Jamaica Gleaner

$100m health screening bill

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

- 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.

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