In response to the Government of Georgia request, UNICEF country office for Georgia commissioned an assessment of the perinatal system with the purpose to identify gaps in provision of the effective perinatal services in terms of appropriate facilities, skilled staff, equipment, supplies and transport. The study was expected to supply evidence for the policy and program recommendations within the perinatal care system.
The CGC team was contracted to assess the perinatal care services.
Actual services provided
The study employed quantitative and qualitative methodology to assess ante and perinatal services in the country. Sample design and the survey tools were based on the WHO guide for Safe Motherhood Needs Assessment. The tools were modified according to the local needs and context.
The survey was carried out in 40 medical service providers (16 maternities, 15 hospitals and 9 antenatal clinics) and included interviewing of the management staff, health care providers (147 Ob/gynecologists, 81 neonatologists and 83 midwifes), medical record review and observation. Client exit interviews were undertaken among 175 antenatal and 137 post-partum women. Additional 3 focus group discussions were arranged among 4 obstetriciansâ and 19 neonatologists.
Finally, the study included a review of the national health statistics and available reports on perinatal health and of the policy framework in respective areas.
The study looked at three dimensions:
- the system inputs such as policy environment, physical infrastructure, human resources (availability, knowledge, skill, practice), supply and equipment;
- the system outputs as provision of services, geographical and financial accessibility, clients satisfaction level;
- the system outcomes by analyses of maternal and child health indicators.
GCC delivered the results of the assessment to the health authorities enabling policy makers to develop short-, medium- and long-term strategies for the improvement of perinatal service quality as well as ensure systematic approach to monitor perinatal system.