Flagging primary health care system is reason for high maternal mortality rate

Jan 10, 2016 News

– Dr Frank Anthony
The flagging primary health care referral system is the source behind Guyana’s high maternal death rate, says Shadow Public Health Minister Dr. Frank Anthony.
Anthony stated that Guyana will continue to struggle with maternal mortality if the Public Health Ministry does not address the issue of its faltering referral system, especially health centres across the country.
There are many incidences, he said, when women would be experiencing a high-risk pregnancy and health centres would drag their feet to refer patients to a tertiary medical institution. He stated that if there is early detection of high-risk pregnancy a lot of lives would be saved.
“The referral system is the reason for us having this problem of maternal mortality,” Anthony said, insisting that he has not seen any improvement in the health care system over the past few months.
“There is an urgent need for health centres to detect early cases of high risk pregnancies,” he added.
As of December 30, 2015, Guyana had recorded 17 cases of maternal deaths, which is one case short of the 2014 figure. This has caused the country to miss its goal to reduce maternal deaths by three-quarters between the years 1990 and 2015.
In 2000, 189 world leaders met at the United Nations (UN) Millennium Summit and accepted the Millennium Declaration. It was there they agreed to the eight Millennium Development Goals (MDGs), intended to overcome poverty and other related targets. One of those goals was to improve maternal health and reduce it by three-quarters between 1990 and 2015.
So far, the maternal mortality ratio has decreased from 270% in 1990 to 86% in 2012. Therefore, in order to achieve its target Guyana would have had to reduce its maternal mortality rate to 67.5 percent by the end of 2015.
“If the health centres would detect a- risk pregnancies early we would be in a better position to treat the patient,” Anthony reiterated.
Chief Medical Officer Dr Shamdeo Persaud said the Public Health Ministry is looking to establish high-risk clinics for pregnant women. He said it was very important for these mothers to be under close observation along with the medical institutions having adequate supplies of blood for emergency situation.
He said further that the ministry was working assiduously to reduce teenage pregnancy since it is one of the causes for high risk pregnancy.
The CMO also insisted that an acute shortage of Obstetricians was another reason for the high mortality rate. He stated that they were looking to increase the number of Obstetricians through training programmes.
“We are also advising pregnant mothers to register early at clinics so that we will better able to evaluate their situation. They also need to attend their clinics regularly…we recommend the minimum of four visits in the first eight months of their pregnancy,” he implored, adding that the mothers need to work along with the medical facilities.
Public Health Minister George Norton, however, stated that there is a need for a multi-sectoral approach when undertaking the issue. He also expressed his disapproval with the response of the health care practitioners, especially doctors and nurses, when treating pregnant women.
“I want the doctors to be more involved. They are negligent and I will not hide that fact. I’m hearing talks that I’m micro-managing everything but if that’s what it will take to stop mothers from dying and dropping the maternal mortality rate so be it,” Norton said.
Recently, a United Nations (UN) report revealed that Guyana was among five countries in the region with the highest Maternal Mortality Rate, and among six nations where the incidence had amplified notably between 1990 and 2013.
According to Global Causes of Maternal Death: A WHO Systematic Analysis, more than one in four maternal deaths are caused by pre-existing medical conditions such as diabetes, HIV, malaria and obesity, whose health impacts can all be aggravated by pregnancy.
“We made a commitment in our campaign trail to have maternity mortality rates reduced and we uphold that,” Dr Norton said, adding that the majority of maternal death cases were pointing directly to the negligence of health care professionals.

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