May 20, 2017 News
Public Health Minister, Ms. Volda Lawrence, on Wednesday signalled the end of fragmentation in Guyana’s health services system which she said is “wasteful and uncoordinated and negatively affects quality, cost and
outcomes for patients.”
Otherwise dubbed ‘clinical linkage deficiencies’ among health specialists, Lawrence said the future of the local health service will be tied to effective “networking” which for her, is the way forward.
“We need to be interconnected, to be au fait with what’s happening in all sectors to eliminate overlapping and duplication and be in a better position to impact and improve our health care facilities,” Lawrence told public health employees drawn from four of the 10 Administrative Regions.
“Networking is the way forward; no sector should resist having data which presents a holistic overview.”
The two-day collaborative venture between the Public Health Ministry and the Pan American Health Organisation/World Health Organisation concluded yesterday at the Marriott Hotel in Kingston.
But the Ministry knows full well this will not be achieved easily, and Minister within the Public Health Ministry, Dr. Karen Cummings, pointed this out when she spoke.
“As in systems that have a significant human element, there are challenges. Even amongst the challenges we face in ensuring that we realise equity of access to our public health services, we must recruit, train, and retain adequate and suitable human resources.
“We need to refine the supply chain systems used to ensure the timely delivery of medicines and other medical supplies,” Dr. Cummings said.
The global PAHO/WHO is behind the move to shift from fragmentation to integration here but the concept has been around since the 1930s, gaining traction as a health strategy in the 1980s following the bourgeoning cost of health care in the United States. Some, fearing a systemic meltdown, have been championing the current shift towards integration in the health services sector.
PAHO/WHO considers the integrated health services delivery networks [IHSDNs] as it is known in Guyana’s health sector, according to Minister Lawrence, as “one of the principal operational expressions of primary health care-based health systems at the health services level, helping to make some of its most essential elements such as universal coverage and access, integrated and continuous care, optimal organisation and management among others a reality.”
She is convinced that ultimately it will help reduce inconveniences patients and their families experience when trying to access public health services. It will deliver better quality of service and scale down unnecessary increases in production costs coupled with low user satisfaction.
This is what is driving the shift from fragmentation to integration in the minds of health specialists. Lawrence, Dr. Cummings, PAHO/WHO Representative, Dr. William Adu-Krow, Dr. Kay Shako, Director of Regional Health Services (RHS), and Dr. Reynaldo Holder, Regional Advisor, Health Systems and Services (HSS) all targeted fragmentation which they agreed triggers inefficient allocation of resources [human, financial and technological] which ultimately results in harm to patients.
They all cited the need for restructuring and tighter management control which they assure will help to meet the now- sought-after objective: the existence of units, facilities or programmes that are integrated into the health network; services that cover the entire range of promotion, prevention, diagnosis, treatment, rehabilitation, and palliative care services; services with longevity and that meets peoples’ needs.
In addition to the limitations of the current disintegration of the health services delivery, Lawrence also highlighted communication complications because of a lack of a centralised data systems from which information can be shared,
“This manifests itself in a multiplicity of ways at different levels of the health system, a lack of coordination resulting in undue delays and poor communication sometimes within and across departments as well as across regions,” Lawrence complained.
She, moreover, noted that as a result deficiencies in the planning and implementation of health services and outreach programmes ensue to the detriment of users who are sometimes unable to access services or instances where services do not adequately meet their needs.
“This is particularly evident in the remote interior locations where geographical barriers and communication challenges hinder access to health services,” she said.
Lawrence said that patients are unprepared to continue suffering perennially under the weight of systemic inefficiencies and disconnect within the sector and deliberately ignore well-known structures within the system.
“Although the levels of care are well-defined, in practice, this is not adhered to as patients may bypass the health centre and district hospital to attend the regional hospital and the national referral hospital, thus overburdening the systems and contributing to shortages in drugs and medical supplies and a build-up of patients,” Lawrence considered..
Minister Lawrence is therefore impatient with the “hiccups in the system” affected by a paucity of trained professionals in some sectors, weak vertically and horizontal linkages, lack of effective monitoring and evaluative mechanisms as well as an absence of relevant and current data.
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