$100m health screen­ing bill

Gov’t con­tem­plates rou­tine vet­ting of preg­nant women in wake of Ju­bilee baby deaths

Jamaica Gleaner - - NEWS - Erica Virtue Se­nior Gleaner Writer erica.virtue@glean­erjm.com

THE GOV­ERN­MENT’S free health-care sys­tem is to be­come even more bur­den­some to tax­pay­ers, as it will cost more than $100 mil­lion an­nu­ally for the rou­tine screen­ing pro­gramme be­ing con­tem­plated for preg­nant women whose ba­bies are de­liv­ered at Ja­maica’s pub­lic hos­pi­tals.

The pol­icy de­ci­sion that is be­ing con­tem­plated is as a re­sult of the deaths of seven new­borns, in­clud­ing four who died within 24 hours af­ter de­liv­ery, at the Vic­to­ria Ju­bilee ma­ter­nity hospi­tal. The ba­bies were found to have con­tracted a deadly bac­te­rial in­fec­tion, which af­fected crit­i­cal or­gans of their young bod­ies, caus­ing sep­tic shock and even­tual death.

Chief Med­i­cal Of­fi­cer Dr Win­ston De La Haye, who last week con­firmed the deaths of the seven new­borns, said there was cur­rently no rou­tine screen­ing of the moth­ers, but that may have to change shortly, given what has hap­pened. The de­ci­sion, for which de­lib­er­a­tions are now be­ing held, would see the hospi­tal screen­ing for “Group B strep­to­coc­cus (GBS) bac­te­ria.

“This is a bac­te­ria that can be found in the vagina, rec­tum or res­pi­ra­tory sys­tem of in­di­vid­u­als, and the aim is to iden­tify and treat it to pre­vent in­fec­tion in the ba­bies,” ex­plained the chief med­i­cal of­fi­cer.

Group B strep­to­coc­cus bac­te­ria are nor­mally found in the in­tes­tine, vagina, and rec­tal area in about 25 per cent of all healthy adult and preg­nant women. Ac­cord­ing to him, group B strep in­fec­tions can af­fect neonates and adults, and most preg­nant women who are colonised show no symp­toms.

The in­fec­tion can be spread to in­fants be­fore or dur­ing de­liv­ery, and signs and symp­toms may in­clude fever, breath­ing prob­lems, seizures, lethargy and poor feed­ing. Com­pli­ca­tions of GBS in­fec­tion in­clude sep­sis, pneu­mo­nia, menin­gi­tis, or, oc­ca­sion­ally, death.

TAR­GET GROUP

“I don’t have the ex­act cost­ing, but I can tell you it will cost more than $100 mil­lion to screen and treat. The pro­gramme would be tar­geted at high-risk preg­nant women – those who present with rup­tured mem­branes or ill­ness – any­thing with a fever. This would be done at 36-37 weeks of preg­nancy,” De La Haye told The Gleaner yes­ter­day.

The cost to the Gov­ern­ment would in­clude the cost of med­i­ca­tion, as he said it made no sense to iden­tify the bac­te­ria with­out of­fer­ing treat­ment.

“So the pre­scrip­tion would be writ­ten and they go to the phar­macy and col­lect the med­i­ca­tion. The treat­ment for GBS in­fec­tion is an­tibi­otics,” he told The Gleaner.

He said de­lib­er­a­tions were un­der way but there would be no manda­tory test­ing of all women who opt for de­liv­ery at the hospi­tal. He pointed to the United King­dom, where there was no manda­tory test­ing and where the num­ber of women who present with bac­te­rial in­fec­tion are not nec­es­sar­ily a cause for con­cern.

How­ever, he ex­pressed con­cern that the hospi­tal could not turn any­one away.

“At the Uni­ver­sity Hospi­tal of the West Indies, moth­ers wish­ing to de­liver there must reg­is­ter within three months of preg­nancy. We can’t do that at Vic­to­ria Ju­bilee, and there are those who sim­ply turn up at the hospi­tal for de­liv­ery, and hence the con­stant risk,” he pointed out.

A com­pre­hen­sive pub­lic ed­u­ca­tion pro­gramme by the health min­istry is also be­ing con­tem­plated for clin­ics and na­tion­ally fo­cus­ing on hy­giene, in­clud­ing sim­ple things such as the wash­ing of the hands.

But Op­po­si­tion Spokesman on Health Ho­race Dal­ley has de­scribed the re­sponse of the min­is­ter of health in re­la­tion to the death of the ba­bies as dis­ap­point­ing. He said he was also con­cerned about the full make-up of the team put in place by Tufton to in­ves­ti­gate the deaths of the ba­bies at Vic­to­ria Ju­bilee Hospi­tal.

DE LA HAYE

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