Meanwhile, Mongolia has a large amount of snowfall, preventing pregnant women from getting an adequate amount of physical exercise and/or activities that they need. It is traditionally believed that pregnant women must eat for two people, but in Mongolia, people’s diet heavily relies on meat and dairy products. Also, people’s belief that bigger babies are healthier and better encourages pregnant women to eat more. These factors cause a high obesity rate among pregnant woman. There are a number of cases in which women suffer from high blood pressure, high blood sugar or complications during childbirth. Obesity has been a life threatening issue for pregnant women, but there is no support or guidance offered to solve this issue. The improvement of the obesity issues or any other individual health issues is simply left in the hands of respective pregnant women. Heavy snowfall also results in women giving birth at home without any professional assistance. Many women give birth at home thinking that they are healthy, but end up dying after losing a large amount of blood. However, there is not even any statistical data on the number of such deaths because childbirth usually occurs privately. Project aim: The project aims to contribute to the reduction of maternal mortality and improvement of the health of pregnant women and infants in Mongolia and support the Mongolian midwives to offer more accessible and practical midwifery services in the country. Through this project JMA will share and transfer skills and knowledge of midwifery practice and services to MMFA to enable them to provide quality midwifery services and pregnancy guidance for pregnant women and their babies in Mongolia. Most women in Mongolia currently have no access to adequate health services concerning pregnancy and childbirth. This project will contribute to the improvement of their health and reduce mortality rate. Main objective: To improve antenatal midwifery services and address the problem of obesity among pregnant women and their families in Mongolia. Specific objectives To create awareness among women and their families on the dangers of obesity. To sensitize women and families on the prevention of obesity To advocate for the institutionalization of information on obesity in the schools of midwifery To train midwife instructors who will teach other midwives Activities to Be Conducted: The Key activities will be Health education of women and their families As the first step to improve health and mortality rate of pregnant women and their babies in Mongolia, JMA believes that enlightenment of women and their families to avoid obesity is the most effective, important and urgent action to be taken. Therefore, the organization is creating a brochure for them to explain about dangerous health problems caused by obesity, such as high blood pressure, diabetes, complications, and blood loss at childbirth, which could all lead to death, knowledge necessary to maintain health and information about diet. JMA aims at distributing this brochure to 82,000 pregnant women each year for free. Institutionalizing the information in the schools of midwifery JMA also plans on developing a textbook for midwives in Mongolia based on the maternity health guidance and midwifery services that Japanese midwives provide in Japan. The textbook will include instructions and guidelines concerning providing health and dietary guidance to prevent obesity, prenatal checkups, and prevention of accidents during childbirths, and medical information explaining why overeating, obesity and so forth are dangerous for pregnancy. Dissemination of information and knowledge and skills transfer By using this textbook, JMA is considering organizing midwifery seminars in Mongolia to share and transfer its knowledge, techniques, and methods used and know-how of Japanese prenatal checkups and midwifery services provided to pregnant women in Japan. The Japanese midwives will work with the Mongolian colleagues to adopt and adapt some of these methods and techniques to their own situation. The type of services and practices that JMA considers teaching MMFA include nutritional/dietary guidance, prenatal exercise programs, and assistance for natural childbirth, in addition to knowledge and know-how regarding prenatal checkups. Nutritional/dietary guidance and maternity exercise are crucial for prevention of obesity and high blood pressure during pregnancy. Peer support and peer coaching JMA also plans on working with MMFA member midwives on ways to help pregnant women whose babies are in a breech position, such as methods to check a fetus’ position so that they can detect a problem at an early stage and send a pregnant woman who needs medical attention immediately to a hospital. They are also going to show MMFA a special exercise to help the baby to move into the right position. Sharing ideas about the Japanese system Midwives in Japan help women have natural childbirth at maternity centers. They are only permitted to handle normal childbirth, but they have partnerships with hospitals in the case that a pregnant woman needs urgent medical attention by a doctor, such as high blood pressure or the baby is in the breech position, and they send such woman to a hospital immediately. Pregnant women are obligated to receive prenatal checkups in Japan, whether at a maternity center or a hospital. This enables pregnant women to discover any problems and get the care they need at an early stage. Hospitals also have midwives providing pregnant women with health guidance and consultations, and health care services. JMA also would like MMFA member midwives to learn about the Japanese system and utilize the information in Mongolia. Training of Mongolian Midwife instructors In collaboration with MMFA, JMA aims at holding six seminars in different areas of Mongolia and will invite 50 MMFA member midwives, who can eventually work as instructors to spread their skills and knowledge further to other midwives in the country, to respective seminars. After the training, the MMFA member midwives will carry out these activities in a small area with little access to medical or midwifery services on a trial basis first, and teach other midwives how to provide these services so that the other midwives can offer detailed and quality midwifery services, prenatal checkups, infant health checkups and so forth, in their respective towns and villages. Once the trial is finished, MMFA will conduct this activity in other remote areas in the country to distribute skills and knowledge further to midwives throughout Mongolia.

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