Health Promotion and Disease Prevention Perinatal Healthcare Improvement through Education: Case study

The Official Macedonian Reports on the situation in the field of perinatal health care demonstrated high rates in perinatal/neonatal mortality for a longer period, of final ranking Republic of Macedonia at the bottom of the list of European countries. This required urgent Strategy for improvement of the efficiency of perinatal health care services in Macedonia in late 1990-ties (1,2). The primary idea for such strategy originated in 1998 when the doctors from three Departments (neonatology/intensive care units) within the Gynecology and Obstetric Clinic, the Pediatric Clinic and the Special Hospital for Gynecology and Obstetrics, all in Skopje, started complaining that the equipment was outdated, lacking or non-functional, there weren’t standards for the appropriate levels of care regarding equipment, space and staff, accentuating that all these weaknesses are the main reasons for the high perinatal/neonatal mortality and morbidity rates. Thus, the need for an urgent change was apparent. The initial requirement included the need for equipment and enlargement of intensive care beds (capacity). The objectives of the Ministry of Health (MOH) and the World Bank and the needs assessment clearly defined the urgent need for a larger initiative at national level. The Report from the first meeting of the directors of these three hospitals, followed by a short overview on the perinatal/neonatal care services and data were submitted to the Ministry of Health, and accepted as a priority for the already secured Credit. The Government of the Republic of Macedonia secured a Credit (Cr.2889-MK) from the International Development Association (IDA) to help finance the development of the health sector, supported by the Health Sector Transition Project, including a component to strengthen the Basic Health Services. Part of this component related to the Perinatal Services Support Program. For the Republic of Macedonia this project was managed by the Macedonian Ministry of Health (MOH) through its International Project Unit (IPU), (3)