Promotion and implementation of mother and child health handbook discussed in Dushanbe

In the field of implementation and promotion of MCH Handbook "Rokhnamo", JICA has been providing technical support. JICA supported development of guidelines for health workers on the Handbook. As part of its training courses, annually JICA sends specialists from Tajikistan to Japan to improve their knowledge and increase their skills. JICA also supports the participation of representatives of the Tajikistan in international trainings (Indonesia) and conferences on this Handbook.

For a wider coverage and discussion of the progress and challenges for the implementation of “Rohnamo” in Tajikistan, on June 21, 2019, JICA Tajikistan Office organized a roundtable on MCH Handbook. The roundtable participants discussed the roles of key organizations supporting the implementation of “Rohnamo” in Tajikistan, and suggested and recommended new plans and actions to further promote MCH Handbook in Tajikistan. The purpose of the roundtable was also to increase the understanding of the value of the Handbook, and to share knowledge and exchange experience to ensure positive outcomes from the usage of "Rohnnamo".

The event was attended by Mr. Zoir Nabiyev, Head of the Department of Medical Services for Mothers, Children and Family planning of the Ministry of Health and Social Protection of Population, Mr. Ken Inoue, Seinor Representative of JICA Tajikistan, representatives of development partners, as well as Ms. Keiko Osaki, Senior Health Advisor of JICA Headquarters in Tokyo.

It is important to note that the participants of the roundtable exchanged experiences, shared hopes and ideas about how to build greater cooperation and ensure effective pilot implementation in order to achieve even more ambitious goals for countrywide introduction of the Handbook and reaching all mothers and children in the country.

“Protecting the health of mothers and children is one of the most important and most challenging tasks facing the national health system,” said Zoir Nabiyev. According to him, child and maternal mortality remains high in the country. “Most of the young women mostly die due to bleeding and high blood pressure. A fatal outcome could have been avoided if timely medical care was provided. The country's strategic documents indicate the need to reduce maternal and infant mortality and increase the life expectancy of the population”, he noted.

Mr. Ken Inoue stated that through this roundtable it is expected to develop new and effective approaches to the implementation of the MCH Handbook. He expressed confidence that “the recommendations and proposals prepared by the participants of the roundtable will be in demand in practice and will contribute to the further implementation of the Handbook.”

In her presentation, Ms. Keiko Osaki summarized progress and challenges of MCH Handbook in Tajikistan. She provided information on JICA's experiences in introducing, developing and implementing MCH Handbook in the world and noted that already many countries today have the Handbook. According to Ms. Keiko Osaki, World Health Organization’s recently published comprehensive guidelines on home-based records related to the health of mothers and their children demonstrate values of home-based records.

Ms. Farida Khudoydodova, Deputy Director of the State Institution of the Republican Educational Center for Family Medicine, spoke about the MCH Handbook, which was launched in Tajikistan since 2016. According to her, the Handbook increases the knowledge of parents including nutrition and child development, promotes an integrated approach in presenting a range of services related to maternal and child health, strengthen the network of medical institutions at various levels, and expand the interaction between medical workers and parents, guardians.  She also noted that today there are first results from the pilot implementation of the “Rohnamo”, which say about the expansion of pilot areas, ensuring sustainability, increasing public perception and strengthening the health system, improved integration and ensuring further funding. Speaking of further steps, she said that in the “Rohnamo”, it was necessary to make improvements that were proposed by the health workers and the population itself.

R.S. Reducing the maternal mortality rate, the neonatal mortality rate and the mortality rate among children under five years are important goals to be achieved in the framework of the Sustainable Development Goals.

The MCH Handbook is a comprehensive home-based booklet for providing relevant medical information and including integrated medical records about maternal and child health. The Handbook contains medical records and information about pregnancy, childbirth, newborn and childhood periods, and child growth and immunization.

The Handbook supports the integration of maternal, newborn and child health services. The Handbook is dedicated not only to health education, but also for creating a sense of responsibility among women and family.

In 1948, Japan became the first country in the world to develop and disseminate a maternal and child health handbook to protect and improve the health and well-being of the mother and child. Currently, there are about 40 versions of the Handbook, all adapted to local culture and socio-economic conditions.

Using the MCH Handbook helped to improve mothers’ knowledge on mothers and children health and contributed to changes during the pregnancy, childbirth and after birth. Using the Handbook as a tool to enhance continuous care can improve the health of pregnant women, newborns and children. Doctors can make more informed care decisions by referring to the patient’s medical history and health check data recorded in the MCH Handbook