Committee in proactive mode to help reduce maternal deaths

Feb 03, 2019 News

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Dr. Neville Gobin is driven by a moral compulsion to help reduce maternal deaths in Guyana.
Having spent most of his 45 years as an Obstetrician/Gynaecologist in the private sector, Dr. Gobin has lost none of his passion and thirst for helping pregnant women throughout his long and stellar career.
Despite his longevity in the field, he still believes firmly that he “can [still] make a positive contribution in achieving the goals of reduction of maternal mortality to as close as possible to zero,” he disclosed in a taped interview Friday in the boardroom of his Woodlands Hospital, Carmichael Street, Georgetown building.
Maternal mortality is still a bane in Guyana’s health system and Dr. Gobin is heading the government’s Maternal Mortality Review [MMR] committee to help reduce the national figure, which has fallen between 15 -18 or less deaths per year, but still above the national target.
Maternal deaths are linked to three problems: performance of medical personnel, system failure of medical institutions, and non-compliance of patients or put differently, the fault of the care providers, fault of the health care system and fault of the patient.
The MMR committee was launched in 2007 to investigate maternal deaths, that is, deaths during pregnancy or up to 42 days after delivery; probe ‘near misses’ mothers who were critical but made it through; still births [children who were born dead] and to develop strategies to help with protocols to reduce maternal deaths.
Their mandate also includes reviewing cases: examining charts, community interviews and hospital audits before making recommendations to the Chief Medical Officer [CMO] for the necessary action based on their findings from the probes.
The MMR committee comprises Dr. Gobin as the Chairman; CMO Dr. Shamdeo Persaud; Dr. Lucio Pedro, Consultant; Dr. Sheik Amir, Surgeon; Dr. Ertenisa Hamilton, Director, Primary Health Care, Ministry of Public Health; Dr. Oneka Scott, Maternal and Child Health Officer; Dr. Umadai Rattan, Women’s Health Coordinator; Dr. Malika Mootoo, Paediatrician; Ms. Debra Henry, Public Health Nurse; and Linda Johnson, Chief Nursing Officer of the Public Health Ministry.
The MMR Committee has already begun being proactive and not waiting for a death in child’s birth and conduct investigations. It has been visiting “all medical institutions that conduct delivery of babies in Guyana,” Dr. Gobin said.
He said the visits are to identify problems and to provide training and guidance for medical staff across the sector in a bid to bridge the gap between standards of care in the hinterland and the coast.
The objective of the visits is “not to wait for mishaps but to try and get in before… we are in preventive mode,” Dr. Gobin noted.
In addition to investigating maternal deaths and near misses, he said the MMR committee will also focus on intra-partum management of patients, that is, pregnant women who are experiencing symptoms of labour; neo-natal deaths and injuries; promoting family planning services; abortion [which the physician said is a dangerous practice and expensive] as a family planning mecha

nism.
Dr. Gobin is confident the MMR Committee can reduce maternal mortality to near-zero by strengthening and improving the competence of medical staff nationwide by sharpening their ability to spot and manage complications early in pregnancies.

His confidence is also boosted by the “very keen” interest shown by Public Health Minister, Mrs. Volda Lawrence, who is pushing for improved women’s health across the 10 Regions of the country. Her sense of concern is reflected by her relentless push to improve health care for women across the sector and ensuring there is “more scope” for the MMR body to improve the standard of care and reduce maternal mortality throughout the country.
The committee is “fired up” by Lawrence’s perennial support of their mandate, Dr. Gobin said.
So far, the committee has visited the staff of Suddie Hospital, Pomeroon/Supenaam [Region Two] in December 2018 and early last month. The back-to-back visits to Suddie Hospital are based on “a series of mishaps” between September and December last year which resulted in the deaths of three pregnant mothers, Dr. Gobin disclosed.
He said the team has also visited Hospitals in Barima/Waini [Region One] and in Kamarang, Region Seven [Cuyuni/Mazaruni] where they continue to focus on the direct causes of maternal mortality.
As part of the public health sector blueprint for reducing maternal deaths, the Public Health Ministry has been conducting training stints targeting more Community Health Workers [CHWs]; Midwives, Medex; Traditional Births Attendants [TBAs] and fathers.
Dr. Rattan is buoyed by the interest shown by fathers in the programme.
“More men are attending the ante-natal clinics throughout the country,” Dr. Rattan shared.
Training for these groupings has already been completed in six regions and the remaining four will begin shortly, Dr. Gobin said.
Based on current statistics and programmes implemented by the Ministry’s Maternal and Child Health Department, Dr. Gobin is forecasting “marked reduction” in maternal deaths in Guyana in the next five years, based on heightened family planning awareness and training of health-care workers managing women suffering with maternal haemorrhage
The global twin body, PAHO/WHO, is backing this aspect of the initiative, Dr. Gobin said.

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