The setbacks experienced by the health sector in the area of maternal health care last year reflect the sector’s “biggest disappointment” in the last decade, according to Health Minister Dr. Leslie Ramsammy. Ramsammy, in an interview with the Guyana Chronicle, said 2011 will see significant measures being taken to ensure that Guyana get back on track in delivering quality maternal health care and, by extension, meeting the Millennium Development Goal of improving maternal health care.
The Health Minister said these measures will include:
* Going back to basics, systems which proved successful in the past;
* Introducing eight  new doctors at the maternity ward of the Georgetown Public Hospital who will advance their expertise, working with seasoned health workers, as well as contributing to bettering the quality of care with their new skills;
* Allocating a theatre dedicated to maternal surgeries at the hospital;
* Introducing a post graduate programme in obstetrics at the University of Guyana; and
* Increasing awareness, expressly among health workers, to ensure that maternal cases are attended to with an increased sense of urgency.
“We have had almost 10 years of reducing maternal deaths and at the start of 2010 we were doing well…we recognise the need for improvement and all efforts will be directed to ensuring that we get back on track,” Ramsammy said.
According to him, in 1990, the maternal death rate was 32 per every 10,000 deliveries, and in 2008 that was significantly reduced to 8.9 deaths.
The primary target included under the MDGs, as it relates to maternal health care, was the reduction of the maternal mortality ratio and the target set was 8 per ever 10,000 deaths.
Ramsammy said, “We had almost reached the target…up to 2008 we were doing well and we started off very well in 2010. From September, we saw an increase and by the end of the year we had between 18 and 20 deaths…this moved our ratio to 13 deaths per 10,000 deliveries.”
At least 15 of the maternal deaths occurred at the GPHC, all of which have been under the scrutiny of GPHC’s Maternal Mortality Committee.
The other maternal deaths occurred at the Skeldon and New Amsterdam Hospitals.
Ramsammy stated that health workers were most “dejected” at this lapse.
The minister said a major step being taken to ensure that maternal health care is improved is the adoption of the World Health Organisation’s (WHO) indicators to monitor emergency obstetric care at health care facilities across the country.
“There are several indicators and while some of them are short term changes that can be made, others are long term and these will take some time…we have started to improve the capacity,” he said.   
Ramsammy noted that the ministry is working with the United Nations Population Fund (UNFPA) and the Pan American Health Organisation (PAHO) to advance the improvement of maternal health care.

Improvement Link
Ramsammy pointed out that once an individual area, such as maternal health, is improved, there is an overall improvement in the sector, which ultimately translates to an increase in the life expectancy rate.
Currently, life expectancy in Guyana stands just over 70 years and moves are being made to take that to 75 years.
Closely linked to maternal health care is child health, in particular the reduction of the child mortality rate.
In 1990, the rate was between 90 and 120 out of every 1,000 children, and the 2015 target is to lower that to between 12 and 16.
Ramsammy reported that in 2010, Guyana’s child mortality rate was 19.6 for every 1,000 children.
“This is an improvement on the number we used to have…carrying the numbers down to 19 is a real achievement for the health sector…there has been a consistent reduction,” he said.
In terms of childhood mortality, the two major causes of deaths are acute diarrhoeal diseases (ADD) and acute respiratory infections (ARI).
ADD and ARI together reportedly account for 8.7 deaths per 1,000 children, and together accounted for 46 per cent of all deaths of children under five in 2008.  
ADD caused an average of 5.2 deaths per 1,000 children under five, accounting for 27per cent of all deaths of children under five in 2008. This makes diarrhoea the leading cause of death among our children.
ARI caused an average of 3.5 deaths per 1,000 children, accounting for 19per cent of all deaths of children under five in 2008. ARI was the second leading cause of deaths in Guyana.
Globally, ADD and ARI are the two leading causes of deaths among children. Together these two account for more than 40 per cent of all children deaths in the world. ADD accounts for 17 per cent and ARI accounts for 19 per cent of all under five children deaths in the world.
Despite the startling figures, the minister contends that most of the deaths due to ADD and ARI are preventable and, as such, the ministry has been intensifying efforts to prevent ADD and ARI-related morbidity and mortality.