As EPI/MCH meeting gets underway… Guyana’s measles free status linked to laudable surveillance system -need to address ‘worrisome’ maternal mortality emphasised -HPV vaccination campaign expanded to include boys

Feb 12, 2019 News

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Guyana remains on high alert in the face of an ongoing measles threat that has already infiltrated neighbouring territories.
Although cases of the disease have been confirmed in Brazil and Venezuela, Guyana has been fortunate enough to keep it at bay. This development has been linked to Guyana’s vibrant surveillance system.
This notion was emphasised yesterday by Pan American Health Organisation/World Health Organisation [PAHO/WHO] Representative, Dr. William Adu Krow, who observed that currently measles is highest in the countries of the Americas.
Dr. Adu Krow noted that while there were 847 cases in 2017, the figure increased to over 6,000 in 2018. “There has been no recorded case of the ailment migrating to Guyana…This is testament of the strength of Guyana’s surveillance system,” Dr. Adu Krow noted.
The PAHO/WHO Representative’s measles disclosure was forthcoming even as he addressed the opening of the Expanded Programme on Immunisation – Maternal and Child Health [EPI/MCH] meeting being held at the Kingston, Georgetown Pegasus Hotel.
The meeting, which will span the period February 11 – 15, 2019, represents a collaboration between the Ministry and PAHO/WHO.
Chief Medical Officer [CMO], Dr. Shamdeo Persaud, turned the attention of the mainly MCH officials audience to the issue of maternal and child health. “This is uppermost i

n peoples’ minds,” the CMO announced even as he alluded to the country’s struggles with teenage pregnancy.
He said Guyana and other Caricom countries are exploring ways to “expand interventions” to deal with the teenage pregnancy phenomenon here. He pointed to the fact that the country’s struggles are compounded by the influx of pregnant women from neighbouring countries.
He continued by stressing the importance of the survival of pregnant women. “Mothers must survive for children to survive.”
He intimated that the birthing process is poised to be strengthened countrywide.
According to the CMO, while the country’s immunisation programme has achieved global standard of 95 per cent coverage, he emphasised that all children must receive their full complement of vaccine to be fully protected, “otherwise we would be only giving vaccines.”
Dr. Persaud also encouraged the MCH officials to pay attention to record-keeping issues and to maintain the high standards expected in the sector.
Dr. Adu-Krow challenged the country’s healthcare workers to “use every strategy in every Region, in every village and every community to ensure all are vaccinated.”
On the issue of maternal mortality, he cited “worrisome” early 2019 figures. So far there have been four maternal deaths in Guyana.
“No woman must lose her life during pregnancy because of haemorrhage,” Dr. Adu-Krow said. He called for improvements in clinical competencies in Guyana’s health sector.
He suggested a review of maternal deaths and ‘near misses’ as well as assessments of maternal anaemia. He even stressed the need for the correct use of death certificates involving pregnant women and the high unmet need of family planning in the country.
“Persons of reproductive age who want contraceptive must have it,” said Dr. Adu-Krow.
Despite the several challenges faced by the Public Health sector, Minister of Public Health, Volda Lawrence, who also delivered remarks at yesterday’s forum, recalled, “EPI in Guyana, which celebrated 42 years last year, has registered great success with the support of all stakeholders including the private sector.”
The Public Health Minister made it clear that Guyana continues to expand its coverage of antigens with the addition of the birth dose Hepatitis B that is currently being piloted in Regions Two, Three and Five and will be expanded to three others this year.

A review of the last five years, the Minister said, has shown that the immunization coverage for the immunized child at one year remains above 90 percent for all antigens. However, she noted that there continues to be a decline in the coverage after this period.
But despite the inroads made, she noted that Guyana remains vulnerably challenged with migration issues, constant border traffic, increase in neighbouring countries of outbreak of measles, yellow fever or diphtheria, hence the need for active monitoring and surveillance.

The Minister also made reference to the ever constant problem of the country’s difficult geographic terrain as well as lack of adequate cold chain, communication among others.
These, she shared, amplifies the notion that “we must focus on ways of effectively responding to these hurdles, and of course lobbying for adequate funding to increase protection for our people.”
“We must identify our targets; use our data to make informed decisions so that our activities reach the intended objective. Nothing remains constant, and situations may change dramatically.
“It means therefore that we must cater for the unexpected, try always to remain one step ahead, and ensure that our procurement process for supply of vaccines is efficient, and that we are prepared to effectively deal with any threat or outbreak,” Minister Lawrence warned.
She also alluded to the need to ensure that “vaccines can easily reach our hinterland Regions, that the monitoring process is well established and that there is ongoing training of personnel for new vaccines and for Effective Vaccine Management.”
Even as she highlighted the need to focus on the Ministry’s ongoing HPV vaccination campaign, the Minister noted that the primary aim is to reach as many girls as possible, even in the hinterland.
“Let us remember that cancer is rampant in our country and we have to intensify our efforts to sensitize, educate and protect the young assets of our country,” said Minister Lawrence.
She disclosed that from yesterday, the HPV vaccination campaign has been expanded to include boys in all regions of the country. Added to this, she said that the Ministry has also introduced the “opt-out” policy for parents who do not want their children receiving the HPV vaccine. “We will not force any child to take the vaccine,” Minister Lawrence assured.
At yesterday’s forum too, the Minister disclosed that the Public Health Ministry is set to ink a Memorandum of Understanding [MOU] with the Guyana Defence Force with a view of expanding its delivery of healthcare services to hard-to-reach interior communities.
Among the other key officials slated to present at the EPI/MCH meeting are: Dr. Ertenisa Hamilton; Dr. Oneka Scott; Dr. Travis Freeman; Dr. Dennis Bassier; Dr. Janice Woolford; Dr. Padmini Singh; Dr. Serena Bender; Dr. Suzanne Siebs; Ms. Shonette Jonas; Mr. Wilton Benn; Dr. Karen Campbell; Ms. Andreea Budburg and Medex Ms. Debra Henry.

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