Improving maternal and perinatal health care in the Central Asian republics.
OBJECTIVE
To describe our experience of a complex training intervention to introduce effective perinatal care, evidence-based medicine, national confidential enquiries into maternal deaths, and facility-based near-miss case reviews in the Central Asian Republics.


METHODS
We describe our experiences from training sessions and report on findings from data extraction from patient records, patient interviews, discussions with healthcare staff, and observation of health care during our follow-up visits.


RESULTS
Many outdated practices in perinatal care have been abandoned, and several recommended approaches have been adopted in pilot facilities. Familiarity with the concept of evidence-based medicine has increased among participants. National confidential enquiries into maternal deaths are being prepared and facility-based near-miss case reviews piloted.


CONCLUSIONS
The experience of the complex training intervention to improve maternal and perinatal health care in the Central Asian Republics is encouraging, but roll-out will be challenging. The quality of care and the attitudes of healthcare providers will have to be monitored continuously.
Borchert
Matthias
M
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. matthias.borchert@lshtm.ac.uk
Bacci
Alberta
A
Baltag
Valentina
V
Hodorogea
Stelian
S
Drife
James
J
D001209:Asia, Central; D004502:Education, Medical, Continuing / Q000379:methods*; D004509:Education, Nursing, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009774:Obstetrics / Q000193:education*; D018743:Perinatal Care / Q000379:methods*; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy