Drop in maternal deaths recorded in 2016

Post-partum haemorrhaging main cause of fatalities

The Ministry of Public Health (MoPH) last year recorded five fewer maternal deaths than in the previous year.

At the ministry’s end-ofyear press conference last week, Junior Minister Karen Cummings told reporters that in 2015, there were 17 recorded maternal deaths, while in 2016 that number has been reduced to 12.

It was clarified that while there have been 13 deaths, 12 have been verified. The last death is still being investigated although preliminary investigations show that the mother died from high blood pressure.

It was also reported at the press conference that seven medical personnel have been found culpable in the maternal deaths over the 2015 and 2016 periods; four in 2015 and three in 2016. Of this number, four were senior doctors and three were at the registrar/residency levels.

In responding to a series of questions from Stabroek News, then Health Minister Dr George Norton said that several personnel have been found culpable and disciplined by the Medical Council of Guyana.

Chief Medical Officer Shamdeo Persaud, who sits on the council, explained that in 2015 four doctors were sanctioned, while in 2016 one was sanctioned and two are still before the council.

“The council utilised three levels of sanctions: (censuring), which means they are placed under some kind of supervision, they can also be suspended from the register for a period of time or struck off of the register. The four from last year were all censured, with two having been suspended from practice for a period of time. This year (2016), one individual was ordered to cease offering termination of pregnancies and asked to go under supervised retraining to bring his practice in line with the Act,” he explained.

The remaining two practitioners are still before the council, with one of them having been brought before a disciplinary committee.

Norton explained that this case has been delayed due to a statutory requirement that the committee be presided over by a sitting magistrate. “The practitioner shows up with his legal counsel and the medical council have their legal representative, so it was necessary that we have a sitting magistrate interpret their argument. A magistrate has now been assigned so that case should be concluded soon,” he said.

The ministry officials explained that the main cause of maternal deaths in Guyana continues to be post-partum haemorrhaging, while gestational hypertension has been recorded as the most frequent contributing condition.

Despite these challenges, the slight reduction has been attributed to the fact that there are more trained doctors in the public health system in the field of obstetrics.

“This has resulted in earlier diagnosis of complications,” Cummings explained, before adding that “to date, some 75% of all Cuban-trained medical practitioners have been trained in ALARMS (Emergency Obstetrics Training), while 40 more health care workers were trained in ALARMS in 2016.”

The reduction in the number of maternal deaths is also being attributed to increased education, women receiving prenatal care earlier in their pregnancies, and an increase in the number of medical evacuations.

The Medical Evacuation programme is an initiative implemented for the purpose of providing efficient and safe emergence and transportation services for critically ill patients from the hinterland regions. While in 2015 185 patients were evacuated on 142 flights at a cost of approximately $66.6 million, that number increased significantly in 2016 to 255 patients, who were transported on 212 flights at an approximate cost of $82.3 million. According to the ministry, the increase in the number of medical evacuations in 2016 is primarily as a result of the ministry’s position on the transfer of all high risk pregnancies from hinterland regions in an effort to reduce maternal mortality and morbidity.

“Curbing the maternal and neonatal mortality rate is high on the ministry’s agenda and key to these efforts is the InterAmerican Development Bank loan for the improvement of maternal and neonatal health granted in 2016. These funds will see the (maternal and child care) department intensifying its efforts in this area in 2017,” Norton said.