Prognosis of the level of perinatal care in the Czech Republic in near future II. From the World Health Organization point of view

Overview

Aim of the study:
Evaluation of performance according to Goals of the WHO Project Health for All 21 in the Czech Republic.

Study design:
Comparative study of the WHO recommendations and the situation in the Czech Republic.

Setting:
Institute for the Care of Mother and Child, Prague-Podolí.

Methods:
Comparison of completion of 4 out of 21 Goals of the WHO Project Health for All 21 related to perinatal care in the Czech Republic.

Results:
After experience with the WHO Project HFA 2000 for Europe (introduced in late 70s) consisting of 38 goals for particular fields of medicine to be achieved by the end of 2000 (adapted in 1992), the WHO Project HFA 21 with 21 Goals to be achieved by 2020 was introduced. While in relation to the Project HFA 2000 the Czech Republic analyzed the situation in 1993 without application of individual goals into the health care system, in 2003 the group of experts prepared „Recommendation for achievements of the Goals“ of the WHO Project HFA 21. In 4 goals related to perinatal care, the recommendation postulated the ways and timeline and responsibilities in effort to accomplish these tasks. The evaluation of achievements by the year 2009 is attached. In the Goal 3, related to indicators of perinatal care, we have accomplish the decrease of perinatal mortality and the Czech Republic got among countries with the best results. On contrary, we have observed increase of low birth-weight rate and increase of frequency of cesarean delivery, and increase of drug abuse among pregnant women. The legislature in the field of long-term follow-up of handicapped children was not prepared. In the Goal 15 the Czech Republic accomplished the introduction of functional organizational system of care. In the Goal 17, the financing of high level of care was underestimated. In the Goal 20, the health care policy was not prepared to fulfill the requirements of this Goal.

Conclusion:
Comparison of recommendation of the 4 goals of the WHO Project Health for All 21 related to perinatal care in the Czech Republic and the national recommendations was confronted with the results. While the improvements of indicators of level of care and introduction of organization of perinatal care were achieved, the lack of health care policy was the main deficiency of the system.

Key words:
WHO projects; Recommendations of the Czech MOH; fulfillments of the Goals.