It is symbolic that the plenary session, which was the central event of the symposium, was the first event held at the newly built Tashkent’s Symposium Palace. At the opening ceremony the President of Uzbekistan Islam Karimov said the universally recognized “Healthy Mother – Healthy Child” motto had truly come to be a unifying and mobilizing appeal to the population. It has become a priority managed from the highest state level as much as the wider public.

To be sure, we were well aware of the fact that attaining a goal we set out was possible only with thoroughgoing reforms and modernization of the entire public healthcare system.

Today we have every reason to declare that our healthcare system continues to be built and renovated on the robust backbone that has been created during independence years.

Further, the head of our state has deeply analyzed the work carried out in the past, stressing that "All these past years our efforts have been directed primarily at creating facilitating conditions for bearing and bringing up a healthy generation with an aim of longer-term effect, that is, preserving and improving the gene pool of the nation, and uplifting the expectancy of life and its quality."

The Director General of the World Health Organization Margaret Chan took part at the meeting. For her outstanding performance in organizing the work of WHO in healthcare and advancing primary medical aid, implementing the Global Strategy on Mother and Child Healthcare she was awarded, by the Decree of the President of the Republic of Uzbekistan, with the Order Soglom Avlod Uchun (For Healthy Generation) of the 1st Degree. In her speech, she highly rated the development of the healthcare in Uzbekistan, stressing that the achievement of the Uzbek model of healthcare is an example for many countries.

Detailed information about National Model of Securing Maternal and Child Health, created in Uzbekistan in twenty years, and which has contributed to nearly three-fold reduction of maternal and child mortality in the country, has been submitted by the Ministry of Health.

In particular, it was noted that in the framework of the State Program on Healthcare Development, the country has established a network of modern medical facilities, including Republican Specialized Scientific-Practical Medical Centers of Pediatrics, Obstetrics and Gynecology, Prenatal and Screening Centers, and more than 3200 Rural Medical Stations. All of them are involved in the implementation of the UN Convention on the Rights of the Child, 14 laws, 20 Presidential Decrees and Resolutions, and 100 Decrees of the Cabinet of Ministers of Uzbekistan, aimed at securing people’s health and strengthening the gene pool of the nation. Noteworthy, all this work is carried out by close collaboration with the Women's Committee and different public nongovernmental organizations along with international organizations, including the WHO, UNICEF, UNFPA, UNDP, GIZ.

Uzbekistan allocates 15.7% of the state budget on public health, which makes 4.1% of GDP. Much of these funds are used for disease prevention. An important role is played by the program of measures adopted in pursuance of Presidential Decree ‘On additional measures to protect health of mothers and children, and form a healthy generation'. The material-technical base of medical institutions is strengthened, thorough medical examinations and procedures on health improvement of fertile age women are regularly conducted by specialists, international standards of medical care are implemented in physicians’ practice. Under National Immunization Calendar all children have opportunity to receive free vaccines against controlled infections. To prevent non-communicable diseases, including iodine and iron-deficient illnesses, cancer, diabetes, vascular pathologies, in the country on regular basis is conducted special work to improve nutrition and involvement of children in physical activities and sports.

This work has received high ratings from international experts. According to rating list compiled by international organization Save the Children, this year, Uzbekistan is among the top ten countries in the world, where children’s health is best cared. Since 2007 the country has became one of the four states in the region defined by the WHO for implementation of European Strategy ‘Health and Development of Children and Adolescents’. Regional office of UNICEF recognized Uzbekistan as the model country for implementing program on maternal and child healthcare.

The symposium’s agenda was full of activities. Topical issues regarding the development of maternity and childhood protection on national and international level were discussed here. In particular, such discussion occurred during the round table ‘Priorities for the Millennium Development Goals 4 and 5 in the European Region’, held under the auspices of the European Bureau of the World Health Organization. The panel was attended by ministers and delegations from countries participated at the symposium as well as by leaders and experts from international organizations.

They discussed the achievements and future plans on further reduction mortality rate among children under five and among women during pregnancy and childbirth period. It has been noted that in the area covered by WHO’s European Office was seen a tendency of maternal and infant mortality reduction, the number of children born with poor health is falling too. In particular, over the past ten years, for the first time in 50 years, the number of under 5 years children deaths is below 10 million cases and currently stands at 7.6 million.

It is noteworthy that during the discussions, the participants repeatedly turned to the experience of Uzbekistan. Director of the World Health Organization's Regional Office for Europe, Zsuzsanna Jakab, considering the experience of Uzbekistan as an example, has enumerated a number of key factors resulted in achieving by the country high results. Uppermost, the Director noted the presence in the republic of science-based policies and strategic plans aimed at improving child and maternal health and quality of provided medical care, the country follows recommendations and methods from the WHO. According to her, the achieved progress was possible due to the development of health infrastructure in the country, better provision of medical institutions with equipment, medicines and consumables, as well as the work on developing a healthy lifestyle among population and raising medical awareness in families.

The main course of further improving the quality of maternal and child health, which sounded during the round table discussion at the plenary session, were elaborated in details during following workshops and breakout sessions.

During the forum, the leading national and foreign experts conducted 15 master classes for doctors from the regional health institutions. These sessions facilitated to the dissemination of the best practices in diagnostics, as well as their therapeutic and surgical treatment.

With assistance of doctors from Poland, Russia and Switzerland demonstrative operations – on new for Uzbekistan type of operation, such as Cardiac Surgery in the maternal and child health - were held in two medical centers, at Republican Scientific Center for Emergency Medical Assistance and at Republican Surgery Center. During the operations the professionals have demonstrated new methods of conducting aortocoronary bypass surgery on a beating heart, the mitral heart defect correction, the correction of partially anomalous pulmonary venous drainage and the endovascular interventions on congenital heart defects.

Three exemplary operations were analyzed at the National Research Practical Center of Minimally Invasive and Child Endovisual Surgery. The methods, demonstrated by specialists from Russia and Belarus, on endovisual correction of anomalous development of colon and urinary tract, have provoked great interest among specialists from regional institutions. This is due to the fact that in the coming years the equipment necessary to conduct such operations will be delivered to all regional children multi-disciplinary medical centers. Meanwhile, the foreign participants of the master classes with great interest familiarized with the experience of Uzbek colleagues on laparoscopic echinococcectomy. Uzbekistan is one of the few countries with huge successful experience of conducting such operations.

It is remarkable, that the majority of the master classes took place in the leading medical centers of the country with the technique ‘in the workplace’.

Upon completion of the symposium was adopted a resolution. It embraced the actions necessary to further improve maternal and child health and health promotion. All paragraphs have been elaborated after detailed study during the breakout sessions and master classes. Physicians in the field took part at the discussions too. The participants of the symposium via videoconference communicated with physicians - who performed within frameworks of the 28th week of rehabilitation of women of fertile age, adolescents-girls and children - the medical inspection of rural residents in Sirdaryo region as well as at Namangan branch of the Republican Specialized Scientific Practical Medical Center of Obstetrics and Gynecology and at Jizzakh Regional Screening Center.

Thus, the resolution calls for active participation in solving urgent problems. Further improvement of medical care in ambulatory-policlinic institutions stays ahead. The improvement of emergency medical care is in the focus of attention. The institutions of specialized medical care for children and women will undergo further development. The practice of physicians will be enriched with modern perinatal and neonatal techniques of treatment, based on the principles of evidence-based medicine. Screening of mother and baby will be developing as the main factor in prevention congenital and hereditary disorders. The Government, public and international organizations will continue their support to the vaccinal prevention and to the improvement of medical aid to children with infectious diseases. The issues of improving reproductive health and the formation of medical culture in families, as well as promotion of nutrition education still remain to be the priority. It was declared that ministries, NGOs and international organizations will collaborate to achieve Millennium Development Goals in maternal and child health.

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All this once again proves that a man and his well-being are regarded as the ultimate goal of the reforms in Uzbekistan. And that the health of the people and the gene pool issues are in trustworthy hands. The participants of the symposium agreed that unusual format of the forum, which included events on discussing the ways of improving the organization of medical aid, and master classes with leading specialists for medical practitioners, will undoubtedly contribute to improve the quality of care not only in the Uzbekistan but also abroad.

From the first days of independence Uzbekistan identified the health of mothers and children as the main priority, the most appropriate step for the present and the future. The President of Uzbekistan Islam Karimov clearly stated this in the title of the model - ‘Healthy Mother - Healthy Child’ - created by his own initiative and successfully implemented in the country. Your country pays great attention to the constant development of healthcare, and I highly appreciate the successes achieved by Uzbekistan in this sphere.

Providing for maternal and child health is the most important and challenging task. It embraces all tiers of healthcare - primary care, hospital care, regular checkups, emergency medical care, immunization, screening diagnostics and specialized medical services. In Uzbekistan, the work of all these sections has been elaborated in integrity, in accordance with international standards, which brought about such high results in realization of the national model of mother and child healthcare.

Uzbekistan can be proud of the fact that its population health indicators have not deteriorated, but on the contrary, the life expectancy has been lifting up. One important reason for this is immunoprophylaxis. Your country implements a well-functioning program of people immunization with high level of control. Such approach is particularly important for children's health, as well as for early disclosure and prevention the spread of infectious diseases that could threaten the entire nation.

Leonid Roshal, director of Moscow Clinical and Research Institute of Emergency Children’s Surgery and Trauma, Russian Federation:

I am acquainted with Uzbekistan’s children's doctor for a long time. We are not just friends; we specifically co-operate to find optimal solutions to pressing medical challenges. The most close and fruitful relationships have been established with the Republican Scientific Practical Center for Minimally Invasive and Endovisual Child Surgery.

The colleagues from this Centre implement and develop low-traumatic and endovisual methods of treatment. I had an occasion to be an official opponent during the dissertations of young scientists from the Centre. They tackle complex problems and promote children's surgery ahead.

 In the framework of the symposium, I had the opportunity to meet again with the specialists from this Center and with main children's surgeons from country’s regions. We had an interesting conversation, during which we discussed the peculiarities of minimally invasive endovisual surgeries on children. I am pleased to note that that the country is expanding the list of pathologies which surgeons treat with these low-traumatic and safer methods. Its very good, that the conditions for application of these techniques are created not only in medical institutions of republican level, but also in those of regional and district levels.

Roland Wauer, Professor of Charité Clinic, Germany:

I was Uzbekistan for the first time in 2005. Since then, during various master classes I've come to this republic eight times. I am impressed with the measures being undertaken in the country to improve newborn care.

 Just during my last visit, the Republican Perinatal Center - the country's main center for helping pregnant women with abnormalities and to children born with poor health - was located in a relatively small building. When I arrived with a master class for specialists of the center at the symposium, at the same place I saw a large palace. An additional edifice has been constructed to the Center, not because the number of patients is increasing, but because the doctors are getting new equipment to assist patients with various pathologies and they are adopting cutting-edge practices of care. Another news - a good one - over the past year in order to improve medical assistance provided on the ground, similar centers have been established and equipped with modern medical equipment in all areas of the country.

I am glad that with my master classes I have an opportunity to participate directly in the development of perinatal services in Uzbekistan, and to help colleagues in development of this important service, which saves thousands of maternal and infant lives. At the symposium, we have discussed new technologies for neonatal emergency care, neonatal resuscitation and transanimation.

No Bo-kim, branch manager of Save the Children international charity organization:

This year, our organization has made a rating of 161 countries in terms of care for children's health. Uzbekistan has taken the ninth place on the list. This suggests about high level of organization and quality of medical services provided to pregnant women, new mothers and newborns.

Today, even in many developed countries, institutions of skilled medical aid are concentrated in cities, making it difficult to people from rural areas to get medical service. In Uzbekistan, delivery rooms, rigged with modern medical equipment, work in all rural areas. Rural Medical Stations, which are practically in every village, also facilitate to provide qualified health services.

The country successfully implements laws and programs to improve nutrition; breastfeeding is supported and promoted; flour is being enriched with micronutrients, salt food is being iodized, people from risk groups provided with prophylactic drugs. These measures contribute to the improvement of health conditions, and in particular reduce the prevalence of iodine deficiency and anemia among women of childbearing age.

There is another important point. According to the assessments of World Health Organization, in order to provide qualified medical care to mothers and children, the number of doctors should be 23 specialists per ten thousand people. In Uzbekistan, not only cities but also villages correspond to this standard.

Joao Breda, regional adviser at Nutrition, Physical Activity and Obesity, WHO Regional Office for Europe:

Well nutrition and physical activity are important components for child’s normal development and maintenance of good health. Uzbekistan is a good example where both this aspects are defined as priority tasks; the experience of working on this sphere is a model for others.

Uzbekistan has implemented programs aimed at improving nutrition. We also see that there is an active process of reinforcement and building of new sports facilities, many of them are created specifically for the popularization of sport among children. From year to year the number of children, adolescents, and that is especially important – of girls involved in sport activities under the guidance of professional coaches and mentors increases in the country. As you know, sport is the basis for effective prevention of many noninfectious diseases.

During the symposium to these issues was paid particular attention. They have been discussed in almost all events, including special master class devoted to the prevention of non-communicable diseases.

Ernas Tuleutaev, head of pediatrics department at the National Research Center of Motherhood and Childhood, Kazakhstan:

Uzbekistan is a country with one of the strongest in the world and constantly developing system of maternal and child healthcare. Key factor in achieving by the republic such high international recognition is the presence in the country of experts with good experience and skills in solving actual problems. I have repeatedly convinced myself of their professionalism during meetings with them at various international events. This time, when I visit Uzbekistan for the first time, as I arrived here as a participant of the international symposium, I was able to see by my own eyes all achievements the republic did in this sphere.

In many ways, the progress provides intercourse and exchange of experience. To increase contacts with Uzbek colleagues we need to make greater use of telemedicine. Now it allows conducting videoconferences, counseling critically ill patients, and sharing important medical information.

 I am confident that development of dialogue with pediatricians from Uzbekistan will further enhance and improve the quality of medical care in both countries.

Ezizgeldy Hellenov, reproductive health advisor at UNFPA Regional office for  Eastern Europe and Central Asia:

Care about reproductive health is a reliable way to prevent many diseases; it is important element of strengthening the gene pool. A solid and reliable foundation for further work in this direction is created in Uzbekistan.

The country has Republican Reproductive Health Center and 13 branches of it in the regions. It constantly and regularly works on training young families about modern approaches of solving urgent problems of family planning, birth and upbringing of healthy children.

The organization in the country of effective system of skilled medical care contributes to the improvement of reproductive health. In order to improve its quality, the country, on a regular basis, conducts medical examinations of women and children, on the ground, by leading experts of regional and republican health institutions.

Vera Revyakina, member of executive committee, Federation of Pediatricians of CIS countries:

It is obvious that the final result of medical aid to a child will be higher if this assistance is provided by a pediatrician, a specialist on children's diseases. With current trends in health care, it is important to maintain and to develop the pediatric service.

In Uzbekistan, its improvement is a priority. Over the past five years, the country has created Republican Specialized Scientific Practical Medical Center of Pediatrics; multi-functional children medical centers work in all regions of the country; pediatric departments of district hospitals are also developing. The construction of new and reconstruction of existing buildings, allocated for the needs of these institutions are being continued. In the near future they will be fitted with latest medical equipment. This whole range of activities should help qualified professionals, who, as I said, constantly try to improve themselves and build up their performance, relying on the principles of evidence-based medicine.

There is no doubt that further improvement of the medical care to child population and the salvation of thousands young patients heavily relate with pediatrics. I am glad that Uzbekistan has created all conditions not only for wide application of advanced technologies in this field of medicine, but also for the development of new high-performance methods for diagnostics and treatment.