Kishokai Medical Corporation Kishokai Medical Corporation

JICA Grassroots Technical Support Project

JICA Grassroots Technical Support Project

In October 2017, the【Project for Strengthening Midwifery Skills and Guidance of Health Management During Pregnancy in Mongolia】was adopted and from July 2018 to October 2020 6 sessions were implemented.
Aiming to help local midwives provide appropriate guidance, advice and health management to pregnant women, we created a Mongolian version of our teaching plan with reference to Japanese perinatal medical services. Based on this plan, we gave lectures to local midwives and nurses and conducted activities with the goal of disseminating the knowledge gained from these sessions to more midwives and nurses through OJT.

Activities Report

Mongolia October 7th, 2020

JICA 6th Grassroots Technical Support Project - Activities Report

Originally our plan was to finish this project in June but travel to Mongolia was impossible due to the effects of the Corona virus and so we had to extend the time period and make plans with the hope of traveling in October for the final sessions and the closing ceremony. Unfortunately, the Corona pandemic showed no signs of decreasing and in addition, the Mongolian Government issued a notice that foreign entry would be prohibited until April 2021.
Therefore we switched to ZOOM for the final session and closing ceremony. This gave us the opportunity to move towards the closing ceremony, looking back on the last 2 years of lectures and receiving opinions from the participants about their future prospects and views as midwives in Mongolia. At the closing ceremony, as a video montage of the last 2 years was played, we were brought to tears remembering the hard times and the good times that we had experienced together.

Currently in Mongolia, although all mother's classes where large numbers congregate have been cancelled, the health guidance materials we have created so far (5 x 20 min) and the lecture material (90 min) from the first and second semester mother's classes have been divided and used for individual guidance.
We'd like to express our utmost gratitude to Ms. Umezaki (Director, Nursing Division) and Ms. Sumida (Deputy Director, Nursing Division) and all the other members who, although busy with their own work, were able to find the time to create materials and devise ideas in order to continually improve and make the training more effective.

From now on, First Maternity Hospital intends to create and implement an annual schedule for health guidance. We sincerely hope that the midwives will continuously implement what they have learned and that our efforts have contributed, even just a little, to the improvement of maternal and child health in Mongolia.

Feedback on the content of the childbirth preparation class
Message to the participants from the CEO & President
A summary of the 2 year training
Closing ceremony group photo
Mongolia December 4th, 2019

JICA 5th Grassroots Technical Support Project - Activities Report

Through the cooperation and combined strength of Dr. Ochir, the local manager, Ms. Umezaki (Director, Nursing Division) and Ms. Sumida (Deputy Director, Nursing Division), cumulative daily training was implemented in order to achieve our goal of "Strengthening the ability (knowledge and skills) of local midwives so that they can independently carry out health management for pregnant women".
The Mongolian population, which was about 3 million in 2016, had increased to 3.2 million in 2018, and the First Maternity Hospital handles more than 17,000 deliveries annually with just doctors and a small number of midwives.
At the start of training, the participants voiced the following opinions. "With so many deliveries, we don't have the time to connect with the mothers", "ANC examinations are carried out at the family health center set up in the community and mothers only come to higher-level medical institutions, such as the First Maternity Hospital for the actual delivery, so there is no time for health guidance".
The challenge was how to incorporate the health guidance plan into the hospital system. However, because of our training, the Director of the Nursing Department of the First Maternity Hospital said that they had started incorporating education programs for local pregnant women into the hospital curriculum at a pace of twice a month It seems that this result was achieved because the participants were able to persuade the hospital management of the importance of health guidance for pregnant women.
In a very limited time, not only were the local midwives able to consider how they would like to improve the current situation for pregnant women in Mongolia, but they were also able to plan and implement health guidance independently. This was very pleasing news for us, as organizers of the training.
Our training program will finally come to an end in April 2021. We hope that, by that time, we can establish a system that promotes the continuous implementation of the content introduced in this program.

CTG interpretation lecture by Dr. Ochir (center)
A scene from the training
Mongolia October 2nd, 2019

JICA 4th Grassroots Technical Support Project - Activities Report

The 4th workshop was held, for 4 days, from September 21st to September 24th. One year after the start of the project, we divided the class into 5 groups and spent about 8 months creating a health guidance plan and continuing demo lessons among the participants. In addition, each group's representative was responsible for holding a demo lesson for the target pregnant women during the health guidance class.
Although there were moments when both participants and instructors were in tears due to the strict evaluation of their teaching and communication methods, during the break the members from other groups could be seen discussing and giving advice on how to improve their communication style. The team of about 20 students became more aware that improving their own knowledge and teaching skills would lead to improved maternal and child health in Mongolia and their enthusiasm left a lasting impression.
The next day, we could finally hold a maternity class for 10 pregnant women on the themes of obesity and oral care during pregnancy. The speaker was able to successfully clear the problems faced in the previous day's demo lesson and make a confident presentation to the pregnant women.
The pregnant women asked many questions about BMI measurement and diet, showing a high level of interest, with many participants saying that it would have been good if such a class had been implemented earlier.
There are 6 workshops in total and we are finally reaching the climax. From now on, we would like to proactively continue our activities, from considering the lecture content of childbirth preparation classes through to guidance methods and actual practice, working towards our ultimate goal of nurturing independent midwives.

A scene at reception
Health guidance for pregnant women
Mongolia June 1st, 2019

JICA 3rd Grassroots Technical Support Project - Activities Report

For 4 days from May 13th, we welcomed 19 participants at First Maternity Hospital, for the 3rd training session. Not only did Ms. Umezaki (Director, Nursing Division) and Ms. Sumida (Deputy Director, Nursing Division) provide lectures on delivery procedures, they also observed the actual work of the midwives in the delivery room and gave advice in an OJT format.
As part of the education plan at First Maternity Hospital, CTG interpretation classes were implemented and in order to firmly establish the technology Dr. Ochir conducted a case study seminar. In addition, the particpant's training and skills regarding the exercise guidance given in the last workshop were evaluated through written and practical skill tests.
This time, 20 pregnant women, at over 36 weeks gestation were able to participate, making this the first time we were able to interact with local pregnant women. A maternity exercise class conducted by Ms. Ishihara and a childbirth preparation class based on the health guidance plans created by the students themselves were held. The classes were a great success with the pregnant women showing great interest in each topic and asking questions in a lively manner.
Although the participants who made the presentations seemed nervous, they did their best to convey the information that they wanted the other participants to remember and their sense of responsibility as a midwife shone brightly for all to see. Actually, only 3 of the 5 guidance plans were presented so the remaining 2 plans will be presented in the next childbirth preparation class. We are also considering having the participants who passed the exercise guidance practical test hold their own maternity exercise class.
Almost a year has passed since we started this project and although we cannot say that we are always on the same page when it comes to communication, the change in the midwives awareness and motivation can clearly be felt.

A scene at reception
Health guidance for pregnant women
Mongolia December 18th, 2018

Activities Report of JICA Partnership Program 2nd Session

Our second training session was held at First Maternity Hospital over four days from December 10-13.
This session was made up of lectures on disorders during pregnancy (hypoglycemic disorders, anemia during pregnancy, and hypertensive disorders), maternity exercises, and continuing from the first session, the creation of health guidance plans.
Creation of the guidance plans continued between the first and second sessions through video teleconferences held with the participants (split into five groups, each making a plan). Each group gave presentations on their guidance plans on the first day of this session. However, perhaps because of some translation issues, the intended goals were not communicated, and groups tended towards making pamphlets rather than guidance plans. As a result, an emergency session on "What a Guidance Plan Is" was held, and through the lectures and guidance of the instructors, the groups were put back on track.
Between January and April of 2019, the groups will refine their guidance plans, and those that pass approval will then provide demonstrations, in preparation for actual use.
Dr. Bayasgalan, director of First Maternity Hospital said, "There are no facilities in Mongolia providing health guidance (in particular nutritional guidance) and guidance in maternity exercises. I look forward to working together with Kishokai on this project for the pioneering development of midwives in Mongolia. "
We will work closely with our local counter part, Dr. Lkhavga-Ochir, to improve on each session for an even more effective training project.
The next training session is scheduled for four days starting on May 13th. Continuing from the second session, the subject will be "Midwifery in the Conduct of Labor."

Mongolia October 1st, 2018

Activities Report of JICA Partnership Program 1st Session

On September 17th, the project opening ceremony was held at First Maternity Hospital, attended by the 21 participant health professionals, as well as guests from the Ministry of Health, Ulaanbaatar Health Bureau, National Mongolia University of Medical Science, and the directors of First Maternity Hospital and Chingeltei District Hospital. In Mongolia the scope of work for midwives is limited, and not as broad as in Japan, but in order to overcome a variety of issues in perinatal care, as a matter of health policy there is a need to expand the scope of midwives' duties, and introduce a new system for their contribution to maternal and child health. As Kishokai's training program dovetails nicely with this policy, representatives of the Ministry of Health expressed a desire to expand it to all midwives. This program will take place over 6 sessions from now until June, 2020. First, we will proceed in our activities in cooperation with the local midwives, taking into consideration what the local mothers need, what we must do for them to contribute to maternal and child health.
In the first session, made up of lectures and workshops based on the keywords "From theory to practice", Kishokai Nursing Division Director Fumiko Umezaki and Deputy Director Mariko Sumida lectured on 10 subjects over 2.5 days, including topics such as the changes in maternal and child health in Japan, the role of midwives, and the importance of health guidance. On Day 3, the participants split into 5 groups to discuss the actual necessary items of health guidance for mothers in Mongolia, as well as practice the creation of guidance plans for those items. This time, the participants divided childbirth and child care into the phases of Pregnancy, Delivery, Post-Partum, and Child Care, discussed what should be communicated to Mongolian mothers at each of those stages, and developed an activity plan for each group's subject. Each participant is expected to develop a guidance plan by the 2nd Session (December).

Director G. Bayasgalan (center) and participants
View of the training session
Mongolia May 15th, 2018

JICA Partnership Program - Beginning of Preparations for Activities in Ulaanbaatar, Mongolia

Kishokai's proposal for "Project for Strengthening Midwifery Skills and Guidance of Health Management During Pregnancy in Mongolia" has been accepted as a JICA Grassroots Technical Cooperation Support Project for June 2018. For two years, from 2018 to 2020, Kishokai will engage in a cooperative project with First Maternity Hospital of Mongolia to improve midwifery skills.
Midwives and other staff from Kishokai will travel to Mongolia to provide instruction, including technical and nutritional guidance, to local midwives working at a district hospital, and a family health center.

Mongolia December 20th, 2017

JICA Partnership Program in Mongolia - Activities Report

Over five days from December 11-15, 2017, staff from Kishokai began prepatory activities for this project by visiting its local counterpart First Maternity Hospital of Mongolia, and the affiliated Chingeltei District Hospital, and Tanii Itgel Family Health Center, as well as explaining the project and confirming its process with related organizations, such as the Ministry of Health. The goal of this project is that "target midwives/nurses will acquire the knowledge, and guidance methods for a program for health management during pregnancy (balanced nutrition, exercise and weight management, reducing alcohol/tobacco intake, pregnancy-related conditions), and become able to appropriately and continually implement that program to expecting mothers." Kishokai staff will engage in activities so that the target midwives/nurses can deepen their knowledge, obtain the methods to make best use of it, and actually provide guidance within a health management program for mothers.

Mongolia November 1st, 2017

Kishokai Proposal for JICA Partnership Program Accepted

Kishokai's proposal for "Project for Strengthening Midwifery Skills and Guidance of Health Management During Pregnancy in Mongolia" has been accepted as a JICA Grassroots Support Project. A midwife team from Kishokai will instruct local midwives/nurses in Mongolia, with the goal "Improve the midwifery knowledge and skills, and instructional capability for health management during pregnancy." Also, Kishokai will aim to improve health management through educational activities and guidance towards expecting mothers, and the regular implementation of outpatient midwife counseling sessions and mother classes, so that the mothers themselves can understand the importance of health management during pregnancy, and manage their own health.
Currently, Kishokai is looking to complete the necessary signing of contracts by the end of March next year, in order to begin activities over a year and a half starting in April.

Kishokai's Director of Nursing (2nd from left)
and local obstetrics hospital staff
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