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Community IMCI - Ferghana, Uzbekistan

Community IMCI - Ferghana, Uzbekistan. Mary E. Skarie, USAID/CAR. Under-five Mortality Rates in Central Asia. Uzbekistan: 69 2000 UNICEF MICS Kazakhstan: 71.4 1999 DHS Kyrgyzstan: 72.3 2000 WB ( 96.4 in lowest economic stratum) Turkmenistan 90 2000 DHS

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Community IMCI - Ferghana, Uzbekistan

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  1. Community IMCI - Ferghana, Uzbekistan Mary E. Skarie, USAID/CAR

  2. Under-five Mortality Rates in Central Asia • Uzbekistan: 69 2000 UNICEF MICS • Kazakhstan: 71.4 1999 DHS • Kyrgyzstan: 72.3 2000 WB (96.4 in lowest economic stratum) • Turkmenistan 90 2000 DHS • Tajikistan 126 2000 UNICEF MICS

  3. Existing Uzbekistan Structures Supporting Community-Based IMCI • PHC Physician and nurse home visiting program • Community education system in place from Soviet times • Local neighborhood structure (Mahalla) provides social support network Issues Community-Based IMCI Can Address • Exclusive breastfeeding to age 6 months at only 22% (2000 UNICEF MICS) • 61% of children under 3 have anemia (1996 DHS) • Lack of knowledge on prevention/home treatment/professional treatment Diarrhea ARI

  4. Community Involvement Schools, Kindergartens, & Youth Centers NGOs & CBOs Primary Health Care Facilities (Healthcare System) Health Promotion Centers Community & Religious Leaders

  5. Community IMCI Activities • Health campaigns • anemia & general nutrition (target: general nutrition) • ARI • diarrhea • IMCI danger signs (incorporated in diarrhea & ARI campaigns) • breastfeeding (upcoming) • Health fairs - PHC sponsored • hygiene • diarrhea • ARI • breastfeeding • NGO grant activities • Nabahor: improving client education by visiting nurses and midwives, including weekly bazaar event • Hilol: Mother Support Groups • Ayol Va Salomatlik: improving child health

  6. Examples of Community IMCI • Training Health Promotion Center staff to conduct ‘community conversations’ and health events (e.g., health fairs) • anemia & general nutrition (target: women and children) • ARI • diarrhea • hygiene • Training SVP/SVA health workers for client education • anemia & general nutrition (target: women and children) • ARI • diarrhea • hygiene • breastfeeding

  7. Examples of Community IMCI • School health lessons • diarrhea • ARI • hygiene • nutrition • transmission of germs/disease • School song competition • winner of best song: Diarrhea • Cassette with songbook (songs, skits, fables & poems) • hygiene • diarrhea • importance of staying healthy • healthy habits

  8. Health Knowledge, Attitude, and Practice Survey This survey was conducted among the population in four locations in Uzbekistan in June 2001: • Quva Rayon – a mature rural site(Ferghana Oblast) • Ohunbabaev Rayon – a new rural site(Ferghana Oblast) • Margilon City – a future urban site(Ferghana Oblast) • SyrDarya Rayon – a future rural site(SyrDarya Oblast)

  9. Survey Results:Integrated management of childhood illnesses When should a child be seen by a health care worker or taken to a health are facility: a) blood in stools d) high temperature b) inability of drink e) breastfeeding poorly c) cold or cough with f) continues to get sicker difficulty breathing Average number of reasons to take a child to a health care provider correctly identified. Quva Rayon = 2 Ohunbabaev Rayon = 1.8 Margilon City = 1.4 SyrDarya Rayon = 1.6

  10. Survey Results: Knowledge about Breastfeeding

  11. Future Activities for National Scale-Up • Extend previous health campaigns nationally through Institute of Health • Expand NGO grants program for "Healthy Communities” • Extend school health curriculum nationally through Ministry of Education

  12. Future Activities Oblast-wide • Conduct 2 new health campaigns per year • Train visiting nurses and midwives on improved client (child & mother) screening and health education during home visits • Pilot Mother Support Groups at community level • Promote collaboration among all organizations involved in community-based health education through Oblast Health Promotion Working Group

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