Shortage of specialists hampers primary health care agenda

May 24, 2017 News

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A shortage of specialist doctors has been severely affecting the Ministry of Public Health’s attempts to advance primary health care. This notion has been amplified by Minister within the Ministry of Public Health, Dr. Karen Cummings.

What obtains as a result of limited specialists in the system is that there continues to be far too many referrals of patients. This has moreover impacted negatively, the Ministry’s agenda to have more people utilise health care facilities in their respective regions.
Dr. Cummings has admitted that “a paucity of specialist doctors in the region presents challenges to the public health system since it results in numerous patient referrals.”
The Georgetown Public Hospital Corporation [GPHC], the country’s main referral institution has been attracting the greatest referral traffic from the regional health facilities.
But according to Minister Cummings, moves are apace to arrest this situation in the interim, even as the Ministry looks to incorporate a permanent solution.
This has translated to the temporary placement of some specialist doctors who visit regional communities as the need arises. According to Minister Cummings, some of the specialist areas that are covered in this regard are orthopedics, paediatrics, and ophthalmology.
Minister Cummings disclosed, “We at the Ministry recognize that the effectiveness of the organization and management of service delivery in the regions depend on, among others, the competence and number of members of the regional health management teams as well as relevant management teams in health centres, health posts, and communities. These teams must effectively coordinate the planning, implementation, monitoring and evaluation of health service delivery,” she added.
In strengthening the leadership of regional health management teams, the Minister noted that “there is need to ensure that regional health systems have technically-competent health management teams that give leadership at the regional health offices, district hospitals, regional hospitals, health centres, health posts and communities.”
Added to this, the Minister said that district health management teams should also be competent enough to provide outstanding leadership in service delivery, health financing, information and health technologies, and general regional healthcare management.
According to her, too, regional public health teams should be developed using formal and sustainable capacity-building programmes.
“Continuously refining the implementation of a comprehensive package of essential health services is an excellent way of ensuring public health care services are available for respective communities.”

The comprehensive health services package, she noted, should be based on population health needs. However since there are barriers to equitable expansion of access to services and available resources, she stressed that the package needs to be considered as the minimum that can be provided during a specified timeframe.
Minister Cummings is convinced, too, that there is need to consider the complementary capacities of the different levels of care and the necessary balance among promotional, preventive, curative and rehabilitative services.
As such improving the organization and management of health service delivery will also positively impact on accessibility. But in order to ensure availability, quality and a continuum of public health care and to reduce the frequency of hospital visits by patients, Minister Cummings noted that there is need to use effective service delivery models that promote efficient referral systems and integration of services.
This would therefore amplify the importance of integrated management of childhood illness, Dr. Cummings said. “There is need to improve the quality and quantity of integrated supervision to ensure continuity of superior health care. The interface between community public healthcare and the formal public health care system must be strengthened in order to improve access to essential services,” the Public Health Minister added.
The Ministry of Public Health is working assiduously to ensure that “we realize universal health care. We want to establish comprehensiveness, as well as, people-centered public health care that are equitably administered regardless of one’s location.”
A national priority of the Ministry of Public Health is to deliver the highest quality of public healthcare to persons living in Guyana, regardless of their location or social status.
Minister Cummings said that the Ministry’s commitment is to significantly narrow the gaps of inequity as it relates to the timely, efficient, and effective delivery of public healthcare that is of uncompromisingly high standards.
But according to her, the achievement of all of these goals remains a work in progress as the Ministry continues to build capacity, particularly within the regions to better serve the people of Guyana. “We at the Ministry of Public Health recognize that access to healthcare services is critical for residents of rural communities. Ideally, residents should be able to conveniently and confidently use services such as primary care, dental, behavioural health, emergency, and public health services.”
One of the nerve centers of the Ministry is the Regional Health Services Department (RHS) which is responsible for the delivery of public healthcare throughout the regions of Guyana. But one of the major challenges that affect the delivery of best quality healthcare is the vastly remote geographical spread of some areas within the hinterland communities. Such is the geography of Guyana that it sometimes poses a transportation challenge to public healthcare professionals tasked with the delivery of care, treatment, and medicines to the communities they serve.
According to Minister Cummings, “Residents of our hinterland communities often experience barriers to healthcare that limit their ability to get the care they need. In order for rural residents to have sufficient healthcare access, necessary and appropriate services must be available which can be accessed in a timely manner.”
However, the Public Health Minister noted that in addition to having an adequate supply of healthcare services in the community, there are other factors that play a significant role in healthcare access and these too much be addressed to attain the goal of universal health care.
Minister Cummings was at the time speaking at a Continuing Medical Education programme which was conducted by the Public Health Ministry in collaboration with the Bridges Global Medical Mission and other stakeholders in the health sector.
This programme was intended for physicians, nurses, medical students, nursing students and allied health professionals to explore current best practices regarding medical issues impacting the community at large.
The medical conference is to help update local professionals on current approaches that can lead to the reduction in morbidity and mortality in their respective milieus and to identify public health and medical practices that can impact health care delivery.
Minister Cummings address focused on ‘Challenges in Access and Delivery of Healthcare Programmes’.

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