“Two triplets were born in our district maternal wards this year,” says Nemat Abdullayev, a neonatologist from Gurlan, a remote town in northwestern Uzbekistan, with an air of satisfaction. “Both cases were premature births — the babies were 31 and 32 weeks old. Fortunately, they survived and left the hospital fully healthy.”
In his 22 years as a doctor, Nemat has dealt with hundreds of cases of premature births. Not all the newborns could make it. He vividly remembers one of his recent patients, a young woman who complained that her son had stopped breastfeeding. The baby was having difficulty breathing and was in a very serious condition.
“It was almost too late to save him. Women should know about the early signs of complications that threaten children’s lives,” says Nemat.
“It is really important that quality medical services are available for women at all phases of pregnancy. Family clinics in rural areas and district hospitals are key to ensuring this as they are the first port of call for most people living in villages.”
Nemat knows Gurlan’s health system well as he, apart from doing shifts as neonatologist, also works as the deputy head of the district health department where he is responsible for maternity and child health. In this post, his work has focused on improving healthcare services in rural areas.
“We recently created new emergency medicine stations in four areas located far from the district center to bring emergency medical services closer to people,” he continues.
“In the past, ambulances used to travel long distances to reach people who needed immediate help. It used to take 1-1.5 hours to reach patients. Now it is taking 20 minutes at most, as the stations are located close to the settlements.”
Nemat and his team, in coordination with UNICEF, helped set up special coordination centers which serve as a link between district hospitals and village clinics, ensuring constant monitoring of patients after they leave hospitals. The centers also communicate with medical facilities to ensure regular nursing is provided to pregnant women and newborns in a timely manner.
UNICEF has been implementing District Health System Strengthening in Khorezm, a region that continues to be affected by the growing impact of the shrinking Aral Sea. The measures aim to strengthen district health systems by helping local healthcare officials identify and deal with problems that cause bottlenecks in the system.
Nemat was one of dozens of health professionals who attended two workshops organized by UNICEF, to explore and analyse shortcomings in district health systems and make detailed plans to find solutions.
“We already have results,” reflected Nemat following one of the meetings.
“Quality of medical services have started improving. With help from UNICEF, we have also been training local medical workers to engage closer with people and raise their awareness about health issues.”
“Engaging with people should be an important part of raising the quality of medical services. By talking to patients, I see that most of the problems could be avoided if women, especially young women, know more about risks related to pregnancy and childbirth. Many come to seek doctors when it is too late.”
“We have to better inform the population about health issues. People should understand that they are responsible for their own health.”
Nemat is hopeful that such cases will eventually decrease thanks to the ongoing efforts that his district is making together with UNICEF to bolster the health system.
“I hope to see more triplets, twins and simply healthy babies in my district,” he says.
Dilmurad Avalbaev is a freelance writer for UNICEF Uzbekistan and a senior editor for BBC Monitoring, Central Asia Unit where he monitors and covers political, economic and social stories across Central Asia and beyond. His reports have been published by the BBC and other media outlets.