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Public Health Services Aimed at the Final Stages of Pregnancy and the Beginning of Baby's Life



The province of Kocaeli, with a population of 1,502,123, is one of the 81 provinces of Turkey. With the objective of achieving one of the Millennium Development Goals, the Kocaeli Metropolitan Municipality planned a policy aimed at reducing mortality rates for newborn infants. In Turkey, approximately 1,400,000 babies are born each year, and 17.6 per 1000 of them (30,380 babies in 2008) lose their lives before reaching their first year of life. In other countries, the mortality rate is much lower. Among the proposals put forth in order to eliminate this identified social problem, were the ideas that the expectant mothers should be monitored by health professionals and that they should gain the habit and possibility of having sufficient nutrition during their pregnancy and breastfeeding periods.

This project takes into account the last three months of pregnancy and the first three months after birth. For the last three months before birth and the first three months after birth, mothers are given 12 L of milk per month and 72 L of milk per person total. In addition, the health of the mothers is monitored by health professionals and protective vaccinations for the baby are provided. Between 2006 and 2010, over 128,000 prospective mothers and babies who live in the Kocaeli metropolitan region have benefited from the project.

In the beginning stage of the project, information meetings were held with non-governmental organizations with regard to mothers’ health and these organizations were also helpful in the promotion stage. These efforts encouraged the mothers and prospective mothers to be more knowledgeable citizens. Through the project, the average number of women receiving medical supervision and the number of medical visits per pregnant woman and baby have increased.

Most obstacles have involved the distribution of milk, such as having a sufficient number of milk distribution points and convincing private market owners to be part of the distribution network. There were also difficulties in monitoring how many mothers had milk and how many mothers did not have milk, and how many mothers had gone to a Health Center. This problem was solved through developing and using a comprehensive computer program to manage the program.

The policy has been funded by the Kocaeli Metropolitan Municipality, with an estimated cost of over € 7 million between 2006 and 2010. There have been some difficulties in financing the project to date, and to obtain sufficient funding for a desired expansion of the project in the future.