PAHO working with Health Ministry to reduce maternal mortality

Jun 24, 2014 News

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“No woman should die during child birth,” was the firm assertion of Resident Representative of the Pan American Health

Organisation (PAHO), Dr. William Adu-Krow, as he spoke of plans in the making to ensure that this objective is realised in Guyana. Dr. Adu-Krow, during an interview with this publication recently, disclosed that currently, close attention is being directed to maternal health.
Dr. Adu-Krow, who recently assumed the position of PAHO Resident Representative, said that he has already met with officials of the Ministry of Finance and the Health Ministry, including Minister of Health, Dr. Bheri Ramsaran, to address the challenges of maternal health. “Both Ministries, Health and Finance, have come together to assist in health…along with PAHO and other development partners to come up with a plan whereby no woman should die during childbirth,” said Dr. Adu-Krow.
But according to the PAHO Representative, despite efforts made over the years, there are some women in Guyana who are dying from avoidable circumstances and “there is no way that we should allow that to happen.”
During the past year the local health sector recorded a total of 18 maternal deaths, a figure that Chief Medical Officer, Dr. Shamdeo Persaud has called “way too high.”
He, during an interview with this publication said that of the recorded cases, 11 were directly linked to pregnancy complications while seven were triggered by indirect circumstances ranging from malaria to heart conditions.
But according to Dr. Persaud, it is usually only the direct causes that are used in the calculation of the maternal mortality rate. Moreover, he disclosed that the Health Ministry, based on the estimated number of births for last year, recorded a maternal death rate of 79.7 per every 100,000 live births. “This is just about where we should be in terms of our Millennium Development Goal (Five)…we should be 80 or less in terms of our indicator; so this means that we can absolutely have no more than 11 direct maternal deaths,” said Dr Persaud.
The main direct causes recorded last year were mostly due to haemorrhagic conditions, hypertension in pregnancy, eclampsia and adverse effects relating to bleeding. There was also a case related to an ectopic pregnancy and two related to termination of pregnancies where some complications were encountered.
Two of the indirect cases were linked to malarial complications and there were three cases with patients who had various types of chronic diseases – with at least one being an HIV related complication.
One case entailed a patient who had an underlying heart condition as well which led to the unfortunate outcome of death, Dr Persaud disclosed.
As part of efforts to put measures in place to help reduce the instances of maternal death, Dr Adu-Krow said that an assessment has been done and a report has been generated. This, according to him, has allowed for efforts to be directed towards the process of compiling a report and deriving a workable plan to guide the way forward. “I think in about five years time we should not be having the number of deaths that we are having now,” said Dr Adu-Krow. This, he said, will be addressed with the planned moves by the Health Ministry to recruit 10 obstetricians in the near future, and train even more, so as to ensure that the country is furnished with well trained personnel to conduct deliveries. This is in spite of the fact, Dr Adu-Krow noted, that “there are many women who deliver without the assistance of obstetricians.”
But according to the PAHO Representative Guyana, from all indications, is in a much better position when the targets of the Millennium Development Goals (MDGS) Four and Five are considered. “Coming from Papau New Guinea (where he previously held the position of Resident Representative) I think Guyana is much better off…however it doesn’t mean that we have done everything that needs to be done; there is lots of work yet to be done,” Dr Adu-Krow noted.
MDG Four speaks to the reduction of child mortality while MDG Five is one that addresses the improvement of maternal health. Although strides are consistently being made to meet these goals by next year, as recommended by the United Nations, the PAHO Representative has expressed some concern that MDG Four may not be attainable by the stipulated period. “I think it appears we may not be able to achieve that by 2015…however I think we are setting ourselves targets that are more meaningful,” said Dr Adu-Krow.
In the quest to refine the approach to reducing child mortality, the PAHO Representative disclosed that bottlenecks have been identified and “so now what we have to do is work towards getting rid of those bottlenecks and ensuring that we execute the plan to achieve the results we are looking for.”

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