THE Maternal Mortality Review (MMR) committee is working with hospitals across the country as it takes proactive steps to prevent maternal deaths. This is according to Dr. Neville Gobin, the Head of the MMR Committee who has spent most of his 45 years as an Obstetrician/Gynaecologist.

In an interview on Friday at the Woodlands Hospital in Georgetown, Dr. Gobin said he firmly believes that he “can [still] make a positive contribution in achieving the goals of reduction of maternal mortality to as close as possible to zero.”
The (MMR) committee is working to reduce the national figure which has fallen to between 15 -18 or less deaths per year, but still above the national target.

Maternal deaths are linked to three problems, viz, performance of medical personnel; system failure of medical institutions, and non-compliance of patients or put differently, 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 Gobin, Chairman; CMO Dr Shamdeo Persaud; Dr Lucio Pedro, Consultant; Dr Sheik Amir, Surgeon; Dr Ertenisa Hamilton, Director, Primary Health Care, Ministry of Public Health (MoPH); Dr Oneka Scott, Maternal and Child Health (MCH) Officer, (MoPH); Dr Umadai Rattan, Women’s Health Coordinator, (MoPH); Dr Malika Mootoo, Paediatrician; Ms. Debra Henry, Public Health Nurse, (MoPH); and Linda Johnson, Chief Nursing Officer, (CNO) of the MoPH.

However, instead of awaiting a case, the MMR Committee has taken a proactive approach. It has been visiting medical institutions that conduct delivery of babies in Guyana.
Dr. Gobin 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,” Gobin pointed out.

In addition to investigating maternal deaths and “near misses,” Gobin said the MMR committee will also focus on intra-partum management of patients; neo-natal deaths and injuries; promoting family planning services; abortion (which the physician said is “a dangerous practice and expensive”) as a family-planning mechanism.

Gobin is confident that 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.

According to him, his confidence is boosted by the “very keen” interest shown by Public Health Minister Volda Lawrence who has been pushing for improved women’s health across the 10 regions of the country.

The committee is “fired up” by Lawrence’s perennial support of their mandate, Gobin said.
So far, the committee 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 MoPH 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,” Rattan said.
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 MCH, 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.