Maternal deaths must become rarity – PAHO Country Director
By Melanie Allicock
Kaieteur News
February 10, 2007

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“No one in the health sector should rest easy until maternal deaths are so rare that the occurrence of a single case will all give us pause.”

Country Director of the Pan American Health Organisation (PAHO), Dr. Kathleen Israel stressed this point at the opening of a three-day meeting of the Maternal and Child Health (MCH) Department of the Ministry of Health recently.

Under the theme “Promoting Family Health” the three-day seminar was attended by public health workers and officials from the ten administrative regions, representatives of PAHO and the United Nations Children's Fund (UNICEF) and aimed at reviewing the strengths and weaknesses of the MCH programme last year.

Noting that the seminar responds directly to at least two of the Millennium Development Goals (MDGs); safe motherhood and reduction in maternal, infant and child mortality, Dr. Israel called for an intensified and integrated approach to ensure that these goals are met.

“There can be nothing more devastating than deaths from pregnancy-related causes. These constitute a major tragedy and should not be tolerated by the health community. ..Gone are the days when most maternal deaths were due to infections, over which we had limited control. Nowadays, with improved medical and health technologies and access to improved health services, most of these deaths are avoidable.”

Dr. Israel noted that despite the best efforts of policy makers, development and health planners, and health professionals (including public health nurses), the targets established by the MDGs continue to elude us.

While there has been a reduction of child mortality and morbidity in Guyana due to vertical programmes such as Oral Rehydration and Expanded Programme on Immunization (EPI), among others, there was a clear need for a more integrated approach to addressing child health in the primary care setting, Dr. Israel noted.

She pointed out that this thinking resulted in Guyana 's decision to introduce the Integrated Management of Childhood Illnesses Strategy in 2001. This plan she noted is particularly suitable for Guyana as it takes into consideration issues of limited resources, and difficulty in accessing populations in remote areas where there is not a full range of diagnostic services. With technical support from PAHO, a core group of health professionals were instructed as trainers and training material and protocols were modified and published to ensure that they were applicable to Guyana .

“I want to remind everyone that the Ministry of Health alone cannot do it and require the support of all of us; caregivers, health professionals, professional organisations, all sectors and organisations engaged in development work.”

Dr Israel emphasised that it goes without saying that action to reduce newborn mortality needs to be intensified in order to meet the target for under-five mortality.

She described as ‘sobering' the fact that almost three million babies can be saved annually with low-tech, low cost interventions, which would also help to save the lives of mothers.

Guyana she noted, through its primary health care system has made significant strides towards child survival.

Significant success she noted has been achieved in the area of preventable diseases.

Health Minister Dr. Leslie Rammsammy noted that continuing in its efforts to promote family health through the improvement of maternal and child health, his ministry is now working towards new goals to accomplish immunization of all children and the reduction of maternal and mortality rates.

He noted that through Guyana 's successful EPI, it was able to receive the Henry C. Smith award given by PAHO for outstanding immunisation and surveillance coverage.

Guyana 's immunisation programme is ranked the most important public health intervention, making it one of the few countries to have achieved this recognition.

The EPI programme has been in existence since 1995 and has made significant strides in the eradication of polio, yellow fever and measles. Guyana was granted polio-free status by PAHO/WHO in 1994.

In 2004 Guyana initiated the Rotavirus Surveillance at the Georgetown Public Hospital Corporation (GPHC) to analyse the magnitude of the disease among children under five. Additionally, the EPI programme has seen a 90 percent vaccination rate among children under one year.

The programme became a beneficiary of the Global Alliance on Vaccine and Immunisation (GAVI).

GAVI introduced a special vaccine for hepatitis B, haemophilus influenza, diphtheria, pertussis, whooping cough and tetanus.

Guyana has built its vaccination stockpile and now has vaccines for all types of diseases. These include hepatitis A and B, influenza, measles, whooping cough, polio, tetanus, and chicken pox.

The Minister reiterated that the MCH programme is one aspect of the promotion of family health and urged that family health be the main emphasis of any consultations.

Although the mortality rates for infants and children under five have been significantly reduced in Guyana , Minister Ramsammy noted that the task is still unfinished because several preventable maternal and infant deaths are still evident.

Guyana has achieved over 90 percent of its vaccination coverage for various illnesses but according to Minister Ramsammy there are a few children who are still to be reached. He outlined his new goal, which is to see coverage for all children in Guyana .

The Roto-virus and pneumococcol vaccines are two of the new vaccines to be introduced in the health system this year that will add to the universal coverage of children.

The Human Papilloma Virus (HPV) vaccine is also in the pipeline for implementation this year and will specifically target girls prior to the age of reproductive health.

Communications Officer of UNICEF, Leslyn Thompson, said a new survey on motherhood is being undertaken and when completed will add significantly to Guyana 's MCH programme.

The organisation also recently committed to an integrated family health and Prevention of Mother to Child Transmission (PMTCT) programme and a flagship publication focusing on healthy women.

Guyana is on target with its MDGs, which 191 United Nations Member States agreed to in 2002.

Regional presentations were also made to the areas with the best delivery in health care over the last year.

Region Five was awarded for the highest quality of service for the MCH programme, while Region Two received an award for the most improved. Region Two was credited for over 90 percent surveillance of cases.

A total of $10B has been allocated to the health sector this year which represents 11 percent of government's expenditure. It will devote more resources to reducing maternal, postnatal, and infant and children under-five mortality rates.