However, other sources provide different figures. According to UNFPA and the WHO, in 2005 the maternity mortality ratio was estimated at 150. According to a multi-indicative cluster study in the Kyrgyz Republic in 2006, the level of maternity mortality in Kyrgyzstan was 106 per 100,000 live births.
The main reason for maternal deaths is obstetrical haemorrhage, which is the reason given in 29.8% (2007-52.2%) of the cases. Hypertensive pregnancy disorders (HPD) are also frequently reported, in 26.3% (2007 -22.4%) of the cases. The high rate of mortality persists despite the fact that a reported 96.4% of deliveries in 2008 took place in the presence of trained medical personnel. The fundamental problem remains the quality of and access to medical services, especially for women in remote areas.
The primary factors for high perinatal mortality include women’s health prior to pregnancy, improper care during pregnancy, and weak neonatal care practices including inadequate emergency services and a general lack of newborn care (i.e. non-observance of newborns’ temperature). Factors contributing to the poor health of the women include early age pregnancy and inadequate spacing of births. These factors are a consequence of inadequate education amongst the population and traditional approaches to health in general and reproductive health in particular, that are not in line with modern medical knowledge. As in other countries in the region, poverty, absence of transportation and lack of qualified medical personnel seriously hamper the ability of women to obtain quality care. Moreover, the economic problems Kyrgyzstan faced during the last five years have posed an additional challenge to the health system: lower budget allocations heave led to fewer possibilities to improve or even maintain the quality of services, and more trained professionals have left the job.
While various projects and technical assistance programs have provided some modern medical equipment to the Territorial Hospital and other supplies to the regional and city obstetrics organizations and perinatal centres, these materials are not used effectively due to the low number of pathological cases referred, untrained staff, and an inability to adequately maintain and repair the equipment. Virtually all Medical and Treatment Institutions (MTI) in rural areas show an inadequate level of basic infrastructure, such as a constant water supply, heating and electricity. In fact, 19.1% of water supply pipelines do not comply with sanitary requirements, and water purification facilities and disinfectant installations are too often absent. These problems are caused by a general lack of capacity at the management level, where people often do not have adequate skills to effectively manage an institution and ensure safe conditions for delivery.
Nonetheless, the government of Kyrgyzstan supports the implementation of the WHO Effective Perinatal Care recommendations. These recommendations include clinical protocols on obstetrics and neonatology, and standard practices in cases of haemorrhage, eclampsia, and sepsis. According to data provided by the Ministry of Health, at the start of 2010 effective technologies were implemented in 55% of obstetrics institutions.
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