UN Health report highlights flaws in Guyana’s maternal facilities
A report compiled by the United Nations and the Ministry of Health Guyana reveals that Guyana has an inadequate number of Emergency Obstetrics and Neonatal Assessment (EmONC) facilities.
The EmONC report was formulated for the Ministry of Health in collaboration with the United Nations Population Fund and the Bureau of Statistics. The report focused on 2010.
According to the report the adequate amount of EmONC facilities is a standard five per every 500,000 population and that will not work for Guyana. It was noted that the minimum would not work because of the country’s topography.
The report stressed that with a population of more than 751, 233; there should be at least eight EmONC facilities, at least two of which should be comprehensive.
“There was only one facility, West Demerara Regional Hospital that qualified as a basic EmONC facility. This facility could readily be upgraded to a comprehensive facility with the addition of caesarean section.”
Also noted in the report was that the availability and distribution of appropriately trained staff must be taken into consideration.
The report further stated that every person providing maternal and neonatal care must be suitably qualified. It was also noted that all health care providers should be exposed to every training opportunity that is being provided. Record keeping and maintenance of registers continue to pose a problem and should be improved, according to the report.
It was further stated that it is, however, recognized that certain services can in fact be provided by mid-level personnel with proper training for assisted vaginal delivery, manual removal of placenta and vacuum aspiration of retained products, which are all elements of emergency obstetric care.”
Legal provisions must be put in place to accommodate task shifting and suitable recognition should be given for the added responsibility. The report posited that training should be given in the area of newborn complications, especially that of asphyxia.
The report for the first time looked at the national baseline information on the availability, use and quality of obstetric and newborn care services as recommended by the United Nations family including the World Health Organization. The report provides critical evidence to guide planning, implementation, monitoring and evolution of maternal and newborn services which are provided at the National and Regional levels. The report focused on the year 2010.
Guyana was identified as one of the countries in the Americas with the highest maternal mortality by the UN system in 1990. The country has made significant progress through government’s commitment and UN support but these gains are still fragile and need to be sustained. The Ministry of Health also recognizes that Maternal Mortality is not only a health but a development issue and therefore the response must move beyond the MOH and toward an inter-sectoral approach for ultimate results.
Meanwhile, Minister of Health Bheri Ramsarran yesterday said that although the report highlighted several weak spots of the system, the Ministry has made significant strides since 2010, when the report was done. He noted that there are many programmes the Ministry is currently embarking on which would ensure that quality healthcare is given.
The Health Minister said that the report is the baseline to illustrate where Guyana has come from in the past to where it is currently. According to him, the report did not fully reflect the referral system. He said that the Ministry might not have centres of excellence in every report, and this report could not have reflected that because this was in 2010. The changes have been implemented, but even at that time, we had a strong referral system that cost money.
The Minister further noted that he was in no way criticising the report, but it was a dated report which gives a reflection from where the Ministry has come from.
It was recommended that a policy decision must be taken within the public system to mandate the use of partograph. In doing so the type of partograph must be indicated and all facilities must be provided with blank forms, the management protocols and the training of relevant staff carried.