Actions must be taken to improve our people’s reproductive health
In 1987 our country acceded to the Universal Declaration on Human Rights and by so doing the then Administration committed, among other things, to strive towards the elimination of all preventable maternal deaths. Concomitant with that commitment was the formulation of requisite policies and additional resources becoming available to the Ministry of Health to ensure the required results.
The Family Health, and more specifically the maternal and child health department, embraced the concept of Safe Motherhood Initiative with the five pillars namely - preconception care, prenatal or antenatal care, the identification of high-risk pregnancy, clean and safe delivery, and postnatal or postpartum care. The five pillars are strategies and interventions aimed at reducing deaths in women of reproductive age and to improve family health. The Sustainable Development Goal Number 3, Target 1 calls for the reduction of the global maternal mortality ratio to be less than 70 per 100, 000 live births while Target 2, seeks to end preventable deaths of newborns and children under five years of age by 2030 and to have a neonatal mortality ratio of twelve per one thousand live births.
Considering the commendable impact of previous efforts in this area of health care, we are extremely disappointed at the captions in our newspapers and find the maternal, perinatal, and neonatal deaths highly unacceptable in Guyana in this twenty-first century in a golden oil rich country like Guyana. During the A Partnership of National Unity (APNU/AFC Coalition) tenure in office, stringent efforts were pursued to ensure greater access of primary health care for pregnant mothers.
Additionally, respectful maternity care with special focus on healthcare workers as it related to transforming of attitudes, interpersonal communication, and training on values were undertaken.
The Guyana maternal mortality rate for 2015 was 172 per 100,000, a decline of 1.15 per cent from 2014 and Guyana maternal mortality rate for 2017 was 169 per 100, 000 a decline of 0.59 percent from the figure in 2016. The then Administration was aware of the common contributing factors such as poverty, pregnant mothers living long distances from hospitals, lack of information, inadequate services, and cultural practices, sought funding to improve pregnancy health outcomes. Further, waiting homes were built in the hinterlands at Lethem Regional Hospital, in the Upper Takutu/ Upper Essequibo Region and in the Barima/Waini Region. This was a significant development towards providing quality care for the antenatal mothers and their newborn.
One hundred and thirty- three million dollars were obtained for the expansion of the Georgetown Public Hospital Corporation Maternity Unit to increase its capacity by fifty beds. The Inter-American Development Bank (IDB) had loaned Guyana the sum of US $8 million to assist in the reduction of maternal, perinatal, and neonatal deaths at 140 health facilities and in 88 communities, benefitting at least 140,000 women and 9,000 newborns per year over a period of five years. Additionally, to mitigate the prevalence of premature and untimely maternal deaths, the Ministry of Public Health, and the Pan American Health Organization (PAHO) provided actual birth stimulators to assist the health care personnel to see when the baby is coming out of the pelvis opening. This expanded the teaching and understanding of obstetricians and the nurses’ obstetric practitioners and alerted them to the appropriate model or type of maneuver that would be best suited to get the baby out. These interventions were designed in conformity with accepted standards and common obstetric practice that the pregnant mother should not lose more than 150mls of blood during labour. With faster delivery time, there must be less risk of infections, injury, and blood loss.
It is therefore the recommendation of the APNU + AFC that the recent reported maternal deaths be subject to a mandatory postmortem and a proper maternal death review process. Such actions would help to provide adequate information and accurate data that could guide the Ministry of Health on programmes, policies, and strategies for the prioritization of resources. Dr. Frank Anthony, Minister of Health for the government, the construction of a thirty-two billion dollars Women and Children Hospital at Ogle on the East Coast Demerara would not “cut it” if the correct actions are not taken to improve the health outcomes of the wonderful, hardworking, and reproductive people of Guyana who deserve to see the elimination of all preventable maternal deaths by the year 2030.
It must be evident to this Administration by now that money alone would not accelerate our development. It requires harmony, justice, equity and the elimination of all forms of racism to unleash the creative energies of our people to build a better country - not for one but for all Guyana.