Perinatal Health Care Improvement in Macedonia Through Education: Case Study

Abstract

The Official Macedonian Reports on the situation in the field of perinatal health care showed for a longer period high rates in perinatal/neonatal mortality which ranked the country in the bottom of the list of European countries. It required urgent Strategy for improvement the efficiency of perinatal care services in Macedonia in late 1990-ties. The main issues within the strategy were: prevention and health promotion, training and education, infrastructure, equipment supply, institutional and organizational change and policies and procedures. The example of Macedonia emphasized the role and the value of the education and training and health education in highly successful implementation of the National strategy for perinatal care improvement. The most appropriate learning startegies and methods of assessment were chosen in order to get the best scores in theoretical and practical sense. The greatest achievement was the overall decrease of 27% in the Perinatal Mortality Rate, compared 3 years before intervention with 2 years after starting intervention (27.4 to 21.5 per 1000 births) and decrease of 36% in early neonatal deaths in babies >1000g (12.0 to 7.7 per 1000 live births), reflecting the postnatal thrust of the program. The process of change management in perinatal health care was kept along implementing the standards, and the results were published as “successful story” in the final Report after the evaluation, prepared by the external consultant Prof Dr Heather Jeferry and submitted to the Ministry of Health of the Republic of Macedonia.