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BuryatiaRhinelander

Buryatia, Russia / Rhinelander, Wisconsin

1998-2000


Focus: Neonatal Resuscitation, Maternal and Child Health



The Partners

US Partners: The Baikal-Great Lakes United Medical Program (BGLU) is a project of the Illinois-Russian Cultural and Economic Institute (IRCEI), a nonprofit organization whose mission is to develop connections, exchanges, and cooperative projects between the people of Russia and America. It was formed with the purpose of developing long-term, ongoing relationships between communities of the US Great Lakes Region and those around Lake Baikal in Siberia, concentrating on issues of health within the cultures and environments of each area. Professionals from Sacred Heart-St. Mary's Hospitals, Inc., Rhinelander Regional Medical Group, and Gunderson Lutheran Hospital also greatly contributed to the partnership.

Russian Partners: The Ministry of Health of Buryatia led this partnership with the City Maternity Center and the Republic Maternity Hospital in Ulan Ude playing an active role.



Partnership Objectives

The overall objectives of the partnership were to improve maternal and child health in Buryatia and its environs and to strengthen capacity and sustainability of the Neonatal Resuscitation Program previously initiated by AIHA in the region.

In support of these objectives, partners:

  • Conducted a series of surveys to establish baseline assessments of newborn health and developmental progress for normal, high-risk, and impaired infants, which were continued at periodic intervals to ensure ongoing assessment and evaluation;
  • Implemented a regional schedule for systematically training and/or re-training health professionals in maternal and neonatal health;
  • Established a neonatal resuscitation classroom where regional training and re-training in neonatal resuscitation procedures could be conducted; and
  • Linked Buryatia practitioners trained in neonatal resuscitation to a network of colleagues throughout Russia as a means of improving information sharing and problem solving.



Key Events and Achievements

Clinical Organization and Capacity Building

In 1998, partners at City Maternity Hospital in Ulan Ude trained a total of 21 area health professionals in the first provider course conducted at the Neonatal Resuscitation Training Center (NRTC); nine of them
successfully completed the instructor course and became trainers. Six more graduates completed the instructor course over the next two years, bringing the total number of master trainers to 15.


From 1998-2000, the NRTC trained a total of 195 healthcare providers in modern, low-cost, low-tech neonatal resuscitation techniques.

In May 1998, a US obstetrical nurse visited Ulan Ude Maternity Hospital where she conducted a series of lectures for a mixed audience of more than 50 health professionals. She presented on the important role nurses play in labor support, newborn resuscitation, initial newborn care, treatment and prevention of hypothermia and hypoglycemia in newborns, and the signs, symptoms, and treatment of premature labor. She also lectured on hypertension in pregnancy, infection control and hand washing, and postpartum care, and gave mini-lectures and clinical demonstrations to small groups of healthcare providers on newborn assessment, thermal regulation, glucose regulation, hyperbilirubinemia, prophylactic use of Rh-Immune globulin for mothers, and prophylactic use of antibiotic eye ointment in newborns.

Midwives from both Russian partner institutions participated in a Childbirth Education Conference and subsequently made significant changes and improvements in perinatal care practices at their home institutions.

Both facilities established family-centered birthing rooms that became increasing popular with patients. At the Republic Maternity Hospital in Ulan Ude, for example, 20 percent of all births in 1999 took place in the family-centered birthing rooms while the number increased to 25 percent in 2000. At City Maternity Hospital, 70-72 percent of all births in 1999 and 2000 took place in the new family-centered birthing rooms.

Partners trained 102 local midwives in advanced maternal and neonatal health topics between 1999-2000. 1998


Maternal and Child Health

As a result of training they received, Buryatia partners began using erythromycin eye ointment as a prophylactic against conjunctivitis in newborns. They found this practice to be so successful that it has since
become the official standard of care in the region.


At City Maternity Hospital No. 2, a woman can have her husband and/or family members present for labor delivery and can choose a particular midwife and obstetrician for an extra fee. Both partner institutions also offer the option of rooming in and provide for early contact between the mother and child during the first 24 hours after birth. These new options represent the beginning of a fundamental shift from government-controlled services to a consumer-driven model.


Lutheran Social Services provided funds to support a facility for children with Down syndrome and other mental disabilities in the Zakamensky Region.


A US dentist who adopted a child from the region worked with Lutheran Social Services to establish the "No Tears Dental Program" to provide all Buryatia orphans with basic dental care using novocaine.

Lutheran Social Services also provided funds to the Neonatal Center at Children's Hospital No. 1 to support newborns age five days to three months, and to Maternity Hospital No. 2 to assist in care for newborns for the first five days of life and for abandoned children. These funds were used to purchase drugs, supplies, and baby food for abandoned children.


Lutheran Social Services established foster care sponsorships for abandoned children and a “Birth to 3” training program for caretakers of preschool children at homeless shelters, orphanages, and special care facilities.


Neonatal Resuscitation

From 1996-2000, the Ulan Ude NRTC trained 361 people — 49 neonatologists, 130 nurses, 40 midwives, 86 pediatricians, 30 ob/gyns, and 26 anesthesiologists.


The neonatal resuscitation techniques taught at the NRTC have become the standard of care at Ulan Ude City Maternity Hospital, where 3,500 babies are delivered each year.


Neonatal resuscitation data collection began in May 1998. Partners worked together to develop a systematic approach to data collection, review, and analysis that helped ensure it would have a positive
impact on the quality of services, as well as newborn mortality and morbidity. As a result of the program and accurate tracking of cases, the neonatal mortality rate decreased from 9.9 percent in 1996 to 8.6 percent in 2000. Rates of early neonatal mortality decreased from 8.0 percent in 1996 to 6.3 percent in 2000, and perinatal mortality decreased from 15.9 percent in 1996 to 12 percent in 2000.


The regional Ministry of Health sent two pediatricians from City Maternity Hospital No. 2 to Moscow for a year of advanced training in neonatal intensive care. Both of the chosen pediatricians participated in the NRTCs provider and instructor certification during the initial AIHA-sponsored training course in 1998.




Partnership Data

Dates of MOU Signing: November 9, 1994  
Exchanges: NIS Partner Exchanges

13
  NIS Partner Exchange Days

214
  US Partner Exchanges

16
  US Partner Exchange Days

200
  Total Exchanges

30

  Total Exchange Days

414

Estimated Value of In-Kind Contributions:    
Medical Equipment and Supplies, Educational Materials

8,765
  Human Resources

392,219
  Total

$403,531




Participating Institutions

Read more about this partnership...


Improving Maternal and Child Health in Russia’s Lake Baikal Region (PDF)

Updated: March 13, 2009