Across Russia, a transformation in maternal health care has caught the interests of both doctors and their clients, as the health care industry embraces a patient-centered approach that John Snow, Inc. (JSI) and the Russian Institute for Family Health (IFH) introduced in several regions.
I find it very exciting, therefore, that local governments in Russia are now reaching out to JSI/IFH for guidance on applying this approach to strengthen the health care system overall, with JSI now out of Russia, but IFH able to carry on this important work.
JSI worked in Russia for 14 years to introduce a client-focus and evidence-based approaches to maternal health care. In Russia, which inherited the Soviet health system, with universal access to free and comprehensive health care, virtually all women already received prenatal care and delivered their babies in hospitals—a basic level that we are still seeking to reach in many parts of the developing world. However, quality of care was at issue. Despite access, key maternal and child health indicators were lagging.
The work that JSI began, and that IFH is continuing has contributed to replacing the older soviet medical system with modern evidence-based and integrated approaches that are more responsive to women and families, achieve better health outcomes, and reduce costs. For example, husbands can now room-in with their wives during hospital deliveries, and they participate a great deal in the entire birthing process. Although there was initial resistance to this non-medical approach by the doctors, the clients were very enthusiastic, the outcomes (healthy mothers and babies) were improved, and thus the medical practitioners have been more open to these simple innovations that have contributed to better experiences for mothers, and have gotten fathers more involved in the lives of their newborns.
With USAID-funded projects now ending in the country, IFH has continued to disseminate the lessons of this work in Russia, spreading client-based medical care to other areas of health care outside maternal health. Local governments and health care facilities are now funding this work themselves, which demonstrates just how much the Russians have recognized the value of this transformation.
This past fall, organizers of a health care conference for the Tyumen region of Russia, with assistance from IFH, and where JSI/IFH have implemented many of the maternal health reforms, invited JSI to discuss health care reform here in the United States under the Affordable Care Act. Ann Keehn, the Director of Operations for our US Health Services division, presented on quality assurance, the client-centered approach, and outcomes, as the new focus in the United States. Conference attendees were highly engaged, asking many questions about legal issues, insurance schemes, and the US Affordable Care Act.
In the meantime, JSI is continuing to advise, on a pro bono basis, the Institute for Family Health on bringing international standards to their work. IFH is currently conducting an assessment of a hospital in Tyumen, to include a plan on how to improve quality, to include training, development of internal and external quality assurance, clinical audits, and communication.