Newborn Mortality Rate Decreases
In 2018, as compared to the annual average indicator of the past three years, the newborn mortality rate at Muratsan Hospital Complex, which is servicing all the marzes of the Republic of Armenia, decreased by 48%, and at the Department of Neonatal Resuscitation and Intensive Care of the Institute of Perinatology, Obstetrics, and Gynecology by 29%. This fact was noted by Hrant Kalenteryan, President of the Armenian Association of Neonatal Medicine, who also added that this very positive result, which exceeds the expectations, was achieved during the implementation of the program on Improving Quality of Neonatal Care Services in Armenia. “When developing the program we considered the capacities of the marz structures, the deficit of equipment in Yerevan and the marzes, the knowledge of specialists and predicted that as a result of work over a period of three years we would bring this indicator to 25%, however, our work yielded a better result,” he said.
The Armenian Association of Neonatal Medicine has been implementing the program on Improving Quality of Neonatal Care Services in Armenia with funding support from US Agency for International Development, having set as its key goal the reduction of newborn mortality rate in Armenia. According to Hrant Kalenteryan, when developing the program, they took into consideration the situation with neonatal care services in Armenia, the issue of the availability of the relevant medical staff and technical equipment at medical establishments, development trends, etc. The reduction of cases of newborn mortality is the result of a number of the important components of the program. Hrant Kalenteryan highlighted some of them, such as:
The Armenian Association of Neonatal Medicine has set up a 7/24 hot line at Muratsan Hospital Complex to provide neonatal consultations to all hospitals of the Republic of Armenia. Numerous round-the-clock calls are received from the RA different marzes (provinces) and Yerevan maternity hospitals for the purpose of receiving professional consultations. Modern equipment and video connection create most favorable conditions for interaction of marz doctors with their colleagues at Muratsan Hospital Complex, as well as for getting a complete picture of the problems.
• Guidelines on Neonatal Care
The Armenian Association of Neonatal Medicine has authored clinical guidelines on Care of Healthy Newborns and Management of Sick Neonates, which were endorsed by the decree of the RA Minister of Health. The guidelines developed for specialists involved in care of and medical assistance provision to newborns at birth assistance medical facilities help give a common solution to the problems related to newborn care. They have become a reference book and working tool for specialists in the field.
In addition to the development of the above noted guidelines, representatives of the Armenian Association of Neonatal Medicine organize training courses in the entire territory of the Republic of Armenia to present the guidelines to neonatologists and neonatal nurses. “A circumstance of no lesser importance is the fact that all training facilitators have undergone training themselves to develop the course and to present it,” noted H. Kalenteryan.
• Supervision Visits
The periodicity of birth of very sick patients at marz hospitals is very low. As a result, the medical personnel do not have the opportunity to acquire skills necessary for management of such children. According to Hrant Kalenteryan, one of the guarantees of the program’s success is the fact that the activities have not been limited to conduct of a one-time training course in the marzes. The training courses were followed up by check-up/support visits to the medical centers of the marzes, during which the AANM member facilitators accompanied their colleagues at medical establishments of the marzes during the latter’s work and discussed situational problems and their solutions with them on the spot.
• Technical Reinforcement
Thanks to the program on Improving Quality of Neonatal Care Services in Armenia, it became possible to reassess the technical base of the first-, second-, and third-level medical facilities providing neonatal services, to carry out an assessment of the existing needs, and to reinforce them with new equipment.
The efforts of the Armenian Association of Neonatal Medicine, the US Agency for International Development, the Armenian EyeCare Project have been reinforced by the support provided by Yerevan State Medical University after Mkhitar Heratsi, thanks to which it has become possible to renovate new spaces necessary for neonatal treatment and care, to refresh the air system, to acquire new Critical Care Transport ambulances, to increase the salaries of the medical personnel and to add new nursing posts.
In H. Kalenteryan’s words, the above noted achievement, i.e. decrease in newborn mortality rate, is the result of the direct contribution of all individuals involved in this work. The program with its partners and the medical personnel with its devotion and professional preparedness have managed to act together and save lives of numerous neonates. “The joy for homecoming of every cured child is almost equal to the feelings we experience with the birth of our own children,” says the doctor. The number of these children is progressively increasing.