• Decrease infant mortality within the region.
• Develop a perinatal evaluation center.
• Establish a fetal ultrasound unit.
• Strengthen delivery room procedures to improve the condition of newborns.
• Improve infant resuscitation techniques.

• Improve pediatric programs in cardiology, gastroenterology and pulmonology.
• Train cardiologists to improve diagnostic skills.
• Establish a pediatric ultrasound unit.
• Update the gastroenterology endoscopy suite.
• Improve the treatment of asthma.

• Develop an education program for promoting family planning options.
• Increase nursing documentation.
• Provide models for continuing education, clinical competency and accountability.
• Establish National Nursing Association to support development of the profession.programs.

• Expand prevention, health maintenance and infection control in all areas of the partnership.
• Decrease the number of abortions.
• Improve the recognition and treatment of sexually transmitted diseases.
• Establish a women's health program, including a breast health program.
• Establish an educational unit for doctors and nurses.

• On September 22, partners signed a Memorandum of Understanding between the Children's Hospital of Philadelphia and the University of Pennsylvania on the US side, and the Left Bank Center for Maternal and Child Health Care, Children's Hospital No. 2, and Maternal Hospital No. 6 in Ukraine on the NIS side.

• In September the Philadelphia/Kiev partners sponsored a dissemination conference in Kiev on perinatal and neonatal conditions for representatives from six partnerships in the region.
• Also in September a fourteen-member US Congressional delegation, including Richard Gephardt, House Majority Leader, David Obey, Chairperson, House Appropriations Subcommittee on Foreign Operations, Robert Michael, Minority Leader and David Bonier, House Majority Whip toured the Kiev partnership hospitals.

• In June the Philadelphia/Kiev Partnership sponsored a dissemination conference in Kiev for representatives from eight NIS countries. The conference focused on neonatal resuscitation, pediatric ultrasound, obstetrical anesthesia and family planning.
• The partnership established a family planning unit in the fall. Through the partnership, Ukrainian obstetricians and gynecologists were trained in family planning options and methods.
• The midwives at the Center for Maternal and Child Health Care (CMCHC) organized a family education unit in the fall following the model of a similar unit at the University of Pennsylvania. The center teaches families about reproduction and pregnancy events and encourages fathers to be involved in pre- and post-delivery events.
• The Ukrainian partners also established a School for Young Mothers in the fall, which offers instruction in prenatal care, pain management techniques and fetal development.
• The partnership established a Perinatal Evaluation Center (PEC). Training in fetal ultrasound and fetal monitoring were conducted by the partnership. The PEC sees approximately 200 patients per month.

• The partnership opened two neonatal intensive care units, one in the Maternal Hospital No. 6 and one at Children's Hospital No. 2.
• First Lady Hillary Rodham Clinton visited the CMCHC in May, to observe its success in improving the health of mothers and babies in Kiev. During her visit, Mrs. Clinton observed a birthing education class at the recently organized School for Young Mothers and spoke with trainers and expectant mothers.
• In June the partnership held a conference on pediatrics and obstetrics focusing on the nursing component of family-centered maternal and child care. Approximately 50 medical practitioners from Kiev, L'viv and Odessa, Ukraine and Minsk, Belarus attended the conference.
• The partnership opened an outpatient unit for gynecological patients and a day medical care unit to care for high-risk pregnancies.
• The partnership opened a pediatric ultrasound unit; the unit is equipped with four stations and supports pediatric ultrasonography for head, heart, renal and abdominal studies. Physicians assigned to the unit received extensive training in Philadelphia.
• In August, a regional conference was held on women's health issues including diabetes, obstetrics, cardiology and hypertension, anemia and primary gynecological problems. Conference participants were physicians and nurses from Ukraine, Belarus and Moldova.

• The partners established a library of important cardiology texts and manuals to support the pediatric cardiology unit.

• A Nursing Resource Center was opened at the CMCHC in April. The center provides nursing faculty, students, and practitioners with alternative forms of learning, which enhance traditional nursing instruction. The center will also serve as a meeting place for local nursing associations, enabling nursing colleagues to collaborate on a number of issues.
• In October the partners held a regional conference in mammography, women's health and pediatrics. Physicians and nurses from Ukraine, Belarus and Moldova attended the conference.

• The partnership established a women's health unit, which includes a training program in sexually transmitted diseases (STDs).
• The partnership established a mammography unit and trained two radiologists and one technician in mammography techniques and interpretation.

Perinatal Care

• The Maternal and Child Health Care Center's reputation as a high-quality provider has attracted many women from other districts to deliver their babies there. While the municipal birth rate decreased by six percent in 1994, CMCHC actually experienced a 1.6 percent increase in deliveries over 1993. In 1997 and 1998, the number of deliveries continued at a rate of 3,000 per year. In 1998, the number of deliveries at CMCHC was 12.9% of the total deliveries in Kiev.
• Since the opening of the perinatal evaluation center (PEC) in 1994 trough 1997, approximately 9,700 diagnostic ultrasound procedures were conducted. The number of perinatal diagnostic procedures in 1998 increased threefold compared to 1994.
• According to a mid-year report submitted by the CMCHC in 1997, the average length of stay for all patients decreased from 7.9 days in 1995 to 6.6 days. The average length of stay in the obstetrics department for post-operative treatment decreased from 7.1 days in 1995 to 4.8 days in 1997. In 1998, the average LOS for obstetrics patients overall was 5.4 days. In the gynecology department, the average length of stay for post-operative treatment decreased from 6.6 days in 1995 to 4.5 days in 1998. The overall average length of stay for perinatal care has declined from 7.0 days in 1995 to 5.1 days in 1998.
• Perinatal mortality in the hospital has fallen from 13.5% in 1995 to 9.3% in 1998.
• During the life of the partnership, the number of maternal deaths annually at the Center fell to zero. The partnership also noted a 50 percent decline in morbidity, which was attributed to improved delivery room techniques.
• Infant mortality at the Center decreased from a rate of 8.5 per 1000 in 1995 to 8.2 per 1000 in the first half of 1996. Early neonatal mortality also declined from 4.8 per 1000 in January 1996 to 4.2 per 1000 in 1998. The rate of infectious disease among newborns was nearly halved from a rate of 2.5 per 1000 in 1995 to 1.4 per 1000 in the first half of 1996.
• In conjunction with other clinical and administrative innovations, the PEC achieved a decrease in the postpartum length of stay for normal deliveries from 7.4 to 4 days. Fetal monitoring and ultrasound diagnosis of fetal abnormalities at the Center also contributed to the decline in mortality rates.
• The family planning unit gave contraceptive counseling and contraceptive pills to a focus group of 600 women and closely over a six-month period. These women contributed to a 30 percent decrease in the number of abortions performed at the hospital in 1994. The ratio of abortions to live births in 1997 and 1998 was 1:1, continuing the downward trend from greater than 2 abortions per each birth at the inception of the program.

Infection Control

• The US partners provided seminars and workshops to approximately 200 physicians, midwives and nurses in the general principles of epidemiology of fetal infection, applied epidemiology and biological statistics for infection control, fetal infection pathogens, handwashing procedures, rational antibiotic therapy and preventive care and epidemiology of nosocomial infections.
• As a result of the infection control program, an Infection Control Committee was established at the Center.
• The Ukrainian partners have adopted two new practices in order to prevent septic complications: a) administering antibiotics at the pre-operative stage and b) providing microbiological screening of all newborns from high-risk groups. In 1998, the rate of septic infections in newborns and mothers decreased to 2.94 from 3.5 in 1994.
• The nursing staffs at both partnership hospitals in Kiev established infection control units.

Neonatal Resuscitation

• During 1998 more than 400 newborns were successfully treated in the Neonatal Resuscitation Unit.
• As a result of the partnership initiative, the infant resuscitation curriculum was instituted as part of medical student training at Medical University of Kiev.
• Work with the AIHA-sponsored EMS Training Center in Kiev resulted in questions on emergency medicine being added to continuing education programs for physicians.

 
Information Technology

• Through the AIHA Learning Resource Centers at Children's Hospital No. 2 and Maternal No. 6 in Kiev, physicians regularly consult with their partners and colleagues in Philadelphia via the Internet on pediatrics cases. The US partnership coordinator draws on experts in Philadelphia to provide responses to the Ukrainian requests.

Pediatrics

• Nurses and doctors received a range of training in the area of pediatrics and family-centered maternal and childcare over the course of the partnership.

Women's Health

• The partnership established a women's health unit, which includes a training program in sexually transmitted diseases (STDs).