1. Dinara Mambetalieva, National MCH Center Bishkek - 2015

2. Safe Motherhood Principles Human life is priceless Safe Motherhood is a human right All women have guaranteed access to Emergency Obstetric Care (EmOC) Ensured skilled attendance at delivery (Mother-Baby Package: Implementing safe motherhood in countries. Practical guide. WHO Geneva, 1996).

3. JUSTIFICATION: High rates of maternal mortality in KR Non-adequate and delayed Emergency Obstetric Care Absence of effective and evidence based technologies and practices in provision of EmOC APPROACH: Innovative idea using experience and knowledge of Uzbekistan due to common history, culture, language and common challenges in health system Development of clinical and practical skills and team approach Improvement of continuous medical education in Emergency Obstetrics

4. Main activities Assessment of clinical and organizational bottlenecks in EmOC jointly with Uzbek colleagues Study Tours to Uzbekistan and Lithuania Development, approval and introduction of the 1 st Clinical protocol on anesthesia and intensive care in EmOC Development of 5-day training module on EmOC in for continuous education and retraining Clinical and practical training at national level jointly with regional and international experts (more than 200 doctors trained) On-the-job training and mentoring at oblast level

6. Results (1) Care of critical conditions in obstetrics (pre-eclampsy, hemorrhage, sepsis) is according to approved clinical protocol; Wide application of spinal anesthesia in obstetrics; Team of national trainers and supervisor/mentors on EmOC is built, cascade trainings Commitment and contribution of managers of health organizations on EmOC (equipment, training, provision of drugs) is increased

7. Results (2) EmOC training module is integrated in continuous medical education (KSMIRCE); Training Center under National MCH Center is established and equipped with dummies and training equipment; Regional experience and international expertise has increased the role and the status of anesthesiologists and intensive care doctors of Kyrgyzstan;

8. Challenges Further capacity building of the professional association of anesthesiologists and intensive care doctors in KR (organizational development, task share in training and mentoring, regional exchange) Institutionalization of EmOC programmes (ToT, equipping of Simulation Labs, motivation) National System of Monitoring and Mentoring in EmOC (human and financial resources/potentials)

9. Future perspectives Introduction of training programmes and provision of master- classes on EmOC for anesthesiologists, intensive care and obstetric doctors at national level Active involvement of the professional association of anesthesiologists and intensive care doctors in development of: - New clinical guidelines and adaptation of EmOC standards for tertiary level of care; - Quality management system using monitoring and mentoring tools; - Standards for referral of pregnant women under critical condition to the Perinatal Center

10. Thank you!