Advancing the quality of maternal, newborn, and child healthcare: insights from pilot hospitals in the Kyrgyz Republic
Tilenbaeva N. Abduvalieva S. Askerov A. Beglitse D. Gapaeva M. Kisova A. Kuzmenko O. Lomauri K. Orozalieva A. Ospanova Z. Shukurova V. Teplyakova O. Yasakov D. Jullien S. Weber M.W.
2025University of Edinburgh
Journal of Global Health
2025#15
Background Maternal, newborn, and child mortality rates in the Kyrgyz Republic are high compared to other countries in the European Region of the World Health Organization (WHO). Global evidence suggests that at least half of the maternal and newborn deaths could be prevented with improved quality of healthcare. To address this, we undertook a quality improvement project over two years in ten pilot hospitals of the Kyrgyz Republic. Methods We assessed the quality of care for maternal, newborn, and child health using WHO tools at the beginning and end of the project. We evaluated the availability and appropriate use of resources, case management, and key hospital policies. We used a standardised scoring system from 0 to 3, with colour coding scores and a display of trends (improved, deteriorated, remained the same). After the baseline assessment, we conducted a complex improvement process including the development of hospital quality improvement plans, updating clinical guidelines, training activities in priority topics, supportive supervision, and semi-annual collaborative quality improvement meetings between hospitals. Results The baseline assessment revealed many areas of suboptimal care across the hospitals and technical areas. The endline assessment showed improvements in case management practices (baseline mean (x̄) = 1.6 vs. endline x̄ = 1.9) and policies and organisation of services (baseline x̄ = 1.7 vs. endline x̄ = 1.9). No improvement was achieved in hospital support services (baseline x̄ = 1.7 vs. endline x̄ = 1.8). Eight out of ten hospitals demonstrated overall improvement progress across categories; the two remaining hospitals showed no improvement. Conclusions A complex intervention process focussed on updating clinical guidelines, selected capacity-building activities, supportive supervision, and semi-annual collaborative meetings led to quality improvements in maternal, newborn, and child health. The improvements achieved were still not reaching international standards, highlighting the need for a comprehensive and system-wide approach to quality improvement.
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World Health Organization Country Office in the Kyrgyz Republic, Bishkek, Kazakhstan
World Health Organization Athens Office on Quality of Care and Patient Safety, Athens, Greece
Department of Neonatology, National Maternal, Newborn and Child Centre, Bishkek, Kazakhstan
Association of Obstetricians and Gynaecologists of the Kyrgyz Republic, Bishkek, Kazakhstan
Municipal maternal hospital No.1, Krasnodar, Russian Federation
Gynaecology and Perinatology, National Medical Research Centre for Obstetrics, Moscow, Russian Federation
Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
Department of Neonatology, Tbilisi State Medical University, Tbilisi, Georgia
Kyrgyz Alliance of Midwives, Bishkek, Kazakhstan
Municipal polyclinic No.7, Astana, Kazakhstan
Paediatric Department, Kyrgyz State Medical Institute of Continuous Education named after S.V. Daniyarov, Bishkek, Kazakhstan
National Medical Research Centre for Children’s Health, Moscow, Russian Federation
World Health Organization Country Office in the Kyrgyz Republic
World Health Organization Athens Office on Quality of Care and Patient Safety
Department of Neonatology
Association of Obstetricians and Gynaecologists of the Kyrgyz Republic
Municipal maternal hospital No.1
Gynaecology and Perinatology
Country Health Policies and Systems
Department of Neonatology
Kyrgyz Alliance of Midwives
Municipal polyclinic No.7
Paediatric Department
National Medical Research Centre for Children’s Health
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