IDB US$60M loan to upgrade three main hospitals

Aug 16, 2022 News

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By Kiana Wilburg

Kaieteur News – The Inter-American Development Bank (IDB) has loaned Guyana US$60M for infrastructure improvement and expansion at three priority hospitals, namely the Georgetown Public Hospital Corporation (GPHC), the New Amsterdam Hospital and the Linden Hospital Complex.

The funding is provided under the Health Care Network Strengthening in Guyana Project and is being implemented by the Ministry of Health. The project has three components. The first dedicates US$48M towards supporting hospital health services networks. The bank said this component will finance inputs to allow the hospital network to function more efficiently by expanding capacity at two strategic level-four hospitals, thereby relieving pressure on GPHC, the main national reference hospital (level 5), to provide lower-complexity services, while also increasing the ability of this facility to fulfill its mission in handling specialty referral cases.

The activities to be funded by this component include infrastructure rehabilitation and expansion at the New Amsterdam Hospital (level 4), Linden Hospital Complex (level 4), and the Georgetown Public Hospital Corporation (GPHC) (level 5); purchase of essential medical equipment and furniture for these facilities; and corrective and preventive maintenance of infrastructure works and medical equipment.

Component Two is expected to focus on strengthening digital health at a cost of US$7.2M. The bank said this module will ensure financing for the country’s plans for a digital transformation in health. It will finance the following priority areas: digital health governance and sustainability (which will include assessments of preparedness and establishing creating digital health foundations); and strengthening and expanding of the current teleradiology and teleophthalmology networks to the country’s hinterland areas, including its socio-cultural adaptations.

As for Component Three, this will entail promoting health sector management and efficiency. It is expected to cost US$3M. It will be used to fund a health professional assessment, including current supply, gaps, and projected demand; stock-taking of existing training capacity; curricula review and improvement, including socio-cultural dimensions in health; proposal for addressing sector’s human resources needs, considering training center that could be financed in second operation); and supply chain management.

In addition to the three project components described above, the project will also support project administration and programme monitoring and evaluation at a cost of US$1.8 million. These resources will support the Ministry of Health in programme management and assessment of its effects. It will finance specialized consulting services for project implementation, costs associated with the Project Executing Unit (PEU), and evaluations of project implementation and impact.

In providing justification for the loan, the bank noted the state of the each hospital.

It was noted that GPHC is the main national referral hospital in the country as well as the premier medical teaching and research facility. It also functions as the Regional Hospital for Region 4 – Demerara – Mahaica and the District Hospital for Georgetown. The financial institution said several improvements to the hospital infrastructure are necessary to overcome gaps relating to capacity, quality, and growing demand for specialist services.

It was noted that inpatient bed supply is inadequate, with some wards consistently experiencing over 100% occupancy rates. The bank said the general Intensive Care Unit (ICU) for example has only seven beds, and specialized ICUs and high dependency units frequently have waiting lists. As a shift progresses to more sophisticated minimally invasive surgery techniques and noninvasive procedures, the bank said the lack of specific outpatient day recovery beds is becoming an important limitation.

It was further stated that the main operating theater currently has just six suites, which is insufficient to attend to the growing quantity of elective surgeries requested by an expanded array of medical specialists.

The IDB said similar situations exist at both the New Amsterdam Hospital and the Linden Hospital Complex.

The New Amsterdam Hospital is the second largest hospital after GPHC, and along with the Linden Hospital Complex, serves a significant catchment area, including receiving patients from other regions and the hinterland. The bank said both hospitals possess limited capacity in their accident and emergency departments, intensive care units, high dependency units, surgical suites, and imaging departments. Moreover, the bank said New Amsterdam was constructed nearly 20 ago but has undergone minimal renovation and expansion since then. The bank said it lacks sufficient installations for outpatient clinics, inpatient wards, and the pathology laboratory and has no buildings to house a central sterilization unit, administration, and medical and paramedical staff on call.

As for the Linden Hospital Complex, the bank said it is unable to properly deliver the full contingent of obstetric, neonatal and child health services. It also does not have a burn unit to attend to accident patients.  The bank said strengthening these regional hospitals to provide the full contingent of level 4 services will no doubt reduce the transfer of patients to the GPHC, thus reducing the patient load of that hospital.  The bank was keen to note that the Guyana Government has been working on the improvement in the delivery of healthcare in the country as a commitment to ensuring a modern, world-class healthcare system is developed.

Kaieteur News understands that a National Strategic Plan for Health 2022-2030 is being developed which intends to promote a model based on the principles of Primary Healthcare through an Integrated Health Service Delivery Network approach to achieve universal access and coverage.

Essential functions include healthcare delivery model, governance, financing, human resources, delivery of services, evidence informed decision making, supply chain, emergency preparedness, strategic partnerships, occupational safety and health, and preferred health programs and health determinants. To address other key areas for improvement, the Ministry of Health is preparing a Health Infrastructure Transformation Plan and a Human Resource Development Plan. The Guyana Government has since commenced implementation of aspects of these plans and strategic priorities.

The 2022 national budget has allowed for financing to improve primary level care infrastructure (levels 1and 2,) and to initiate construction of four general hospitals and one specialty hospital, as well as replacement of four existing hospitals (levels 3 and 4). To contribute to these strategies and plans, the government requested the IDB’s support for the areas of investment explained.

 

 

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