. Martin Raab, Project Leader from Swiss Center of International Health, Swiss Tropical and Public Health Institute, participated in the meeting. The meeting served as a platform to share and discuss challenges and opportunities, exchange opinions and agree on the next steps and strategies to reach the set goals.
 

Opening of Coordination Board meeting

Regional teams are working on regional programmes

Presentation of the group work results

Programme implementation supported by MoH Decree

On November 8, 2011 the Ministry of Health signed the Decree on the implementation of Swiss-Ukrainian Mother and Child Health Program. The full text of Decree can be found here…

Building up clinical human capacity in the regions

In October Mother and Child Health program supported trainings for health practitioners of Crimea and Vinnytsya oblast.

• On October 24-26, 2011, sixty nine practitioners – obstetricians and neonatologists – from 23 Crimean rayon and city central hospitals participated in the clinical training on Multiple pregnancy and Stabilization of newborn before transportation. The training was conducted by a team of national and local trainers and was hosted by Crimean State Medical University. Ten faculty members from Obstetrical and Neonatal Departments of the University joined the training as observers.
• In Vinnytsya oblast thirty obstetricians, epidemiologists and nurses from new partner rayon and city hospitals as well as oblast health facilities came together for a training on Infection Control. The training was held on October 24-26, 2011 and introduced participants to WHO practices on how to reduce hospital infections as well as link those practices to the MoH Decree on Infection Control (#234), provided practical recommendations on infection control improvements for maternity hospitals and wards.
   

Group of neonatologists, Crimea, October, 2011

Group work on situation tasks solution, Crimea, October, 2011

Experience exchange as a key factor in professional development

In autumn 2011 Ukrainian health professionals took part in several International Conferences, such as: Perinatal Conference in Moldova and Pediatric Congress in Germany.
Due to MCH Programme’s support Ukrainian specialists from national level health facilities and partner oblasts of the Programme could take part in the above mentioned events. At the Conference “Perinatal Medicine” which took place in Kishinev, Moldova, the representatives from Ukraine not only gained an important experience, but made their reports based on 3 training materials, developed within MCH Programme. Other participants of the Conference showed their interest in English training materials of the Programme which were distributed during the Conference.

Report of T. Bondarenko on Respiratory support of newborns (Moldova)

The Annual International Congress of European Association of Pediatricians and Neonatologists took place on November 2-5, 2011 in Hanover, Germany. The high quality presentations from the professional point of view as well as some topics on which working group is currently working were very interesting for Ukrainian participants. Information learned during the Congress would be used in the development of clinical protocols, training materials, etc.

Note: Reports and feedback of the participants of the above mentioned events could be obtained from PIO.

Swiss-Ukrainian Mother and Child Health Programme signed a Memorandum of Understanding

Swiss-Ukrainian Mother and Child Health Programme signed a Memorandum of Understanding with the Council of Ministers of the Autonomous Republic of Crimea on October 7, 2011. The Memorandum was signed within the framework of the 2nd International Black Sea Economic Forum which main goal is to promote the social and economic development of Crimea. Further information is given here... (Available in Russian only!)

SDC team visited Volyn

SDC team headed by Guido Beltrani, newly appointed Director of SDC office in Ukraine, traveled to Volyn on September 28-29 to meet Mother and Child Health Programme partners and learn more about project results and impact from Phase I as well as discuss expectations and plans for Phase II.

Happy mother and her baby in Horokhiv CRH

Clinical training on multiple pregnancy and newborn stabilization and transportation in Volyn

On September 28-30, 2011, clinical training on multiple pregnancy and newborn stabilization and transportation took place in Lutsk city hospital, Volyn. 27 obstetricians/gynecologists, 26 neonatologists and 10 pediatric nurses and midwifes from 11 Volyn rayon hospitals participated in the training that was conducted by a team of international, national and regional trainers. The agenda was designed to allow on site practical skills training and also introduced new project partners to a number of critical topics in management of multiple pregnancies and sick newborns.

Participants of the training

Working groups on content development began their work

Working groups (WG) on content development established by the Swiss-Ukrainian Mother and Child Health Programme began their work in September. The WG on neonatology met to define the priority content areas and agreed on the following: neonatal primary resuscitation, transportation protocol, qualification (and educational) standards for neonatologists, e-guide on calculation of parenteral nutrition need, and informational materials for parents of sick/preterm/LWB newborns. Swiss-Ukrainian Mother and Child Health Programme also joined efforts with USAID funded MIHP implemented by JSI to collaboratively develop a manual on Antenatal care. The first WG meeting was hosted by JSI office to agree on the manual content and distribute responsibilities among WG members. The next meeting will be hosted by Swiss-Ukrainian Mother and Child Health Programme in October. The WG on the ANC for family physicians met to approve the content and the structure of the manual. The WG experts will meet again at the end of October to review the chapters that are being drafted now.

Preparation to ICT implementation in partner Oblasts

On September 14-15, 2011, four Regional ICT Officers took part in the ICT workshop which was conducted with the participation of international experts Marc Blunier, Claudio Zaugg and Goncalo Castro. The ICT tools available for dissemination were introduced, technical issues and implementation strategies were discussed. Participants also shared and reviewed available baseline data related to ICT component implementation in the partner regions. As a next step, Sensitization Workshop on ICT tools for health care managers will take place in November.

Moderators and participants of the workshop

Introduction of modern perinatal technologies to new partners

On September 5-16, 2011, obstetricians/gynecologists, neonatologists, midwives, and nurses from Vinnitsa and Ivano-Frankivsk oblasts participated in the training on Effective Perinatal Care organized by the Swiss-Ukrainian Mother and Child Health Programme. 44 participants from Vinnitsa and 40 from Ivano-Frankivsk oblast represented new rayon hospitals that joined the project in Phase II. Intensive 12 day training course exposed participants to a variety of topics on safe motherhood and effective perinatal care including both management of normal pregnancy, labor and delivery as well as integration of HIV PMTCT and management of infections and complications in pregnancy, childbirth and postpartum. Trainings were hosted by the medical facilities so the participants had an opportunity to receive practical skills in addition to theory classes.

Training session during workshop

Conference 'Multiple pregnancy: from diagnostics until birth'

International Conference  'Multiple pregnancy: from diagnostics until birth' will take place on December 15-16, 2011 in Kyiv. All details are given on Ukrainian page.

Situation analysis as a basis for decisions making and acting

First monitoring missions to new partner sites of the Programme allowed to finalize situation the analysis and strategic planning in region.

Situation analysis in each region is an important element of strategic planning not only for the Programme implementation but also for effective functioning of perinatal services in hospitals, rayons and regions. In the frame of the Programme implementation situation analysis includes both – data collection and monitoring missions to selected rayons. In July data collection process was completed, particularly, general information about site/ rayon/ region, information about medical equipment and infrastructure, key statistical indicators.

During first two weeks of August the Programme experts teams visited several rayon’s of Vinnytsya and Volyn regions. For second half of August missions to rayons of Crimea and Ivano-Frankivsk are planned.

Missions are based at the formative supervision approaches which Programme always stresses on and uses. According to the methodology and guides of these missions, the delivery departments were visited, discussions with medical staff and questioning of woman recently confined took place. Regional teams and senior specialists were actively involved in the monitoring missions as well. Results of missions were presented to oblast and rayon leadership and authority representatives in order to involve them actively into the perinatal care development in their regions.
 

The team of experts Mother and Child Health Program,
representatives of Vinnitsa OHA and staff of Nemiriv CRH
during a quality assessment of the delivery department

MCH Registry training

On 9-10 August, 2011 the training on MCH Registry took place in Volyn Oblast. According to the Programme implementation plan there were selected 2 health institutions of Volyn Oblast for the MCH Registry piloting: Lutsk Maternity Hospital and Ratno Central Rayon Hospital. 20 doctors from Lutsk Maternity Hospital and 20 doctors from Ratno Central Rayon Hospital participated in the training. They are obstetricians and neonatologists.

The training was provided by SCIH expert, Goncalo Castro, with the support of Ukrainian ICT specialists, Ihor Shchaviy and Vitaliy Moroz. During the training the participants had not only theoretical sessions on the concept, structure and functions of MCH Registry software, but also practical sessions to work with the software. According to agreed plans the MCH Registry piloting starts on August 15, 2011 and will last for 6 months. During the piloting the electronic database of pregnant women who visited antenatal clinic for the first time will be created.

 

After the piloting there will be provided analysis of the collected data. If the results of the piloting will be successful the MCH Registry will be scaled up to all Rayons of Volyn Oblast.
 

Partner regions got acquainted with new phase of the Programme

During June 7-15, 2011 in all Programme’s partner regions there were held initializing workshops devoted to the new phase of the Swiss-Ukrainian MCH Programme.
The programme of the visit to each region covered 3 main tasks:
• formation of the regional team responsible for the Programme implementation;
• presentation of strategies, activities and allocation of responsibilities in the new phase of the Programme;
• Conclusion of the Memorandum about collaboration between representatives of Oblast and Rayon authority, chief doctors of the partner hospitals and Programme.

Фото. Workshop participants.

It should be noted that thanks to the strong support of local partners in the organization of visits, the tasks were successfully achieved. Success during the visits was achieved by the interest and direct participation in the workshops of deputy heads of Oblast administrations and chiefs of Oblast healthcare administrations and Minister of Health of the Crimea.

Photo. The authorities of each region participated in the workshops.
Photo. Signing of Collaboration Memorandum.

The next step is the formation of the regional programs and plans aimed at reconciling the goals and purposes of the Programme to local needs and priorities. Planning at the local level will find the most effective approaches to Programme implementation and to achieve optimal distribution of responsibilities in each region.
 

Partner regions got acquainted with new phase of the Programme

During June 7-15, 2011 in all Programme’s partner regions there were held initializing workshops devoted to the new phase of the Swiss-Ukrainian MCH Programme.
The programme of the visit to each region covered 3 main tasks:
• formation of the regional team responsible for the Programme implementation;
• presentation of strategies, activities and allocation of responsibilities in the new phase of the Programme;
• Conclusion of the Memorandum about collaboration between representatives of Oblast and Rayon authority, chief doctors of the partner hospitals and Programme.

Workshop participants

It should be noted that thanks to the strong support of local partners in the organization of visits, the tasks were successfully achieved. Success during the visits was achieved by the interest and direct participation in the workshops of deputy heads of Oblast administrations and chiefs of Oblast healthcare administrations and Minister of Health of the Crimea.

The authorities of each region participated in the workshops

Signing of Collaboration Memorandum

The next step is the formation of the regional programs and plans aimed at reconciling the goals and purposes of the Programme to local needs and priorities. Planning at the local level will find the most effective approaches to Programme implementation and to achieve optimal distribution of responsibilities in each region.
 

Service package approach has been recognized on the national level

Minister of health, Prof I. Yemets, has signed the decree # 204 “On approval and implementation of Exemplary list of services of perinatal care on the levels of provision” on 13th of April 2011.
“List of services of perinatal care” is the achievement of working group that developed “perinatal service package” in the frame of Programme. This managerial tool defines the responsibilities of primary and secondary levels and, thus, contributes into regionalization of perinatal care.
More details on the gained experience on “service package” development and results of work could be found in the joint report and book “How to improve perinatal care in Ukraine?”. The MoH decree # 204 with annexes could be downloaded here.
The recognition of “List of services of perinatal care” affirms that MoH moves to modern approaches on standardization of medical care. Programme management thanks to all partners involved into development, piloting and approval of document for their contribution and support.
Programme will continue to support MoH in the development of documents needed for the improvement of perinatal care quality.

Summing-up Programme’s experience: how to improve perinatal care

The Programme’s experience is presented in new publication “How to improve perinatal care in Ukraine?”.
This publication represents the summary of the Ukrainian-Swiss MCH Programme implementation experience during 2008-2010. Prepared by a wide group of authors, it contains an objective analysis of the situation in the perinatal field in Ukraine as well as the description of the desired result, which can be achieved by following the developed guidelines. An important feature of the publication is to present those difficulties and obstacles that may arise on the way of change. According to the authors, this will facilitate a more realistic view of the situation.
Significant illustrations and a list of various annexes (provided on CD) makes the publication more useful, interesting and valuable.
The authors believe that the publication "How to improve perinatal care in Ukraine " is useful to health managers at various levels, workers of different NGOs and projects, students and teachers.
Electronic version you can download here. For hard copy of the publication with the CD you can contact PIO.

Perinatal Registry was presented in the International Conference

Perinatal registry developed in the frames of the Ukrainian-Swiss MCH Programme was presented at VII International Conference ‘Telemedicine – experience and prospects’ on March 23, 2011 in Donetsk.
The Programme’s experience on the registry development was presented by Ukrainian consultant V. Moroz. The presentation and abstract were commonly prepared by Swiss experts and Ukrainian specialists. The presentation was provided within “eHealth. Medical electronic records workflow” session.
The participants of the Conference from different Oblasts of Ukraine showed their interest in the prenatal registry. According to their general opinion the main advantage of the registry is its adaptation capabilities as well as this product is open source.

Official website of the Conference is http://telemed.org.ua/pages/conference/program.html

Presentation and abstract reported at the Conference you may find here…

Perinatal registry development is finishing

Working group meeting on perinatal registry took place on April 1, 2011 in Lutsk.
The meeting was supported by Swiss experts: Goncalo Castro, Claudio Zaugg, SCIH and Ukrainian consultants: Ihor Shchaviy and Vitaliy Moroz. The main objectives of the meeting were:
- presentation of the current version of perinatal registry software;
- recommendations and remarks of the working group members to the current software version;
- presentation of data security measurements implemented in the software;
- discussion of the perinatal registry software piloting;
- definition of the steps to be taken on regulatory process.

The total number of the participants of the meeting was 25 persons including specialists on MCH field from the Programme’s pilot institutions of Volyn Oblast.

Presentation during the meeting

The main result of the meeting was the development of further plan which includes software improvement according to the working group members’ recommendations, software registration with State Registry of Ukraine and piloting.

Collaboration with New Life Project (NLP): practical steps

On March 28-30, 2011 first training for the regions which participate in NLP took place in Crimea provided by Programme’s experts.
SCIH experts Claudio Zaugg and Goncalo Castro provided 3 days training devoted to presentation of ICT tools developed within Ukrainian-Swiss MCH Programme’s activity: telemedicine, eLearning and perinatal registry. Besides, they trained participants on how to use openMEDIS the software for medical assets inventory.
Materials from "Health Technology Management" module were used in openMEDIS presentation to the participants.
Among 30 participants there were managers, clinicians and service engineers from 8 Oblasts of Ukraine: Crimea, Dnipropetrovsk, Donetsk, Zhytomyr, Kirovograd and others as well as representatives from the Institute of Pediatrics, Obstetrics and Gynecology and OHMATDYT.

Practical work: data collection for openMEDIS

The main achievements of the training are:
• Managers and clinicians got acquainted with ICT tools implemented by the Programme and showed their interest in using them;
• Clinicians and medical engineers mastered the inventory software OpenMEDIS and expressed their wiliness and readiness to further use of this tool in their institutions.

The results of the training were presented at the meeting in Kyiv on March 31, 2011. The participants of the meeting were:
- N. Zhylka, Head of NLP;
- I. Chibisova, Chief Specialist
- A. Dumcheva, WHO National Bureau Coordinator;
- O. Sherstiuk, National UNICEF Office Coordinator;
- Claudio Zaugg and Goncalo Castro, SCIH.

Discussion before the meeting

Besides the training results, the participants discussed further prospects and steps of efficient OpenMEDIS usage within NLP. During the discussion there were developed some recommendations on possible openMEDIS improvement and its successful implementation.
 

eLearning materials and telemedicine in a Post Diploma Education in Ukraine

In the frames of Ukrainian-Swiss MCH Programme there were prepared and printed the following publications:

1. Voronenko Y., et al. Standartization of approaches to the development of e-learning modules. – Medical informatics and engineering. – Kyiv, 2009. – #2. – p. 4-21.
2. Krasnov V. Principles of development of educational descriptive models of curative process. – Medical informatics and engineering. – Kyiv, 2010. – #2. – p. 39-43.
3. Krasnov V. Development of system for interpretation of medical standards by e-technologies. – Medical and biological informatics and cybernetics: 1st All-Ukrainian congress with international participation, 23-26 of June, 2010: thesis collection. – Kyiv, 2010. – p.110.

1. Act of adoption of e-module “Management of normal delivery” issued by Obstetrics and Perinatology Dept. of Post-diploma Faculty of Lugansk State Medical University.
2. Act of adoption of e-module “Management of normal delivery” issued by Obstetrics Faculty of Bukovina State Medical University; 14.02.2011.
 

Official approval of e-module “Multiple pregnancy”

Main methodological and educational dept. of MoH has officially recommended the using of e-learning module “Multiple pregnancy” in the system of post-graduated medical education in Ukraine (protocol # 1 from 17.03.2011).
The e-learning module has been developed by working group in the frame of the Programme during 2010. The working group consisted of representatives from leading medical universities: NMAPE, Ivano-Frankivsk University, Vinnytsia University.
The content of module is based on obstetrical training materials developed by working group in the frame of Programme. The materials were also officially approved by Scientific Board of NMAPE and recommended by MoH.

For the time being, the e-learning module is recorded on CD and nowadays the distribution has been started among partner hospitals, medical universities and medical libraries.

Modern knowledge will be accessible to obstetricians and neonatologists of Ukraine

Constant professional development is becoming a requirement to medical specialists in Ukraine. This international approach was always supported by Ukrainian-Swiss Mother and Child Health Programme.
Therefore, in the frame of current Programme’s phase there were developed a set of modern training materials including electronic textbooks (read more…). All materials were reviewed by Ukrainian and International experts as well as approved and recommended by key Ukrainian institutions.
Thus, the final aim is to make all those training materials to be accessible to obstetricians and neonatologists of Ukraine. It will improve perinatal care especially in difficult situations. That’s why in the frame of the Programme’s activity there were printed and distributed all publications, among of them are:

		1) “Multiple pregnancy” textbook (for teachers and students) 2) “Pregnancy and delivery in women with a scar on uterus and after C-section” text book (for teachers and students) 3) “Respiratory support of newborns” textbook (for teachers and students) 4) “Stabilization of newborn before transportation and support during transportation” (for teachers and students)
		5) “Multiple pregnancy” elearning textbook 6) “CPAP as a method of respiratory therapy of newborns” elearning textbook

 

Currently we began distribution of textbooks. First recipients were the authors and reviewers of the materials. The textbooks are being sent to all Oblast medical libraries and post diploma faculties of medical universities. Some of the textbooks will be used in the trainings of medical stuff in partner Oblasts as well as in the collaboration with ‘New Life Project’.

It is important to mention that all training materials which were created within Ukrainian-Swiss MCH Programme could be used in the cycles of thematic courses. For instance Obstetrics and Neonatology Department of Ivano-Frankivsk National Medical University is actively using the materials of “Multiple pregnancy” textbook for teaching purposes.

Further development of perinatal care

A Sensitization Conference of the Swiss-Ukrainian Mother and Child Health Programme took place on 18 March 2011 in Kyiv. Among the participants of the Conference were:

- Manuel Etter, Director of Swiss Cooperation Office Ukraine;
- Martin Raab, Leader of the Programme, Swiss Tropical and Public Health Institute;
- O. Dudina, Head of MCH department of the Public Institution “Ukrainian institute of strategic researches of the MoH of Ukraine”;
- Y.Shunko, Head of neonatology department of NMAPE;
- A.Dumcheva, medical advisor on family and community health of the WHO bureau;
- representatives of institutions of higher medical education of Ukraine and partner regions of the Programme.

Objective of the Conference was to present the strategy of the next Programme phase, aimed at dissemination and sustainability of the Programme’s elaborated materials. The Programme’s leader and stuff outlined the fundamental principles of further collaboration, namely:

• dissemination of the Programme’s experience to all rayons of the partner regions, which means coverage of 71 rayon;
• active involvement of partners of the national level, first of all, the MoH of Ukraine, as well as institutions of higher medical education, in implementation of the Programme;
• ensuring sustainability and national dissemination of the chosen Programme’s “products”, e.g.: textbooks, software, etc.;
• an increase of the local partners’ responsibility for implementation of the Programme;
• main areas of activity: enhanced professional potential of medical stuff, elaboration of new clinical materials (manuals, clinical protocols), dissemination of up-to-date informational and managerial tools.

During the discussion of presented approaches it became clear that the Programme’s strategy coincides with the vision of partners of the national level. At the same time, there appeared a lot of interesting ideas during the discussion, which could be realized in the next phase.
Particularly, professor Y.Shunko raised a question of establishing a dialogue between a doctor and a patient. It concerned, first of all, development of informational materials for parents on specific conditions and development of newborns, as well as recommendations for medical personnel how to provide information for parents about the newborn’s condition (in particular, sick newborn’s).
Representatives of the Crimea AR also emphasized the importance of solving bioethical questions in provision of perinatal care in Ukraine. One of the urgent – and among the most complex – is the question of defining standards of starting and finishing resuscitation measures or intensive therapy in newborns with provision of proper maintaining care for them, in particular, peculiarities of primary resuscitation in extremely premature infants.
A result of the Conference may be regarded to be the participants’ common decision: after the official beginning of the new phase, the Programme’s management will send to the Conference participants an official invitation for collaboration in working groups. Formed working groups will define the final subject area and structure of materials and\or activities.

Photoarchive of the event you may find here...

How to improve perinatal care in Ukraine? (part 1)

Achievements Review Conference of the Swiss-Ukrainian Mother and Child Health Programme 2008-2010 took place on 17 March 2011. Among participants of the Conference were:

- Oleksandr Anishchenko, Senior Deputy Minister of Health;
- Georg Zubler, the Swiss Ambassador to Ukraine;
- Manuel Etter, Director of Swiss Cooperation Office Ukraine;
- Martin Raab, Leader of the Programme, the Swiss Centre for International Health;
- Svitlana Ostashko, Director of MCH Department of the MoH of Ukraine;
- Yuriy Voronenko, Chancellor of the National Medical Academy of the Postgraduate Education;
- Raisa Moiseyenko, Head of the Main Health Department of Kiyv City State Administration;
- representatives of partner institutions, oblasts and rayons, other international organizations and projects.

Objective of the Conference was to present approaches to improvement of mother and child health care in Ukraine. Senior Deputy Minister of Health, Oleksandr Anishchenko, emphasized that the Programme’s achievements are complex and weighty for the national system of mother and child health; therefore the Programme’s elaborated materials are worth being disseminated in all the regions of Ukraine.
It is internationally acknowledged that among the determinant factors of the quality of perinatal care are the following: clear distribution of responsibility of the levels of care, qualification of medical personnel, proper infrastructure conditions and medical equipment, systematic monitoring and situation analysis. No less important measures for improvement of the situation are also health contribution, implementation of up-to-date managerial and informational instruments. It is the complex impact upon all the mentioned factors that was the objective of the Swiss-Ukrainian Mother and Child Health Programme 2008-2010.
According to Raisa Moiseyenko (Head of the Main Health Department of Kiyv City State Administration in the present, and Director of MCH Department of the MoH of Ukraine in the past): ‘The Swiss-Ukrainian Programme is one of the best that work in health care field. Within the period of collaboration the rate of infant mortality has decreased and the quality of perinatal services has improved in partner oblasts’. Her words are confirmed by the Deputy Head of Health Department of Ivano-Frankivsk OSA, Zoya Tsichon’: ‘For 12 years of the Swiss-Ukrainian project’s activities in Prykarpattya, the rate of infant mortality has been successfully reduced from 20 to 9 ‰ (in 2009)’.
For the last 3 years the Programme has operated in four regions of Ukraine: Crimea AR, Ivano-Frankivsk, Vinnitsya, and Volyn oblasts. The Programme’s activities and recommendations were based on the up-to-date internationally acknowledged approaches. It is important that the Programme’s experts worked not only with the national and oblast levels of health care, but also with the rayons. Thus, the pregnant women, women in labor and newborns of 22 rayons have now an opportunity to take advantage of up-to-date perinatal services. Oleg Nesterenko, deputy head doctor of Dzhankoy CRH, says that the Swiss-Ukrainian Programme is the first international project that turned its attention to practical medicine at the rayon level.

1 2

How to improve perinatal care in Ukraine? (part 2)

What was achieved in the frames of the current phase implementation?
 

1. The system of medical postgraduate education received four textbooks, elaborated in accordance with the current data of evidence-based medicine and educational approaches: Multiple pregnancy, Pregnancy and delivery in women with uterine scar after the previous cesarean section, Stabilization of newborn’s condition before transportation, Respiratory support in newborns. Their quality is certified by the words of Dr Veronique Isnard from Nice University hospital, France: ‘The developed teaching materials are competitive as well for the west-European countries. We consider the possibility to use them for training in our hospital’.

2. Medical staff of oblast and rayon antenatal clinics (AC) and maternity departments has been trained and improved their routine practices. Prof Elisabeth Shunko (NMAPO) claims: ‘The Swiss-Ukrainian Mother and Child Health Programme – is the first project that makes continuous medical education real in Ukraine’.

3. In all 22 rayons there are operating updated “Schools of responsible parenthood”. There are also established Coordinating boards for contribution to mother and child health.

4. 20 rayons have performed rehabilitation and reconstructions at the local expense in ACs and maternity departments, having created there adequate conditions for partnership deliveries, rooming-in and free visiting. ‘The consultants’ advices and recommendations about reconstruction of maternity department have been taken into consideration – now we have a modern department’ says the head doctor of Khmilnyk CRH, Volodymyr Syvak.

5. Partner institutions of oblast and rayon levels have received from the Swiss Confederation medical equipment to the amount of above 3 million UAH: US sonographers, cardiotocographers, resuscitation tables, incubators, ALV apparatuses for newborns, etc. 'This equipment functions every minute for the health of mother and child, improvement of treatment, diagnosing quality’, says Tair Musayev (MoH Crimea AR).

6. Telemedicine consultations have been introduced, which enable doctors of the rayon level to consult with oblast, national and international experts.

7. Other up-to-date informational instruments have been elaborated and implemented: e-learning modules, perinatal registry, and software for medical equipment inventory.

8. The modern managerial instruments have been implemented: quality assurance, perinatal audit, etc.

9. Pregnant women in partner rayons receive an informational brochure “Diary of my pregnancy” at the first admission on occasion of the pregnancy.

It is worth mentioning that the Programme’s achievements are acknowledged both at the national level and by the local partners, as they correspond not only to priorities of the national politics, but also to specific requirements of the regions. This was evidenced by the partners during the conference.
Of course, such complex approach required intensive work from both Programme’s representatives and partner institutions and establishments. It is possible to achieve appreciable and long-lasting results only by simultaneous influence on the factors of the quality of care. But the received result – growth of the rate of physiological and partnership deliveries, birth of healthy newborns, decrease in the rates of mortality – is worth joint efforts.

Photoarchive of the event you may find here...

1 2

Official approval of training materials

Main methodological and educational dept. of MoH has officially recommended the using of training materials, developed in the frame of Programme, in the system of post-graduated medical education in Ukraine.
The training materials have been developed by the groups of experts consisted of international consultants and Ukrainian specialists. The working groups included the representatives from leading Ukrainian medical universities: NMAPE, Lviv University, Ivano-Frankivsk University, Vinnytsia University, etc.
The topics of training materials were chosen according to their actuality for the improvement of perinatal care in Ukraine. The content of module is based on modern EBM data and presents the algorithms on how to apply theoretical knowledge in routine clinical practice. The materials successfully passed the international and national review and were also officially approved by Scientific Board of NMAPE. Finally, materials have got the official recommendation of Main methodological and educational dept. of MoH:
1) «Multiple pregnancy»: letter from 1.02.2011 № 23-01-25/48;
2) «Pregnancy and labor with uterus scarce after CS»: letter from 1.02.2011 № 23-01-25/45;
3) «Respiratory support in newborns»: letter from 1.02.2011 № 23-01-25/47;
4) «Stabilization of newborn before transportation and care during transportation»: letter from 1.02.2011 № 23-01-25/46;
5) «Application of telemedicine in clinical practice»: letter from 30.12.2010 № 23-05/25-337.

For the time being, training materials are under preparation for publishing. Afterwards they will be distributed among partner institutions and oblasts, medical universities and medical libraries.
Programme management would like to thank all specialists involved into development, review and approval of training materials.
 

Official approval of e-module “CPAP as method of respiratory support”

Main methodological and educational dept. of MoH has officially recommended the using of e-learning module “CPAP as method of respiratory support” in the system of post-graduated medical education in Ukraine (letter # 23-01-25/19 from 18.01.2011).
The e-learning module has been developed by working group in the frame of the Programme during 2010. The working group consisted of representatives from leading medical universities: NMAPE, Lviv university, Vinnytsia university, etc.
The content of module is based on neonatal training materials developed by working group in the frame of Programme. The materials were also officially approved by Scientific Board of NMAPE.
In soon time the e-learning module will be recorded on CD and distributed among partner hospitals, medical universities and medical libraries.
 

Swiss Agency for Development and Cooperation (SDC) will continue collaboration with Vinnytsya oblast

On 2 of December 2010 in Vinnytsya framework meeting of Vinnytsya region heads (head of oblast state administration, head of Vinnytsya oblast and city Councils) and Swiss Cooperation Office – SCO (representative of SDC in Ukraine) took place.
During this meeting perspectives of further collaboration between Vinnytsya region and SDC in Ukraine were discussed. After the meeting the ‘round table’ was organized. It was devoted to SDC projects realization in Vinnytsya oblast; heads of all relevant departments of oblast state administration as well as Vinnytsya oblast and city Councils participated. Main achievements and results of each project implementation were presented and discussed. In Vinnytsya region SDC has projects in such sectors as 

• mother and child health;
• decentralization and local government;
• agrarian production development;
• economical development of Vinnytsya city.

Achievements of Mother and Child Health Programme implementation in Vinnytsya oblast were presented by the head of Health care administration Ms. Lidia Didenko. She stressed that mother and child health sector is the priority not only for the government but for each citizen because everybody understands that delivery of healthy children is the guarantee of the country prosperity. Ms. Didenko mentioned that the Programme made a valuable contribution into perinatal health improve in Vinnytsya region and assured that the oblast government is ready to support new Programme phase which starts in April 2011.
SCO coordinator of the programs in health and social sectors Mr. Petro Ilkiv presented SCO position toward the Programme next phase realization. He accented that main efforts will be put for perinatal services improvement through implementation of the Programme approaches and products in all 27 rayons of Vinnytsya oblast. It requires effective collaboration among the Programme and all partners in the region – from heads of health care administration to doctors who work in rayon hospitals. Also it was mentioned that the Programme implementation is in the line with the concept of reforms which must be started in the health care sector by the government very soon, thus, good preconditions for the Programme effective implementation could be provided.
During the discussion of other projects which are under implementation in Vinnytsya region with SDC support the ways and preconditions for further collaboration were defined. After all the deputy head of the oblast state administration Mr. Volodymyr Baretskiy thanked to SCO director Mr. Manuel Etter and projects coordinators for fruitful collaboration and significant input into the oblast development. Considering collaboration as bilateral process the deputy head and heads of core departments assured their readiness to put all efforts and mobilize available oblast resources for effective collaboration.

Ivano-Frankivsk region: continuous improvement of perinatal services provision

November 2010 was full of events for Ivano-Frankivsk health care system in general and perinatal care in particular.
Health authorities in Ivano-Frankivsk region are always faced to range of challenges due to geographical, climate, ecological, social and economic factors. Nevertheless managers and medical staff of the region are always aimed for heath improvement of the population.
Much attention is paid to mother and child health sphere. Several international projects are being implemented in this region. Various initiatives realization requires much effort from the mother and child health care representatives. Only in the frame of the Swiss-Ukrainian Programme “Mother and Child Health” the following events were held in November:
1) Monitoring visit to partner rayons: Kalush and Verkhovyna, in which representatives of other partner rayons also took part. More details on Programme monitoring strategy can be found here …

Such wards are created in Verkhovyna hospital

2) Clinical training for obstetricians-gynecologists and neonatologists from partner rayons on the following topics: “Pregnancy and delivery after caesarean section” and “Ventilation support for newborns”. Over 40 physicians received both theoretical knowledge and practical skills on abovementioned topics. The trainings were facilitated by a group of trainers and experts among whom were international, national and regional level specialists.

Theoretical part of obstetrical module

Practical session for neonatologists

3) Analysis of Perinatal service package piloting in Kolomyya rayon. Preliminary conclusions on the implementation of this managerial tool (for level responsibility division) were submitted to MoH of Ukraine for authorization and dissemination all over Ukraine. For more details please contact Programme implementation office.
4) Further IMCI strategy implementation (Read more…) in Snyatyn rayon. Due to fruitful cooperation between the region and the Programme, necessary medical equipment was provided to ensure successful IMCI implementation. In particular, Programme provided equipment purchase for the sum 170 000 UAH. IMCI strategy implementation is carried out in close cooperation with the UNICEF Ukraine office which supported additional trainings for regional monitoring experts in November 2010.

In the end of November, regional press-tour was organized aimed to highlight achievements in Programme implementation. In the frame of this press-tour mass-media representatives interviewed Programme consultants and experts, took part in clinical training and also visited Gorodenka central rayon hospital (CRH) which cooperates with Programme since 2005. Press-tour participants enjoyed communication with experts and were impressed with the Programme achievements in Gorodenko CRH, among which is complete absence of infant mortality in 2010.

Such conditions created in Gorodenka hospital since 2007

Taking into consideration health reforms on national level, intentions on Programme prolongation and political will of regional managers, physicians and managers of Ivano-Frankivsk region will further work on perinatal care provision improvement in future.

80th Anniversary of the National Scientific Medical Library of Ukraine

On 30th November 2010 National Scientific Medical Library of Ukraine (NSMLU) celebrated its 80th Anniversary.
As it was said by Mr. Mykola Tomenko, Deputy head of Parliament of Ukraine who took part in the celebration, NSMLU is the center of network of medical libraries and unique specialized establishment that provides services as library and publisher in medical sphere.
Celebration took place in the library building, which is a monument of architecture - a famous family of Ukrainian patrons of art lived there in the beginning of the XXth century. Raisa Pavlenko, director of the library, accepted congratulations from many friends, patrons, readers and guests. Michele Tereschenko, descendent of the famous family who now lives in France, was among the honored guests.
Several exhibition stands in the hall presented photos from the history of the library, medical publications and books, unique old medical works printed in XVII – XIX centuries and preserved now in library funds.

Swiss-Ukrainian Programme “Mother and Child Health” is a long-time partner and friend of the National Scientific Medical Library of Ukraine. On behalf of all Programme team, Andriy Solodarenko, head of the Programme implementation office, congratulated Raisa Pavlenko and all library team on the occasion of 80th Anniversary. In the frame of Programme implementation a lot of attention is paid to educational component and all the groundwork is always presented to NSMLU in order to provide access to it of the large audience of medical professionals. A. Solodarenko recited ancient Rome philosopher Seneka who said that there are three thing very important for young men’s education – time, books and friends. And all those can be found in the library today. A. Solodarenko presented to R. Pavlenko a memorable Dyploma.

 

Available in Ukrainian only.

Snyatyn Rayon is finishing training on Integrated Management of Child Illness (IMCI)

18-22 October, 2010 there was a second training for doctors from Snyatyn Rayon on Integrated Management of Child Illness (IMCI). 
27 pediatricians, medical assistants and nurses of the primary level of medical care from Snyatyn Rayon had 5 days training on IMCI principles as WHO strategies aimed to reduce neonatal morbidity and mortality. The second phase of the training organized within Programme’s activity according to MoH order was organized by Programme’s trainees. All medical staff which is involved into IMCI strategy implementation received sets of medical documentation and information materials* (and for parents as well), which are necessary for efficient IMCI implementation.

Acquaintance with IMCI strategy

Practical lesson in Oblast children’s hospital

Next step will be practical training on monitoring which will be held by the end of the current year with the support of the Programme and national expert prof. L. Kvashnina.

* printed with the support of the UN Children Fund

Ratno central rayon hospital expands its ICT experience

On October 1, 2010 doctors from Ratno central rayon hospital distantly participated in the 23rd meeting of Perinatal Fridays Club which took place in Kyiv. 
Ratno hospital has a great experience and potential in the implementation of different ICT tools. Good technical equipment, doctors’ skills in computer management and administration support – all those factors made favorable conditions for the implementation of modern technologies in the border Rayon of Volyn Oblast. Doctors of the hospital with the support of their chief doctor M. Begal have been working with iPath telemedicine platform since 2006. One of the most active users on iPath is A. Omelyanchuk, head of the delivery department and Rayon obstetrician. Obstetricians of the hospital received electronic text book “Normal delivery management”, which was developed during the previous phase of the Programme.
Technical support is provided by IT specialist V. Moroz who provides necessary trainings for the doctors and supports local network in the hospital. He also takes part in electronic perinatal registry development for all health institutions of Volyn Oblast. Besides, some ideas for this registry V. Moroz gained from the patients’ database which he developed to meet Ratno hospital’s needs a couple of years ago.
In September the doctors from Ratno hospital distantly joined Perinatal Friday Club meeting for the first time. The meeting was devoted to medicine and surgery of fetus and surgical fetoscopy. The meeting was held in Kyiv, but due to Internet possibility doctors from the whole Ukraine could attend the meeting.
Active usage of different ICT tools by Ratno doctors showed that there is a need in information and professional communication as well as basic conditions to implement all this. ICT component of the Progamme is aimed to provide such conditions.

Managerial innovations: achievements of partners

Summary training for managers hold in Kiev on 12-14 of October was devoted to the achievements of partner facilities in the implementation of modern managerial tools. 
28 representatives of Oblast and Rayon institutions took part in 3 days training workshop. Among the main topics of the training were: technology management, BABIES matrix and quality management. New topic for the participants was quality of medical care. Experts of the workshop were: Claudio Zaugg (STPH), Mikhail Startila (MoH, Moldova), Manfred Zahorka (SCIH), Xaver Boch-Capblanch (SCIH). Efficiency of modern managerial tools is proved by Moldovian experience: ‘It helps to better know the population which receives medical service by the institution as well as work efficiency of this institution’ (М.Stratila).
In spite of difficulties in the implementation of new managerial innovations into the Ukrainian health system our partner hospitals have certain achievements which they presented during the workshop. The participants fulfilled homework on BABIES matrix analyzed by M. Stratila and prepared presentations which showed their experience in the implementation of managerial tools in their daily work. Achievement on inventory of medical equipment software was presented by V. Vasylenko (Dzhankoy) and T. Bondarenko (Vinnytsia). Their presentation showed big interest for international experts as well as for the other participants.

Work group on quality management tools

New training module ‘Quality of medical care management’ was of great interest to chief doctors and managers of Oblast level. Interactive exercises helped participants to generate new ideas on how to provide quality in their own institutions.

Presentation «Management of medical care quality», Xaver Boch-Capblanch

Feedback from participants:
«We are very grateful for organization of trainings and for the possibility to prove our knowledge on practice and to gain new experience».
«For healthcare managers such trainings are very useful».
 

100 years to Ukrainian medical association

Since 30th of September till 2nd of October, 13th Congress devoted to the centenary of UMA took place in Lviv.
The agenda of Congress combined plenary section devoted to UMA and thematic sections, e.g. on obstetrics and pediatric. The mentioned section was led by Prof. Dmytro Dobrianskiy who also did the presentation on “Problems of perinatal care in Ukraine in the frame of MCHP”.
More detailed information about the Congress you may find on the UMA web-site: sfult.org
 

Volyn doesn’t stop at achieved

In the beginning of September 2010, monitoring mission and clinical training took place in the frame of Programme implementation in Volyn region. 
These two events were logically interrelated and provided in an update way: 2-day monitoring mission and presentation of its results proceeded to 4-day clinical training.
Monitoring mission was done to two partner hospitals of Ratno and Lutsk rayons. The colleagues from other partner rayons were also invited to these hospitals. Such approach helps to both effectively use human and time resources and contribute to experience exchange, increase motivation and positive competition between hospitals. Also, to strengthen experience exchange between regions, it was decided to include into monitoring consultants’ team the representative of AR Crimea, Dr V. Zhenchenko, chief of delivery dept. of Krasnogvardiysk CRH.
During monitoring mission, the achievements and difficulties of each facility were thoroughly analyzed aiming to develop further recommendations on improvement of quality of perinatal care. The results of monitoring and developed recommendations were presented at the meeting before the training.

Presentation of results of monitoring

This time the consultants’ team was pleasantly surprised by substantial changes happened in delivery dept. of Lutsk CRH. In the very beginning of Programme implementation, the administration got the recommendations to considerably improve the work and conditions of admission ward of obstetrical dept. Thanks to financial support of local authorities and Programme experts’ supervision, the admission and delivery dept. were restructured and repaired according to modern standards of perinatal care.

Dr V. Zhenchenko is pleasantly surprised by comfortable conditions of admission ward

Modern perinatal technologies are actively introduced into practice of renewed delivery dept. of Lutsk CRH. Obstetricians and neonatologists take part in Programme training events. Modern equipment, bought by Programme and state and local budgets, also contributes into the improvement of quality of services. And what is more important – it could be felt that patients of delivery dept. are satisfied with new approaches, conditions and attitude.

Happy mother with newborn

However, Volyn doctors and managers don’t stop at achieved results. As modern development of medicine demands continuous professional growth of medical specialists, doctors of rayon hospitals gladly participate in Programme trainings.
This time the training was devoted to the following topics: “Pregnancy and delivery after CS” and “Ventilation support to newborns”. More than 30 medical specialists took part in the training, among them: obstetricians, specialists of prenatal USD, neonatologists, child nurses. The training was provided by representatives of oblast expert group supervised by national experts and Programme consultants. EBM content, module structure and practical approach of training were highly evaluated by participants.

Prof. Y. Korzhynskyy makes presentation

The beginning of practical session on ventilation support

Soon, the same events will take place in Vinnytsia, and then in Crimea and Ivano-Frankivsk.

Summer School in Lugano

Annual Summer School “Policy, economics and management in health care” took place in Lugano on 9-20 of August.
School was organized by Swiss TPH, University of Lugano and Swiss School of public health, and financed by SDC.
Goal of School was to introduce new approaches to the solving of public health problems, support the experience sharing among participants from different countries, and indulge potential collaboration between different institutions.
The languages of School were English and French. The topics and tutors are presented in separate document. Web address of School: http://www.ssphplus.ch
More than 100 participants of School represent different professions (medical doctors, managers, public health specialists, etc.) and more than 20 countries. Ukraine was represented by several participants: Petro Ilkiv (SDC), Dmytro Konkov (Viinytsia Medical University), Ihor Livshyts (MoH of Crimea), Elena Yurchenko (CWBF), Andriy Solodarenko (MCH PIO).
 

Implementation of IMCI has started

On 9-13 of August 2010 there was the first training on Integrated Management of Child Illness (IMCI) in Ivano-Frankivsk oblast. This training has taken place in the frame of implementation of IMCI strategy in Ukraine. The strategy is recommended by WHO aiming to improve medical care for children under 5 years old. According to MoH order #581 from 15.07.2010, it has been chosen the pilot rayons of several oblasts to implement the strategy. Sniatyn rayon of Ivano-Frankivsk oblast is one of the pilot ones. 
Programme team was actively involved into the process of strategy adaptation and is also included into Coordination Board on dissemination of IMCI strategy (according to order #581). Thus, in the frame of MCH Programme the first training on IMCI has been conducted.
Among the trainers there were:

• Prof. Liudmila Kvashnina, national expert on IMCI, IPOG
• Sherengiya Ketevan (Georgia) and Stasiy Ekaterina (Moldova), international WHO experts
• Zoya Tsikhon and Natalia Khodan, oblast IMCI trainers
• Irina Matvienko and Oksana Chopko, Programme clinical consultants
   

 

In 5 working days 36 specialists – pediatricians, GP, nurses and others, - have become acquainted with strategy principles and IMCI protocols, got practical skills of clinical assessment of child and consultation of parents in clinical settings. Dynamic agenda of training has also foreseen the introduction of ICAT, software for individual and group learning, and reference source. Participants have highly evaluated the quality and clearness of materials and organization of practical sessions.

This training allowed to assess the training materials for its further adaptation. Also, some recommendations on improvement of training agenda and monitoring of strategy implementation have been done.

I Ukrainian congress “Medical and biological informatics and cybernetics”

On 23-26 of June 2010, the First Ukrainian congress devoted to issues of the development of medical and biological informatics and cybernetics in Ukraine took place in Kiev.
The main organizers of congress were MoH of Ukraine, AMS of Ukraine and NMAPE. The aim of congress was to exchange the results of scientific researches and practical work on the development of modern ICT in health care and medical education. More than 200 presentations were done at plenary, satellites and sections of congress. The presentations were done by representatives on known scientific, educational, international and private organizations. More than 10 countries took part in congress: Ukraine, Russia, Switzerland, Germany, Great Britain, USA, Georgia, Belarus, Moldova, etc.
MCH Programme was actively involved into preparation and participation in congress:

• it was one of the sponsors of congress;
• it made two presentations during the congress.
  
  The presentations were done by two Programme experts:

• Claudio Zaugg, Swiss expert, SCIH, who made presentation “Benefit of modern eHealth applications in the Ukrainian Health Care System”
• Prof. Dmytro Dobryanskyy, national coordinator of telemedicine activity of Programme, made presentation “Experience of telemedicine implementation in the frame of MCH Programme”.
   

Claudio Zaugg makes presentation

Active involvement of Programme into congress has allowed as look at the experience of other organizations and countries, so present its own products of long-term Swiss-Ukrainian collaboration. Such exchange of experience creates a basis for the recognition and dissemination of Programme achievements to national level.
 

Training for specialists from partner rayons on conducting lessons in “Schools of responsible parenting” was finished in Kiev

Training on preparation of specialists for work in “Schools of responsible parenting” was carried out on 27-29 of May in Kiev within the framework of component 1. 24 obstetricians and midwifes, and 4 psychologists have completed full course of training, that will enable them to consult and carry out training for pregnant women and their family members at qualitatively new level.
Participants were familiarized with principles of training work within the frame of “Schools of responsible parenting”. Specialists also had opportunity to train their skills in conducting lessons for pregnant women and their partners.

Workshop on fitness for pregnant women

Separate workshops were held on fitness for pregnant women and on application of method of relaxation in the work with pregnant women. One of the sessions (upon the request of participants) was devoted to the delivery at special chair (stool), advantages and features of such deliveries.

Training of skills for session “Bio-mechanism of pain in labor, methods of self-help”

Training was held by experts of component 1: Babich T. Y., Doctor of Medicine, Head of the East Center of breast feeding support, Bratus I. V., Doctor of Pedagogy, perinatal psychologist, and Yurchenko O. Y., obstetrician, specialist in fitness for pregnant women.

Institute of Pediatrics, Obstetrics and Gynecology consults at teleplatform

On 19th of May Dr A. Solodarenko, Head of PIO, took part in meeting of Scientific Board of IPOG.
Programme representatives were invited to participate in the meeting of Scientific Board aiming to discuss the approaches to dissemination of common experience of telemedicine implementation. Specialists of IPOG consult clinical cases at platform since the very beginning of creation of the first Ukrainian perinatal discussion group in 2003. Since then, with the Programme support, the administration of IPOG has developed and implemented the effective algorithm of telemedicine usage, in particularly – provision of second-opinion consultations for presented cases.
As it was already announced, Programme experts have assessed that IPOG provided the highest number of comments on users’ clinical cases at teleplatform during the competition between iPath users (in October – December 2009). According to iPath statistic, specialists of IPOG are always among the five most active experts. The highest number of consultations is provided by departments of neonatology, internal pathology of pregnant women, miscarriage problems, endocrinal gynecology, pathology of pregnancy and labor, family planning, fetus medicine, surgical correction of congenital malformations, etc. As the one of winners of competion, IPOG has got the prize from Programme management. Also, during the meeting Dr A. Solodarenko made the presentation “Role of experts in increasing clinical effectiveness of telemedicine”, that became the basis for the discussion of the strategy of further dissemination of gained experience. The book “Models of improvement of perinatal health in Ukraine” describes in details the model of telemedicine implementation; and it is the background for the discussion of the strategy and further presentation of it in Academy of Medical Science of Ukraine.

Presentation was made by Dr A. Solodarenko for Scientific Board of IPOG

The copies of books were presented to IPOG

Client-oriented consultancy will help pregnant women

During April-May in the framework of component 1 there were provided trainings on consultation services on the issues of mother and child health on the base of client-oriented approach for the specialists from pіlot rayons.
Two trainings were held in April: in Ivano-Frankivska oblast (22-24 of April) and Volynska oblast (26-28 of April). Total number of specialists, who took part in the trainings, was 55, among them: obstetricians, midwifes, nurses, and social workers. Two trainings were provided in May: in Vinnytska oblast (17-19 of May) and Crimea (20-22 of May).
During the trainings participants were taught the main principles of the client-oriented approach, developed their skills in listening, questioning, providing information to the clients. The second stage of trainings is planned for July 2010.
 

Available in Ukrainian only.

Open Medis success at Med-e-Tel in Luxembourg

Luxembourg, April 14-16: Marc Blunier, Claudio Zaugg (SCIH) and Andriy Solodarenko (PIO) met with new and old partners at the Med-e-Tel 2010 Conference for eHealth, Telemedicine and ICT in Health. 
The Programme experience and expertise of the Health Technology and Telemedicine Unit (HTTU) of the Swiss TPH contributed to topics such as the “Benefits of Free/Libre Open Source Software in Health Care” with a presentation on “Implementation of an Essential Information System for Medical Devices in Low- and Middle-Income Countries" and a short paper published in the conference proceedings. The Programme and HTTU’s input focused mainly on "openMEDIS", the open source software currently being implemented by the HTTU in three countries, particularly in Ukraine. With this example, our capability to bring relevant open source health care applications into practice was clearly demonstrated – a success bringing us further in line with the Swiss TPH eHealth strategy. More information: http://www.medetel.eu/index.php.

Training on inventory of medical equipment

On 26-27 of April 2010 the training on software for inventory of medical equipment took place in Ivano-Frankivsk region. 
27 representatives of Programme partner facilities of rayon and oblast levels took part in the training. They are metrologists, book-keepers and service engineers who are responsible for inventory in facilities. Besides, 4 students of KPI took part in the training; furthermore, they will be involved as assistants of implementation of software in partner facilities.

The training was provided by SCIH expert, Claudio Zaug, with the support of Ukrainian consultant, Ihor Shchaviy, and Programme coordinator, Kateryna Rimarenko.
During two days the participants had not only theoretical sessions on the concept, structure and functions of Open Medis software, but also practical sessions to work on skills. According to agreed plan, trained specialists will create data base of medical equipment in Open Medis in their facilities in two months. That will become the beginning of inventory that corresponds to modern international standards.

More about. As it was already announced, in the frame of Programme component #4 Programme experts work on the development and implementation of software Open Medis that allows providing inventory of medical equipment according to modern European standards.

This software is being developed by Swiss expert group of SCIH. They regularly involve Ukrainian partners to assess the functionality of software. Open Medis allows saving inventory data in unified format, forming necessary reports on equipment status, need in repair, planning justified purchasing of new equipment.
For the time being, Open Medis software has its full working version that is proposed to be implemented by the administration of partner facilities. The process of implementation foresees the provision of training and supervision of specialists responsible for the inventory of equipment in facility.

Programme partner hospitals have got medical equipment on 3,2 mln. UAH

Programme partner hospitals have got medical equipment on 3,2 mln. UAH with support of Swiss Confederation in the frame of Programme implementation. 
Professional level of medical personnel and availability of modern equipment are one of the key factors of MCH quality.
Taking into account social and economical crisis in Ukraine, Swiss Agency for Development and Cooperation has supported the request of Ukrainian partners and provided donor funds (additionally to Programme implementation budget) to purchase medical equipment needed for provision of care for pregnant and delivered women and newborns. In particular, partner hospitals of AR Crimea have got equipment on more than 1 mln. UAH; hospitals of Ivano-Frankivsk oblast – on more than 600 thousand UAH, Vinnytsia oblast – on more than 500 thousand UAH, and hospitals of Volyn oblast – on about 800 thousand UAH.

Among the equipment purchased, there are: modern USD apparatus, cardiotocographs (to monitor fetus heart beating), resuscitation tables, AVL apparatus, sources of radiant heat and phototherapy lamps for newborns, pulsoximeters, nasal cannules, digital thermometers and weights, portable resuscitation kits, etc. Mentioned equipment allows to partner hospitals to form essential list of medical equipment to assure modern standards of MCH. This equipment will increase the quality of care for pregnant and delivered women and newborns in partner facilities of rayon and oblast level. Programme pays special attention to medical facilities of rayon level because of its important role in the perinatal network.

Doctor fropm Dzhankoy rayon hospital at new USD machine

It is worth to be underlined that Dzhankoy rayon hospital (AR Crimea) has got the unique USD apparatus (more than 0,5 mln. UAH). Diagnostic options of this apparatus are higher than of big stationer scanners and simultaneously it is portable. This apparatus is of high importance for Dzhankoy hospital, because the hospital is going to become inter-district perinatal center soon. Thus it will provide services for bigger number of patients with complicated cases. Availability of modern USD apparatus in Dzhankoy hospital will assure a high-quality diagnostic for pregnant women and women in labor.
It is worth mentioning that authorities and medical management of Dzhankoy CRH and AR Crimea in general understand the need of comprehensive approach to problem-solving in perinatal care, actively involve other sectors to the health care issues, and responsibly implement the Programme.

Press-Conference in Dzhankoy rayon hospital
devoted to medical equipment hadover

According to Programme principles and approaches, the selection of new equipment is based on the following criteria:
1) The equipment is of high priority. It means that this equipment is needed to provide vitally important care for pregnant women and newborns in rayon hospital.
2) The functions of the equipment correspond to those services that are provided by facility of rayon level. Thus, hospitals that usually deal with normal pregnancies, deliveries and newborns need basic equipment. Whereas hospitals of higher level that provide specialized care for pregnant women and newborns with complications need more advanced and poly-functional equipment.
3) The equipment corresponds to the modern principles of dynamic monitoring of patient state and using of noninvasive (not aggressive) procedures.
4) The company (producer or supplier) should provide the training for medical personnel on how to use even the simplest equipment. As it is the issue of patients’ and personnel’s safety, that’s why Programme demands such a training from companies.
5) Quality and time of work of medical equipment also depend on the level of technical maintenance. Thus, Programme pays attention to the implementation of modern HTM approach in facilities.

Press-Conference in Ivano-Frankivsk devoted to medical equipment hadover

During 12 years of Swiss-Ukrainian collaboration, about 15 mln. CHF was spent on MCH care in Ukraine. In particular, medical facilities of Volyn, Donetsk, Ivano-Frankivsk and Rivne regions have got medical equipment for MCH care on more than 5 mln. CHF.
 

Programme continues to make handovers to the libraries of Ukraine

In the end of March 2010 the Programme made a handover to the next two national libraries of Ukraine. 
On 24th of March the Programme made a handover to National Parliament library:

• 20 copies of capitalization book “Model of Improvement of Perinatal Care in Ukraine”;
• 20 copies of manual “E-learning modules for medical knowledge: principles, stages and methodology”.

 

Books handover to the funds of National Parliament Library

Readers of the library made an interest in the Programme's publications

On 26th of March the funds of Vernadskiy National library of Ukraine have got:

• 20 copies of capitalization book “Model of Improvement of Perinatal Care in Ukraine”;
• 20 copies of manual “E-learning modules for medical knowledge: principles, stages and methodology”;
• 4 e-learning modules “Management of normal delivery” on CDs.

Also, the presentation of Programme was made for the personnel in Cultural center of library. Chief of the center and deputy director of library also took part in the presentation.

Presentation of the Programme to employees of National library
named after V. Vernadsky

The exchange systems of the libraries will provide copies of books to the regional libraries and, as well, to international partners of the libraries.

Programme management hopes that these publications will be useful for readers of the libraries who are interested in health care system organization and e-health.
 

Medical clothes for personnel

In March 2010 medical personnel of Programme partner CRHs, in particular obstetricians and neonatologists have got medical clothes with Programme logo. 
Each partner CRH has got necessary amount of medical clothes (costumes and smocks) for medical personnel involved into Programme implementation. Thus, Vinnytsia oblast has got 79 garments, Ivano-Frankivsk oblast and AR Crimea – by 89 garments, and Volyn oblast – 40 garments.

Doctors of Khmilnyk CRH in new medical costumes

Monitoring missions to partner facilities

Regular monitoring missions of Programme clinical consultants to partner facilities took place in March 2010. 
In two weeks two expert groups visited 3 partner regions of Programme: AR Crimea, Ivano-Frankivsk and Vinnytsia oblasts. In April 2010 the monitoring mission to Volyn will take place.
Mission tasks included:

1. Assessment of current situation in facilities of rayon and oblast levels comparing to September 2009 (data of previous missions), including: implementation of recommendations of Programme consultants on organization of care, infrastructure of departments, change of clinical practices, knowledge and skills of medical personnel.
2. Analysis of self-assessment forms of medical personnel, monitoring data of hospitals for 3 quarters, and selected histories of deliveries and newborns developments.
3. Exposure of problems (including data of clinical audit) and common development of the strategy of changes in facilities.

Mission format foreseen that expert group included not only Programme clinical consultants, but also specialists of HA and MoH ARC. Experts made the assessment of each partner facility, defined key achievements and problems, and also organized common summary workshop to develop the strategy of changes. Such approach contributes into making the corresponding managerial decisions to improve the care in each hospital and perinatal network in general.

Programme consultants also paid special attention to the skills of medical personnel on work with new equipment purchased in the frame of Programme implementation.

Detailed report on results of monitoring missions will be sent to all partner facilities. Key points of report will be also presented at Coordination Board meeting in April 2010.
 

Software for the inventory of medical equipment

In the frame of Programme component #4 Programme experts work on the development and implementation of software Open Medis that allows providing inventory of medical equipment according to modern European standards. 
This software is being developed by Swiss expert group of SCIH. They regularly involve Ukrainian partners to assess the functionality of software. Open Medis allows saving inventory data in unified format, forming necessary reports on equipment status, need in repair, planning justified purchasing of new equipment.
For the time being, Open Medis software has its full working version that is proposed to be implemented by the administration of partner facilities. The process of implementation foresees the provision of training and supervision of specialists responsible for the inventory of equipment in facility.
One of such training events took place in Vinnytsia on 16-17 of March 2010. The training was provided by Claudio Zaugg (SCIH); 14 specialists of partner facilities took part in the training. It is the first step in the process of improvement HTM in Vinnytsia oblast.

Training in Vinnytsia oblast

The implementation of Open Medis is already going in two partner rayons of Volyn oblast. Soon, the software will be presented to the specialists of Ivano-Frankivsk oblast and AR Crimea.

Elaboration of e-registry of pregnant women

In the frame of Programme component #3, the elaboration of electronic registry of pregnant women in Volyn oblast takes place. 
The infrastructure of medical facilities in Volyn oblast is prepared for implementation of e-registry. In particular, all CRH and hospitals of oblast level have PC stations for the needs of medical personnel. Also, most of CRH in oblast, not only partner ones, take part in the clinical discussions at iPath platform.
Implementation of e-registry of pregnant women will contribute into the optimization of the service provision for high-risk pregnant women, because oblast specialists will have updated on-line information about situation in any rayon. Such modern monitoring tool will contribute into more effective perinatal network and thus – implementation of the principle of regionalized perinatal care.
Aiming to create and implement the e-registry, the working group was formed in Volyn oblast. It consists of obstetricians, including chief oblast obstetrician, Dr R.Savka, and IT specialists. The methodological support of group is provided by SCIH experts, Marc Blunier and Claudio Zaugg, and national coordinator of component #3, Prof. D.Dobryanskyy.

Meeting of working group on 9th of March 2010
 

Presentation for Rotary Club

Programme representatives made a presentation of Programme for the members of Kyiv Multinational “Rotary Club” on 17th of March 2010. 
Thanks to the initiative of Swiss Cooperation Office in Ukraine, Kyiv “Rotary Club” expressed an interest to get acquainted with Programme activities. During one of weekly meetings, the presentation of Programme was done by A.Solodarenko and N.Riabtseva. It was done short general overview of Programme, approaches and target groups, and activities. Programme representatives also answered on the questions of “Rotary Club” members about specific of Programme approaches and implementation.

The meeting was held in informal friendly way that is typical for “Rotary Club”. Programme management hopes to continue collaboration with “Rotary Club”

About “Rotary Club”
Kyiv Multinational “Rotary Club” was created in 2005 based on general principles of “Rotary Clubs” of different countries. “Rotary Clubs” are informal voluntary units that introduce into life the principles of camaraderie, ethical standards of business, social responsibilities etc. Kyiv “Rotary Club” has already implemented several projects, e.g.: organization of charity balls to gather donations for medical equipment for neonatology, fundraising to help flood victims in Bukovyna region, support of school #6 for mentally challenged children, etc.
 

Conference “Actual Problems of Biomedical Engineering, Informatics, Cybernetics and Telemedicine”

III Conference with international participation “Actual Problems of Biomedical Engineering, Informatics, Cybernetics and Telemedicine” took place in Kiev on 11-13 of March 2010. 
The main organizators of conference were Kiev Polytechnic Institute (KPI), medical-engineering faculty in particular, and Ukrainian association of biomedical engineers and technologists, headed by Prof. Maksymenko V.B. Target audience of the conference was specialists in medical engineering, cybernetics and telemedicine, students of KPI and representatives of technical universities from regions. About 100 persons took part in the conference. Conference program included plenary sessions, posters and workshops. Full version of program is available in Ukrainian only.
The participation in the conference was also taken by two representatives of SCIH, representative of University hospital of Basel, and representative of Volyn region:

1. Reinhold Werlein, SCIH representative, was a deputy head of conference and member of presidium of 3rd plenary session “Medical engineering – new occupation”. He also made a presentation “Health Management Technology in Ukraine – Past, Present and Future. Experiences From Project”.
2. Christian Kluth, representative of University hospital of Basel, made two presentations: “Organisation and management of material and technical basis in European Hospitals. Competence and responsibility of Engineers” and “Function and Responsibility of Biomedical Engineering Association, links and collaboration to/with international associations”.
3. Claudio Zaugg, SCIH representative, made presentation “The Importance and Use of a Web-based Information Systems for Medical Devices in Ukraine”. Claudio also made presentation and master class for KPI students on using Open Medis, software for the inventory of medical equipment.
4. Liudmyla Rozhko, chief pediatrician of Volyn region, made presentation “Establishing workshops and actions in Biomedical Engineering in Volyn Region: Learning from Past Project Activities”.

Reinhold Werlein's presentation

Liudmyla Rozhko's presentation

Claudio Zaugg's presentation

Presentations are available as separate documents.
The conference was held upon support of Programme, SCO in Ukraine and SCIH.
In the frame of conference, it was also signed the Memorandum of collaboration between KPI and Programme. It aims to enhance the implementation of HTM in Ukraine and support the development of biomedical engineering occupation.

Prof. V. Maksymenko, President of the Association and A. Solodarenko, Head of PIO are signing Collaboration Memorandum

Programme also made a handover to KPI library of 5 copies of capitalization book “Model of Improvement of Perinatal Care in Ukraine”, 10 copies of manual “E-learning modules for medical knowledge: principles, stages and methodology” and 10 e-learning modules “Management of normal delivery” on CDs.

Reinhold Werlein is passing publications to Kiev Polytechnic Institute's library

Programme management hopes that these publications will be useful for teachers and students during specialized courses HTM and e-health.
 

Training on preparation to delivery and parenting; 16th PCF meeting

Training for health care personnel of partner regions will be held on 25-27 of March in Kiev within the framework of Programme component 1.
The aim of the training is to teach rayon specialists – particularly, obstetricians, midwifes and psychologists, - on how to provide educational service for pregnant women and their families in “School of responsible parenting”. General number of participants is around 35 persons. It is foreseen that they work directly with pregnant women and their families in “Schools of responsible parenting”. The actuality of this training is explained by the fact that qualitative realization of this service has positive effect on dynamics of characteristics related to perinatal health, in particular: increasing of quantity of partner deliveries, improving of breast-feeding rates (rate of first breast feeding, general rate of breast feeding, etc.), and contributes to emotional relations and communication between parents and newborn.
Training will be held by experts of Component 1: Babich T. Y., Doctor of Medicine, and Bratus I. V., Doctor of Pedagogy, perinatal psychologist.

16th PCF meeting
16th Perinatal Fridays Club meeting took place on 12 of March 2010 in Kyiv.
The meeting was devoted to the issues of using USD to analyze women pelvis bottom, state of uterus scar, and intranatal fetus pathway. Thanks to using of ICT, doctors from Programme partner regions could have taken the part in this meeting.
For this meeting, Programme clinical consultants, Dr A.Chernov and Dr I.Matvienko, have prepared two presentations: “US assessment of uterus scar: technical peculiarities and clinical meanings” and “Child state assessment and Apgar scale assessment: where is the thruth?”.
Next PFC meeting is planned on 23 of April 2010.

Seminar for Head of CCs; Publication of iPath clinical cases

Seminar for the Heads of Coordination Committees was carried out on 3-4 of March in Kiev within the framework of Programme component 1.
17 Heads of CCs who are the first deputy heads of rayon state administration by position participated in the seminar.
The goal of the seminar was to share experience between participants on organization of the CCs and elaboration of MCH programs.

Work of Heads of CCs from different regions

As the outcome of seminar, the participants:

• have familiarized with interim results of component 1 on realization for 2009 and plans on 2010;
• have shared experience in the field of organization the CCs;
• have analyzed of projects of rayon social programs on mother and child health promotion;
• have worked out of systemic vision of organizational provision of social progams realization at the local level.

 

Publication of iPath clinical cases
“TEDDY GROUP” communication agency, Programme partner, continues to publish clinical cases presented at iPath telemedicine platform.
Chosen obstetrical and neonatal cases presented and discussed by iPath users are published in scientific-practical journals, “Caring about woman” and “Caring about child” correspondingly. Thank to this initiative, doctors from all over Ukraine have a possibility to utilize results of their colleagues’ CME, and also join the discussion group at iPath.
 

The reward of iPath competition winners

In February 2010 the winners of iPath competition have been defined. The competition lasted since October till December 2009.
The participants of the competition could have been all users of Programme Perinatal Helath discussion group. Before the start of competition, announce was placed at the Programme web-portal and telemedicine platform. Announce contained information on the beginning of competition, its conditions, nominations and prizes.
The definition of winners was done in collective way with participation of national moderator of telemedicine, Prof. D.Dobryanskyy, Programme clinical consultants and Programme implementation coordinators. Based on results of competition, it was defined winners in the following nominations:

Nomination Winner

The best obstetrical case, 1 place		L.Belobaba (Saky hospital)
The best obstetrical case, 2 place (jointly)		L.Kostenko (Ivano-Frankivsk Perinatal Center)
The best obstetrical case, 2 place (jointly)		O.Gural (Gorodanka hospital)
The best neonatological case, 1 place (jointly)		T.Zagorulko (Volyn Children Hospital)
The best neonatological case, 1 place (jointly)		S.Kuzyk (Ivano-Frankivsk Perinatal Center)
The best CME case		A.Averyanov (Donetsk)
The most active user for the time of competition		M.Les (Luboml hospital)
The most active facility (on the number of presented cases)		Volyn Children Hospital
The most active expert		O.Solovyov (“Nadiya” clinic, Kyiv)
The most active facility (on number of comments)		Institute POG
The most supportive administration of facility		Kalynivka hospital

 

Each of winners has been rewarded. Among prizes there were the following:

• Notebook Asus
• Nikon digital photo camera
• USB memory sticks
• Program soft ware

 

O.Solovyov, the most active expert, gets the notebook from A.Solodarenko, PIO Head

The solemn reward of most winners took place during the workshop “Telemedicine: training for experts and coordinators”, in Kyiv on 3rd of March 2010.

 

Prof. D.Dobryanskyy, national moderator of telemedicine, and winners of competition

Workshop "Telemedicine: training for experts and coordinators"

Workshop "Telemedicine: training for experts and coordinators" took place in Kyiv on 2-3 of March 2010.
The first day of workshop was devoted to oblast expert groups created for effective implementation of telemedicine in regions. On the second day, there were invited coordinators of telemedicine implementation from all Programme partner facilities. The moderation of workshop was provided by Prof. Dmytro Dobryanskyy (Peadiatrics Faculty of Lviv Medical University), national moderator of iPath telemedicine platform and Programme expert.

Prof. D.Dobryanskyy, experts from AR Crimea and PIO personnel

Prof. D.Dobryanskyy comments participant's presentation

This workshop is an important step for the implementation of effective model of telemedicine in partner regions, because oblast expert groups and coordinators in facilities are key persons in the organization of teleconsultation. It is explained by their functions, among which:

1. Oblast expert groups:

• Monitor situation at platform
• Provide comments on presented cases in time

 

1st day participants: representatives of oblast expert groups

      2. Coordinators in facilities:

• Support of implementation of protocol of telemedicine consultation
• Control of 24-hour access of personnel to telemedicine working station and use of Internet
• Support of users in case of any questions or problems on work with platform
• Analisys of doctors' work at platform

 

2nd day participants: coordinators of telemedicine in facilities

Thus, the tasks of the 1st workshop day were the following:

• To present iPath telemedicine p[atform to all experts from oblast groups;
• To explain to experts their role, duties, and requirments to work;
• To agree on the model of work of expert groups in each oblast.

 

Prof. D.Dobryanskyy does the presentation

Group work of oblast expert groups

Structure of workshop foresees the combination of informational presentations, idividual and group work, and participants presentations. In the end of 1st day the following results were achieved:

1. All members of expert groups – about 40 persons – were personally registered at iPath platform and confirmed their readiness to consult at platform.
2. Experts agreed on regional model of teleconsultation that foresees that expert consults first the clinical cases from his/her oblast.
3. Four exper groups presented algorithm of work in each region. All groups have chosen such organization of work that demands obligatory shifts of experts.
4. It was agreed that till 5th of March expert groups leaded by oblast coordinator of telemedicne will form schedule of shifts; the shifts theirselves will start since 10th of March.

The tasks of the 2nd day were the following:

• Present to the coordinators the analysis of telemedicine implementation status in facilities (including results of monitoring missions conducted on 15-26 of February 2010);
• Agree with coordinators their duties and functions, the role of protocol of telemedicine implementation in facility;
• Develop practical examples of protocols of telemedicine implementation in facilities.

Coordinators from all Programme partner facilities (22 rayon and 8 oblast hospitals) took part in workshop; also, coordinators from 7 rayon hospitals of Volyn oblast telenetwork took part in workshop.
 

Group work of coordinators on development of protocol
 

Presentation of results of group work

Thanks to the combination of lecture and practical sessions, the following results were achieved:

1. It was presented achievements and obstacles in implementation of telemedicine in facilities; the obstacles and possible solutions have been discussed.
2. The requirements to coordinators, their role and duties were agreed.
3. It was presented the role of protocol of telemedicine implementation, its structure and key elements.
4. Six practical examples of protocols were developed.
5. It was agreed that till 15th of March 2010 the protocols will be issued in all partner hospitals. The protocols should contain: criteria of case selection, contact data of responsible persons, role of IT specialist, and algorithm of case management and closure.

Summing up: key elements of protocol

During the second day of workshop, the pleasant event took place: the winners of iPath competition have been rewarded.
 

Handover of Programme publications to National Medical library

On 19th of February 2010 the handover of Programme publications to National Scientific Medical library took place.
The following publications have been passed to National Scientific Medical library (NSML):

• 20 copies of capitalization book “Model of Improvement of Perinatal Care in Ukraine”;
• 30 copies of manual “E-learning modules for medical knowledge: principles, stages and methodology”;
• 30 e-learning modules “Management of normal delivery” on CDs.
   

The handover took solemnly place in the presence of Programme PIO Head, A.Solodarenko, and Director of NSML, R.Pavlenko, and personnel of NSML.

A. Solodarenko, Head of PIO is presenting publications in the National Scientific Medical library

Having positive experience of collaboration with National Medical library and considering its high authority, Programme management hopes that these publications will be useful for wide range of readers and contribute into CME in Ukraine.
 

R. Pavlenko, Director of the library and
A. Solodarenko, Head of Programme Implementation Office

R.Pavlenko thanked for presented publications and emphasized that it is substantial input into the development of medical education in Ukraine. As main scientific and methodological center of network of medical libraries in Ukraine, NSML will pass 1 copy of each publication to oblast scientific medical libraries.
 

New associated partners

Considering official letter of Kyiv oblast health administration, since 2010 Kyiv oblast has officially joined to the Programme implementation.

Kyiv oblast center of MCH and Brovary CRH have become associated partners of Programme.

It has become possible thanks to the initiative of recently appointed Kyiv oblast Chief obstetrician, Dr A. Shutka. Before, he was occupied as obstetrician in Ivano-Frankivsk Perinatal Center and thus, took part in Programme implementation in previous phases. Dr A. Shutka stated that implementation of Programme made a real difference in Ivano-Frankivsk oblast, and he would like to share this positive experience to Kyiv oblast to improve current situation.

Since now, medical and managerial personnel of new partner hospitals could take part in the following Programme activities: clinical and managerial training, telemedicine, and receive recommendation of Programme experts regarding infrastructure change. Already, doctors from partner hospitals took part in clinical training (ToT) on 9-11 of February 2010.
 

Managerial workshop

On 9-11 of February 2010 managerial workshop took place in Kiev. Workshop has been devoted to the issues of Health Technology management.
The some of the topics presented at workshop were the following:

• Health technology management: situational analysis;
• Health technology management: policy and structure;
• Planning and budgeting of equipment procurement;
• Experience of HTM in private Ukrainian clinic;
• Inventory of medical equipment as tool for managerial decision-making;
• Software for inventory.
   

Presentation by R. Werlein, SCIH, Swiss TPH

The workshop format included combination of presentation, individual and group work, individual speeches of participants, etc.

Presentation of group work results by a participant

Participants of the workshop. Individual work. 

Head doctors of partner rayon and oblast hospitals were participants of the workshop. Two Swiss experts (SCIH, Swiss TPH), Reinhold Werlein and Claudio Zaugg, were moderators and chief speakers of the workshop. Also, two Ukrainian specialists from private clinic made a presentation about the experience of HTM.

Participants of the workshop

Handover of Programme publications to the library of National University “Kyiv-Mohyla Academy”

On 16th of February 2010, the official handover of Programme publication to the library of National University “Kyiv-Mohyla Academy” took place.

Т. Yaroshenko, Director of the library, І. Gryga, School of Public Health,
N. Ryabtseva, Coordinator of Programme implementation

 The following publications have been handover to the library:

• 10 copies of capitalization book “Model of Improvement of Perinatal Care in Ukraine”;
• 20 copies of manual “E-learning modules for medical knowledge: principles, stages and methodology”;
• 10 e-learning modules “Management of normal delivery” on CDs.
   

Publications presented to the library of NaUKMA

The handover took place in hall of Antonovych’s library of NaUKMA.

Programme collaborates with School of Public Health of NaUKMA, as it is one of leading institutions that contribute into reformation of health care in Ukraine. School prepares professionals in health care management, provides surveys, and collaborates with international organizations. As Programme shares strategy and principles of School, its Head, Dr Irena Gryga, its teachers and students readily collaborate with other Programme experts. As the result, there are several analytical and practical surveys, provision of trainings for managers, and several master theses.

Presentation of Programme's publications to the students of NaUKMA

Considering positive experience of collaboration and assurance in professional potential of Academy, Programme management hopes that these publications will be useful for teachers and students during specialized courses.

 

ToT for clinicians

Last ToT for clinicians took place in Kiev on 9-11 of February 2010 in the frame of “Integrated perinatal care” component.
Training was devoted to work up training materials on the following issues

• Vaginal birth after Cesarean section;
• Lung ventilation at newborns;
• Medicines for newborns;
• Feeding of newborns.
   

40 obstetricians and neonatologists, future trainers, took part in the training. Among them there are representatives of NMAPE, Lviv Medical University, partner oblast hospitals, etc.

Programme strategy envisages that based on developed training materials trained groups of trainers will provide series of ‘step-down’ trainings for medical personnel of partner rayon hospitals in 2010. This strategy is based on principles of CME, decentralization of post-graduated education for medical personnel from remote areas, and credit-module practically oriented training.

 

Afterwards the training, the meeting of working group on training materials took place on 12th of February. The following preliminary prepared modules were discussed: multiple pregnancy and hemorrhagic disorders of newborns. In the end of meeting, the strategy of teaching and principles of trainers’ group formation were discussed; also, members of working group were invited to provide second expert opinion for clinical cases at iPath.

 

PFC meeting; Meeting at MoH

PFC meeting
Regular meeting of Perinatal Friday’s Club took place in Kiev on 29th of January 2010.
The meeting was devoted to the questions of abnormalities of amniotic fluid volume. Dr Irina Matvienko, Programme clinical consultant, made a report “Steroids in perinatology”.
Next meeting of PFC, devoted to the questions of prenatal diagnostic and treatment of heart congenital abnormalities, will take place in Kiev on 12th of February 2010. Specialists of Centre of Child Cardio Surgery will also take part in the meeting. We invite representatives of partner hospitals, first of all from oblast level, to join the discussion (taking part personally or via ICT).

Meeting at MoH
On 18th of January meeting of 1st Deputy Minister, Dr Vasyl Lazoryshynets, and SCO Director, Manuel Etter, took place in MoH of Ukraine. More details are at http://moz.gov.ua/ua/main/press/?docID=14622
 

Auto transport for rural medical facilities; News of Luboml hospital

Auto transport for rural medical facilities
Medical facilities of AR of Crime have got specialized cars “Opel Combo Arizona” in the frame of governmental program on strengthening of infrastructure of rural sites. In particular, each of 7 ambulatories of general practice and family medicine has got 1 new car. These ambulatories serve more than 50 rural sites together.
 

News of Luboml hospital
In the end of 2009 several important events took place in Luboml hospital, in particular in perinatal sphere. Among them, we could mention the following:

1. Implementation of local protocols on “Postpartum hemorrhage: medical personnel actions”.
2. Purchase of 3 humidifiers for oxygen supply to delivery dept. and surgery theatre.

We are also glad to inform that administration of Luboml hospital has submitted the application to get the status “Child-friendly hospital”. We sincerely wish our colleagues to succeed in getting this honorable status!
 

News of Ratno hospital

The end of 2009 was quite intensive for Ratno hospital, reference Programme rayon of Volyn oblast. Some of events and activities have contributed to the improvement of mother and child health in region, for example:

• Several training activities: ToT on implementation of clinical protocols “Miscarriage” and “Preterm delivery”; participation of rayon chief pediatrician in Ukrainian Pediatricians Congress (13-16.10.09); and participation of Head doctor in meeting of committee of Parliament.
• Approval of local clinical protocols on: “Treatment of gestational pielonephritis”, “Parthtogram”, “CTG for follow-up of intra-uterus status of fetus”.
• Purchase of new equipment: contour for lung ventilator “Millenium”.
   

Also, to improve the organization of perinatal care, the administration of Ratno hospital has planned the changes in medical personnel work. According to recommendation of Programme consultants, since 1st of January 2010 the 24-hour post of surgery nurse is to be implemented.
Recognition of the achievement of Ratno hospital by oblast authorities could be also proved by accreditation of health care facilities, successfully passed on 22nd of December 2009.

SC meeting

Regular Steering Committee meeting took place on 8 of December 2009. The meeting was chaired by Dr Lazoryshynetz (Deputy minister, MoH; Chairman of SC) and Dr Moiseenko (Head of MCH dept., MoH; National coordinator of Programme).

Dr. V. Lazoryshynetz and Dr. R. Moiseenko are holding the meeting

Participants of the meeting

Traditionally, the participants of the meeting were the representatives of the following organization: SDC Coof (Donor), SCIH (implementing institution), CWBF (co-implementer, component 1), NMAPE, oblast coordinators, WHO, UNICEEF, Fund “Ukraine 3000”. Such wide range of participants was caused by the importance of the discussed issues that concerned not only Programme implementation, but also national measures in health care.

               Manuel Etter (SDC Coof)                 O. Sherstyuk (UNICEF)  
                Martin Raab (SCIH)                         A. Solodarenko (PIO)

Oblast coordinators, I. Golovanchuk (Ukraine-3000)

The goal of the meeting was to present the results of last mid-year activity and plans for the next half of year. Presented results of work were positively perceived by Ukrainian partners and donor agency as well. Dr R. Moiseenko underlined that improvement of perinatal health care in partner regions is noticeable even at national level and is proved by positive dynamic of statistical rates. Oblast coordinators emphasized first the importance of different training activities provided by Programme. Representatives of donor agency also mentioned that Programme is one of the most successful examples of Swiss-Ukrainian collaboration.
Presentation of Programme plans for the half of year is the standard part of each SC meeting. It allows to discuss and agree key approaches and events of upcoming midyear with partners. Considering that 2010 is the final year of current phase, approval of plans for the first half of 2010 was very important part of this meeting.

Presentation of the work results (A. Solodarenko)

Z. Tsihon' expresses her opinion as Oblast coordinator

Also, during the meeting the decisions on important issues were made. First of all, it was agreed on the approach to include Programme training modules into the official system of continuous medical education in Ukraine. Then, on the basis of monitoring data and applications of partner regions, the status of associated rayons was increased to the status of pilot Programme rayons. Representatives of donor agency also informed that – considering socio-economic crisis in Ukraine and application of partners – additional budget (420 000 CHF) was allocated to purchase the essential equipment for modern perinatal services in partner CRH. Finally, in respond to MoH initiative it was agreed on the format of Programme participation in the fighting influenza (additionally to donation of SDC to UNICEF project).
 

Discussion of key questions (N. Goida)

After the SC meeting, regular quarter meeting of Programme Coordination Board took place. During the meeting, the detailed operational plan for the 1st quarter 2010 was discussed.

 

Events archive

Models of Perinatal Health Improvement in Ukraine.
In December 2009 the book “Models of Perinatal Health Improvement in Ukraine” was published. Thus publication presents the summing up of experience of MCH Programme implementation in 2005-2007. The results of Programme activity are reflected in the description of four models. Each model explains specific aspects of perinatal care and offers innovative approaches to its improvement. All four models are logically interconnected.
Analysis and measures of problem-solving are based on modern international principles of health care – and perinatal care in particular – management. Recommendations are oriented on practical application; therefore they count on specific of national health care system of Ukraine.
The publication could be useful for health care managers of all levels, specialists of social, youth and family services, representatives of international projects, and students of public health and health care management.

13 meeting of PFC
13 meeting of Perinatal Fridays Club took place on 27 of November 2009. This time 60 doctors from Kiev, Rivne, Gorokhiv (Volyn oblast), Illichyvsk (Odesa oblast), Donetsk and Kharkiv took part in the meeting. The topics of the meeting were the following:

• high risk of pregnancy termination;
• risk of preterm delivery;
• reliable symptoms and prevention of these conditions;
• hyper-diagnostic and false-positive treatment of these conditions.

Conclusions of the meeting could be obtained on request to Dr Solovyov (“Nadiya” clinic).

 

News and events of the component “Intersectoral model of MCH Promotion” in October 2009

During monitoring visit to Crimea on 5-8 of October it was estimated the state of implementation of two services: “Preparation of pregnant women and their family members to delivery and parenting” and “Preventive counselling of pregnant women and their family members based on the client-oriented approach”. Professor and Doctor of Medicine Karagodina O. G. (expert-consultant of the project) took part in the visit.
Monitoring visit included meetings with trained specialists who take part in services implementation.
The results of the services implementation in the pilot rayons of the Crimea are the following:

• “Schools of responsible parenting” in Dzhaykonskiy, Bahchisarayskiy, Sakskiy rayons correspond to modern requirements and work upon the program approved by the Ministry.
• A new room (satisfied the standards of antenatal consultancy) was given for “School of responsible parenting” in Dzhaykonskiy rayon; the repair has been made in the room.
• A new room was given for “School of responsible parenting” in Bahchisarayskiy rayon; the repair will be made by March, 2010.

Trainings for CC members in pilot rayons were held in Volyn on 1-3 of October, in Ivano-Frankivsk on 7-9 of October, in Vinnitsa on 14-17 of October. It is the third training of the course for CC members on the issues of mother and child health promotion. The main goal of the training is preliminary work on preparation of the rayon MCHP.
CC have started elaboration of the projects of rayon intersectoral MCHP programs. Oblast consultants – Guryeva L. I., Dovgalyuk I. S., Vinnitska O. I., Petrovich V. S. - work within pilot rayons to assist in this work.

Koziatyn CRH news

In autumn 2009 three important things happened in Koziatyn CRH.
Two changes in personnel happened:

• new deputy head doctor on maternity and childhood – Dr Stanislavchuk Nadiya; she is also responsible for coordination of programs in reproductive health;
• chief of delivery dept., Dr Grubelias Galyna.

The hospital also got the donation from the Netherlands – 6 functional beds.

Training “Implementation of telemedicine in Programme pilot facilities: managerial aspects”

On 30th of October 2009 the training “Implementation of telemedicine in Programme pilot facilities: managerial aspects” took place in Kiev.
The tasks of the training were: 1) to clarify role of administrators in the organization and integration of telemedicine in regional pilot facilities; 2) to define list of actions needed for successful implementation of telemedicine into clinical practice.
The participants of the training were: oblast specialists, head doctors of pilot CRH, deputy heads of CRH, active users of iPath, Programme technical consultants on telemedicine. Moderation and expert support of event were done by Prof Dmytro Dobryanskyy, Programme telemedicine coordinator and moderator of discussion group at the platform.
Training format combined presentations, group discussions and role plays. As the result of active and fruitful work of participants, they could define key factors of successful implementation of telemedicine into clinical practice (administrative ones, in particular), and also specify list of needed actions to achieve expected results. Decisions made have become the basis for ‘home work’ of participants: to develop specific regional plan of actions to optimize the process of implementation of telemedicine into clinical practice of Programme pilot facilities.

12th meeting of Perinatal Fridays Club; Coordination Board meeting

12th meeting of Perinatal Fridays Club
On 23rd of October 2009 the 12th meeting of informal medical Perinatal Fridays Club took place. The meeting was devoted to the questions of erythrocyte alo-immunization. 50 doctors from Kiev and Kiev oblast took part in the meeting. Due to modern telemedicine technologies, the colleagues from Lviv, Donets, Dnipropetrovsk, Nikopol, Kryvyy Rig, Dniprodzerzhynsk could also took part. More detailed information could be obtained from:
http://www.ivf.com.ua/rus/news-article/2009/10/24/12_te_zasidannja_klu_291.html

The agenda of next meeting is available in Ukrainian only.

Coordination Board meeting
On 21st of October 2009 regular Programme Coordination Board meeting took place.
During the meeting Programme consultants presented quarterly reports and results of monitoring missions to the pilot regions. Also, members of Coordination Board made the decisions on important issues raised by Programme representatives, e.g.:

• approbation of ‘perinatal service package’ in pilot regions;
• algorithm of approval of training modules (by credit system);
• challenges of implementation of telemedicine into routine clinical practice;
• improving the communication with partners etc.

Representatives of donor agency (SDC) informed about the approval of additional budget for the purchase of essential medical equipment for perinatal services in pilot CRH. This “step towards” was made by Swiss partners as the respond on the request of Ukrainian colleagues considering economical crisis that obstructed the fulfilment of Memorandum at sites.

In the end of meeting the participants approved the Programme Plan of operation till the end of 2009.

Training module

First trainings were held in Crimea (8-10 of September), Volyn (15-17 of September) and Ivano-Frankivsk oblast (22-24 of September) on implementing of «Early Childhood Development» service. Total number of participants - 79. There were pedagogues from kindergartens (24), psychologies (17), methodologists of education departments (10), representatives of medical sphere First trainings were dedicated to acquaintance with modern approaches to creating of developing environment for children (from birth till 3 years).

First trainings have been started for rayon specialists on implementing of “Training on health” service.
Trainings were held in Volyn (7-9 of September), Ivano-Frankivsk (28-30 of September) and Vinnitsa oblast (28-30 of September). Total number of participants - 87.
Teachers, psychologists, social pedagogues and medical carers from schools were invited. The participants noted that after training they have thought of their health and will intend to work with teenagers.

On September the experts-authors of the training modules took part in monitoring visits to pilot rayons, where they interviewed trained specialists.
Natalya Zymivets took part in the visit to Vinnitsa (8-10 of September), all oblast consultants were present during the visit.
Monitoring visit to Ivano-Frankivsk oblast (Kolomiya, Snyatyn, Verhovina) was held on 14-18 of September. Specialists from different rayons shared their experiences in conducting of “School of responsible parenting”.

Third round of trainings for CC members was held in Crimea on 23-25 of September to the elaboration of the rayon intersectoral MCHP program.

There were 23 representatives from all pilot rayons, including head of CC from Saky.

Trainings in other pilot oblasts will be held in October, 2009.

Monitoring missions
Monitoring missions of Programme consultants was done to pilot rayons of Vinnytsia and Ivano-Frankivsk oblasts in the first half of September 2009. Agenda of missions covered all four components implemented in oblasts. Specific reports of consultants could be obtained in PIO. Monitoring missions to Crimea and Volyn oblasts are planned in October 2009.

IMCI working group meeting
Regular meeting of working group “Adaptation of IMCI in Ukraine” took place in Kiev on 16-18 of September 2009. The WHO expert, Dr Lezhnev Ivan, facilitated this meeting. Short report on this meeting is available in Ukrainian.

Regular (10th) meeting of Perinatal Fridays Club

took place at “Kyiv” Municipal theatre on 28 August 2009. It was devoted to the issue of multiple pregnancy.

Several presentations have been done during this meeting:

• Children after IVF – myths and reality. Dr Zukin, medical genetic, clinic “Nadiya”
• Multiple pregnancy: peculiarities of pregnancy and fetus growth. Dr Tkachenko, NMAPE
• Fetal growth retardation from the point of neonatologist: difficulties and practical questions; peculiarities of multiple pregnancy. Dr Matvienko, neonatologist, MCH Programme clinical consultant
• USD at multiple pregnancy: definition of pregnancy type, calendar of investigation, peculiarities, diagnostic and treatment procedures. Dr Solovyov, obstetrician, clinic “Nadiya”

Main thesis of mentioned presentations are available in Ukrainian.
Next meeting is planned on 25 of September 2009. The detailed information will be announced at iPath.

Monitoring visit

In the frames of MCH Programme implementation during Spetember-October there will be monitoring visit to pilot institutions of the Programme. The main aim of monitoring visit is the discussion of current Programme implementation status in each institution, identification of main problems existing in mother and child health care and ways of their solution.
Plan of monitoring visit:

1. to meet with administration of each pilot hospital;
2. to meet with head of Rayon State Administration (or deputy head on humanitarian issues) on the basis of central rayon hospital;
3. to observe obstetrical department;
4. to observe school of paternity;
5. to provide interview with:

• medical staff;
• young mothers;
• heads of coordination board and specialists responsible for paternity schools and client-oriented consultation;

6. to analyze:

• delivery and newborn records;
• MATRIX BABIES indices of institution.
   

Monitoring visits will be done to some Oblast pilot hospitals where representatives of health institutions will be invited (chief physician or deputy chief physician on mother and child care and Rayon chief obstetrician) from other Oblast Rayons.
Detailed information can be obtained in Project Implementation Office.

The adaptation of WHO IMCI approach

As it was reported earlier at our web-site, there is the process of adaptation of WHO IMCI approach in Ukraine at the moment. Implementation of this approach is guided jointly by MoH of Ukraine, Medical Sciences Academy, WHO, and UNICEF. Swiss-Ukrainian MCH Programme has also jointed to this collaboration: Programme consultant, Dr Oksana Chopko, has been included into the “IMCI adaptation” working group created by MoH order.

The IMCI materials are intended for the usage by doctors of primary level: family doctors and district pediatricians. Current health care system of Ukraine puts on these specialists the responsibility for full and qualitative ambulatory care for children, and also for the timely referral to particular specialists if needed.

The document elaborated by WHO allows to classify the pathology with the help of simple and clear criteria and choose the effective scheme of care provision. IMCI materials include the care for children from birth to 5 years. Considering the peculiarities of morbidity, two chapters are defined:

• “To assess, classify and treat sick child in the age from 2 months to 5 years”
• “To assess, classify and treat sick newborn in the age to 2 months”

Also, the IMCI includes the training materials for doctors: theoretical and practical skills of diagnostic and treatment, parents counseling on child care at home, and considerable amount of illustrative materials.

Regular meeting of working group took place on 25-28 of August 2009. It aimed to analyze the changes included into the document, to assure the correspondence of IMCI guidelines to national protocols.

The next meeting of working group and WHO experts is planned on 16-18 of September 2009. It will be the final meeting in the process of IMCI adaptation. During this meeting, the format of training seminars will be also agreed, as well as options of usage of e-learning manuals during the training. The training seminars will precede the adaptation of IMCI in the pilot regions. Pilot implementation of IMCI approach is planned in three oblasts of Ukraine: Kyiv, Zhytomyr and Vinnytsia. The one rayon will be defined in each oblast to approbate the IMCI.

 

Events archive

First surgical fetoscopy
August 7, 2009 first fetoscopy was provided in Ukraine. Detailed information is given on telemedical platform “iPath” in the case “First surgical fetoscopy”, Ukrainian-Swiss perinatal health programme group.

“Intersectoral model of mother and child health promotion” training
In pilot oblast the trainings for rayon representatives (medical care specialists and social workers) on client-oriented counseling were conducted in the framework of Component “Intersectoral model of mother and child health promotion”: on the 1-3 of July for Vinnytsa and Ivano-Frankivsk oblasts; on the 8-19 of July for Volyn oblast; on 15-17 of July for Crimea.

The aim of the training was to increase the capacity of rayon specialists in counseling based on client-oriented approach.
The schedule of this second round of trainings included practicing the skills of active listening and reflecting the feelings; and also the cases of “difficult clients” and telling negative information were discussed. Trainings were conducted by experts O.Karagodina, T.Tsyuman, V.Lyuty, G.Fedorenko.

Clinical experts I.Matvienko and O.Chopko participated in the training for Crimea specialists.

Survey
During the 1st half of 2009 the survey has been conducted in the frame of ICT component. This survey aimed to evaluate the effectiveness of telemedicine implementation in pilot regions of the Programme.

Survey methodology includes document analysis, interviewing of experts, and questioner for telemedicine platform users (doctors of pilot facilities). The survey has been conducted by the student of Master program of School of Public Health, Olga Yemets. She has defended her Master thesis based on the survey results. The title of thesis is: “Assessment of telemedicine technology implementation for the improvement of perinatal care in Volyn and Ivano-Frankivsk oblasts”.
Some of the main conclusions of the survey are the following:

• favour to telemedicine, found among users, could be explained by correspondence of technologies to users’ needs;
• obstacles on administrative, infrastructural and personal levels prevents more effective implementation of telemedicine in hospitals;
• usage of telemedicine decreases the number of untypical alternative situations when decision about specific clinical case should be made; also, it helps in routine clinical practice when situations of uncertainty occur;
• model of telemedicine implementation proposed by Programme is a valuable experience for the development of telemedicine in Ukraine.
  
  Full text of thesis you could obtain at PIO or SPH.

Events in June-July

Order №484 from 07.07.2009
MoH of Ukraine has issued the order “About changes in regulation of examination at pre-attestation cycles”. The important points of this order are the following: implementation of credit-point system of knowledge assessment, computer control of knowledge level and shortage of cycles to 1 month. MCH Programme also supports the corresponding principles of post-diploma medical education: short-term courses, wide application of telemedicine technologies, rating system of knowledge assessment. Approval of the order assures that system of post-diploma medical education in Ukraine is moving towards modern international standards of education; as well, it means that Programme activity corresponds to the basis of national health care policy. The text of the order is available in Ukrainian only.

6 – 8 July 2009. Managerial training
During 6 – 8 July 2009 with WHO international experts participation a managerial training on the questions of collection, processing and analysis of statistics data in the perinatal sector of the health sphere and on carrying out a perinatal audit takes place. Representatives from the Programme's pilot regions are invited for this training: heads of the regional health care administrations or their deputies; main specialists on obstetrics and neonatology; regional/ republican specialists on statistics; head doctors of pilot rayon medical institutions.

This training will highlight the question of the rules of collection and sorting out, analysis and processing of the statistics data; of finding out the main problems of perinatal care on the basis of data analysis and of working out the possible ways of those problems solving.

In June 2009 the trainings for the members of the rayon Coordination committees „Elaboration of the rayon intersectoral MCHP program” were organized in Volyn oblast (4-5 of June), Ivano-Frankivsk oblast (16-17 June),
Vinnitsa oblast (23-24 June) in the framework of Component “Intersectoral model of mother and child health promotion”. In May such training was held in Crimea. Participants of the trainings – representatives of rayon state administrations, head doctors of rayon hospitals and other specialists from different spheres, who are members of the Coordination committees. The trainings were dedicated to the principles of the development of rayon social programs using the logical framework approach. Participants from each rayon started to elaborate their programs for mother and child health promotion.

On 26 of June 2009, MoH issued an Order # 467 “About additional measures to ensure the realization of Ukrainian-Swiss MCH Programme”.
This order provides to Programme Ukrainian partners necessary regulatory support. In particularly, it approves the personal list of Programme working groups and the topics of training modules that are being developed by the working group in the frame of Component # 1 (IPC).
The Programme management expresses its gratitude to MoH and, in particularly, to National Programme Coordinator, Head of MCH and Sanatorium dept. of MoH, Mrs. Moiseenko R.O. We thank for the collaboration and the recognition of the importance of our common work.
The Ukrainian text of the order you could find here…

Results of mid-term review of the Ukrainian-Swiss “Mother and Child Health” Programme

10 June 2009 a National workshop with presentation of results of mid-term review of the Ukrainian-Swiss Programme “Mother and Child Health” implementation for the last 1.5 years (2008 – first half of the 2009) took place.

On the initiative of Programme Donor – Swiss Cooperation Office – the work started in April to hold strategic evaluation of Program implementation for the last 1.5 years. This research was divided into several stages: organization of working meetings with Programme partners in pilot regions aimed to discuss the process of Programme implementation and to get the feedback on the cooperation and on the effectiveness of Programme implementation in each region and in each rayon; analysis of the received information and organization of the National workshop with presentation of results and further Programme implementation planning. The review was carried out with the participation of a specially employed external expert and representatives from the partner organization – Ukrainian Child Well-Being fund.

Visits to pilot regions – Vinnytsya, Volyn, Ivano-Frankivsk regions and AR Crimea took place during April – May 2009. On 10 June a mid-term review workshop took place in Kyiv. The workshop was conducted with the key Programme partners participation – representatives from the MOH of Ukraine, P.L. Shupik National Medical Academy of post-graduate education, Swiss Cooperation Office, Ukrainian Child Well-Being fund, pilot regions and rayons. Total number of participants was nearly 45 people. Results of this workshop was additionally discussed and agreed on 11 June during the Steering Committee meeting – the main body responsible for the Programme implementation in Ukraine. This meeting should result in a plan confirmation of the Programme implementation during the next 1.5 years.

Events in June

2nd of June 2009. Seminar to provide methodological support to rayon specialists took place in Gorodenka (Ivano-Frankivsk oblast). 20 participants (representatives of rayon state administration, health care specialists, social workers, pedagogues) exchanged their experience in implementing of the Component “Intersectoral model of mother and child health promotion”. Participants analyzed the work of the rayon Coordination committee, and also the achievements and needs for the implementation of the services “School of responsible parenting”, “Client-oriented counseling”, “Training on Health”, “Early child development”.

1-2 of June 2009. The study visit of representatives of Swiss Cooperation Office Moldova was organized to Ivano-Frankivsk oblast. During the visit participants could see the experience of Gorodenka town in the implementation of Mother and Child Health Programme, examples of perinatal and social services.

April - June, 2009. Mid-Term Review
Mid-Term Review will be moderated by external consultant, Dr Irena Gryga, Head of School of Public Health (Kyiv-Mohyla Academy). At the first stage of Review, there will be focus-groups in pilot oblats. The goal of focus-groups is to obtain the feedback about Program implementation from Ukrainian partners. Focus-groups will take place in the end of April – beginning of May 2009. The obtained data will be analyzed and then, as the second stage, the national workshop will be held. The aim of national workshop is to present results of analysis and develop the recommendations for further Program implementation. With the assistance of key partners, the workshop will take place in Kiev in the beginning of June 2009.

Events in May

May 30-31, 2009. Scientific and practical Conference of obstetricians, neonatologiosts, anaesthesiologists and ultrasound specialists. The conference took place in Koblevo, Mykolayiv Oblast and was devoted to International saving children day. The title of the conference was: "Safe motherhood: association of obstetricians, neonatologiosts, anaesthesiologists and ultrasound specialists". Ukrainian report of Programme's clinical consultants I. Matvienko and A. Chernov about this conference you may find here.

May 26-27, 2009. Training for the members of Coordination committees in Crimea. In the framework of Component “Intersectoral model of mother and child health promotion”, the training for the members of Coordination committees was organized in Crimea. This is the new phase in CC members training, dedicated to the development of local social policy document on MCH. Training was held in Lelino rayon of Crimea.

May 20-22, 2009. In the framework of Component “Intersectoral model of mother and child health promotion”, the second seminar for trainers “Preparation to delivery and parenting” was held in Kiev. 25 participants from pilot rayons of all Programme oblast were present (among them: gynecologist, obstetricians, neonatologists, and social workers). Training was conducted by the Program experts: Ivanna Bratus (Kiev, Child Well-being Fund) and Tetyana Babych (Donetsk, Obstetrical dept. of University). Participants trained their trainers’ skills needed to be used in the “Schools of responsible parenting”. The first training of this cycle was held on the 2-4 of April 2009 and it was dedicated to the methodology and the detailed programme for the “Schools of responsible parenting”.

2 trainings «Counseling based on the client-oriented approach» were organized in the framework of Component “Intersectoral model of mother and child health promotion”:
May 20-22, 2009 – training for representatives of the pilot rayons in Ivano-Frankivsk oblast, where 28 participants from pilot rayons were present.
May 19-21, 2009 - training for representatives of the pilot rayons of Vinnitsa oblast. There were 35 participants (among them gynecologist, obstetricians, nurses, social workers).

May 19-21, 2009. The second training of the programme «Training on Health” was held in Crimea in the framework of Component “Intersectoral model of mother and child health promotion” (the first training of the programme was organized on the 24-26th of March, 2009). 28 participants from all 5 pilot rayons of Crimea (pedagogues, social workers, health care specialists) were trained on how to implement the method of peer-education to share among youth the modern knowledge about health, health care and safety.

May 19, 2009. Seminars to provide methodological support to rayon CC took place in Ratne (Volyn oblast). 25 participants (representatives of rayon state administration, health care specialists, social workers, pedagogues) exchanged their experience in implementing of the component “Intersectoral model of mother and child health promotion”.

May 5-7, 2009. The training «Early childhood development» was organized in the framework of Component “Intersectoral model of mother and child health promotion” for representatives of the pilot rayons of Vinnitsa oblast (35 participants: pedagogues, pediatricians, and methodologists).

May 5-7, 2009. The Second Symposium of Ukrainian International school “Perinatal medicine and safe motherhood”

With support of Ukrainian Society of Perinatal Medicine, the Second Symposium of Ukrainian International school “Perinatal medicine and safe motherhood” took place in Uzhgorod during 5 – 7 of May 2009.

Scientific subject of the Symposium was “Problems of placenta insufficiency in modern perinatology. Perinatal ultrasound”. Ukrainian and international specialists in obstetrics, ultrasound diagnostic, resuscitation, neonatology, anesthesiology, pediatrics made presentation on urgent issues related to placenta insufficiency. More information about the Symposium You could find on the web-site: www.conf.pmz.org.ua.
On behalf of MCH Programme, two experts took part in the Symposium:

1. Dr. Olav Lapaire, Senior Physician, Deputy Head of Obstetrics Department, University Hospital of Basel, Switzerland. Topic of his presentation was: "Swiss regulations of obstetrical tactic: 1) fetal distress at 22-32 gestational weeks; 2) pregnancy termination in case of diagnosed fetal malformations and/or chromosomal anomalies after 22 gestational weeks".
    
2. Dr. Artem Chernov, obstetrician, the Programme clinical consultant. Topic of his presentation was: “Effective monitoring of fetal well-being during pregnancy and childbirth: managerial aspects based on the principles of regionalization in perinatal care”.

Events archive

April 16-17, 2009. Meeting of working group memebers from MCH Programme, MoH, AMS, WHO and UNICEF
MCH Program has been invited to work together with MoH, AMS, WHO and UNICEF on adaption of IMCI to Ukrainian conditions. In the frame of this collaboration, MoH issued an order to form the working group. Program consultant, Dr Oksana Chopko, has been invited as a member of this group.
Adaptation of IMCI aims to:

• assure that IMCI guidelines include the essential child illnesses that should be treated at primary level or referred to a higher level after adequate care;
• take into account the most effective preventive services and include them into IMCI guidelines;
• harmonize IMCI guidelines and current national protocols, recommendations and approaches;
• assure the correspondence of IMCI guidelines to national requirements for their further introduction into health care system; and also to help into family care of children.

Regular meeting of the working group took place on 16-17 of April 2009 in Kiev. As soon as IMCI adaption will be finalized, the training for medical personnel of primary level will take place in the pilot regions.

Clinical training
On 6-10 of April 2009 clinical training on perinatal topics was provided in Kiev for representatives of partner regions. The training was provided with moderation of international experts, Dr Veronique Isnard and Dr Lucas Opitz (University hospital, Nice, France), and support of Programme clinical consultants.
40 obstetricians and neonatologists, future trainers of national and oblast boards, took part in the training. Among them there are representatives of NMAPE, Lviv Medical University, partner oblast hospitals, etc.
Programme strategy envisages that based on developed training materials trained groups of trainers will provide series of ‘step-down’ trainings for medical personnel of partner rayon hospitals in 2010. This strategy is based on principles of CME, decentralization of post-graduated education for medical personnel from remote areas, and credit-module practically oriented training.

March 25, 2009, seminar-presentation of Service Package, MZ, STI, SCIH, NG, National Medical Academy of Post Graduate Education (NMAPO).

March 23-25, 2009, training for managers "Introduction to Management principles", Manfred Zahorka, STI, SCIH.