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Whilst addressing the primary health needs of the population to which
a comprehensive humanitarian response is essential, Family Care developed
and implemented comprehensive indicators for monitoring and evaluation
of its activities in Nagorno Karabagh. It is clear that enormous gains
were made in the first 32 months of program in support of Maternal and
Child Health care. The main achievements were as follows:
Positive trends in health care statistics based on accuracy in reporting
(using internationally defined peri-natal statistics) :
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Decrease in numbers of 'normal "newborn transferred to special
care based
on inappropriate diagnosis of 'morbidity' at birth from 20 % down to 2%
in Nagorno Karabagh.
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Reduction in early neonatal mortality due to better case management
of sick newborn
in Stepanakert central maternity during the life of the project (14.2
per 1000 live births
in 1997; 11.2 per thousand in 1998; 7.1 per 1000 in 1999 and 6.1 per
thousand in 2000).
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Increased awareness in the community of the importance of good prenatal
and
intra-natal care illustrated by the 40% sustained increase in attendance
of women
for prenatal care in the central maternity hospital and attendance
of husbands or
another relative at the birth both centrally and in regions.
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Sound sustained changes in practice of health providers based on newly
taught
evidence based care and protocols; examples of positive impact were: (1)
the rapid
decrease in numbers of cases of birth trauma which was previously caused
by
unnecessary interference in the delivery process; (2) The role and responsibilities
of midwives was significantly increased, lessening that of obstetricians
in normal
physiological labour.
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Increased participation of clinicians in the process of developing in-hospital
training
refresher courses for local staff.
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Increased parent satisfaction with service based on exit interviews
including
that concerning the participation of husbands/ partners in a supportive
role
and involvement of parents in the care of sick and premature newborn.
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Sustained interest of staff to maintain the improved working conditions
of the facilities
in terms of good maintenance of buildings and equipment in all assisted
facilities.
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