A healthy population drives a productive nation (Part II)

-towards better healthcare services in Guyana

Georgetown, Guyana – (November 11, 2016) WHERE a country’s health and wellness are concerned, its government holds the primary responsibility of providing adequate health structures to improve the health and wellness of its population.Continued public health surveillance, which involves the collection, analysis and interpretation of health- related data, is therefore needed for planning, implementation and evaluation of health practices and programmes. Without such surveillance, diseases and illnesses can be misunderstood, leading to a lack of adequate health programmes and initiatives, and a misuse of resources.

Public Health Minister Dr. George Norton has said the Public Health Ministry is focused on ensuring that countrywide surveillance is conducted in order to collect adequate data for the provision of health care services.

To achieve this goal, the Public Health Ministry has conducted a mixed survey with support of the United Nations Children’s Fund (UNICEF). Chief Medical Officer Dr. Shamdeo Persaud, whose office was in charge of completion of the survey, said it offers an in-depth look at health care issues affecting men, women and children, with data being collected from over 6000 households across Guyana.

Within the survey, each group was tested in specific areas, including general knowledge about common health problems, maternal health, safe water and sanitation, gender relationships, violence in society, alcohol use, and smoking habits. The mixed survey further lent support to the completion of a Standard Treatment Guide, which will aid in the delivery of primary healthcare services countrywide.

Minister Norton said he is pleased with the quality of work that was produced, and added that the Ministry has made significant efforts to disseminate the report as much as possible, in order to serve physicians.

“It is very helpful, especially for new physicians who have graduated [and] who might be placed in places where they don’t have access to persons with more experience; so that guide is very useful for them,” he explained.

Within the management of health priorities, disease control is critically important. In the Public Health Ministry’s Disease Control Programme, the collection of data helps to accurately describe and assess the state of health problems in the country. This, in turn, aids the improvement of health care and the effective allocation of resources.

Disease control covers the management and prevention of vector-borne diseases, chronic diseases, and all other disease-related threats to the population. Where vector-borne diseases are concerned, President Granger has called for a broader national effort in the fight against such diseases as zika, malaria, filariasis, chikungunya and dengue.

“Guyana has had some successes in combating these vector-borne diseases. They have, however, proven to be very resilient. At one stage, I’m sure a lot of Guyanese thought we had eradicated malaria, but it is back with a vengeance. We need to develop a much broader approach to combat this public health threat. That approach must involve a more careful management of the environment,” the President said at the launch of the “Health at 50 in Guyana” Progress Health Report of the Pan American Health Organisation and the Ministry of Public Health in May this year.

Minister Norton said the Public Health Ministry has made significant changes within the Vector Control Unit, to allow for better administration, control and prevention of these diseases. He added that the Ministry continues with stringent sensitisation of the public on disease prevention.

He noted, too, that the recent clean-up of Georgetown has aided in the reduction of mosquito-borne diseases.

Meanwhile, the fight against HIV/AIDS in Guyana continues to be an ardent one, the Minister said, and while there have been reports of an increased number of HIV cases in Guyana, one area of improvement can be seen in the area of mother-to-child transmission of HIV, as well as cases of HIV infection through blood transfusion. No new cases have been seen for the year in these areas.

But he noted that there has been a shift in the age group for an increase in new infections, whereby a younger sector of the population is now being infected. “We are not happy about this, but we continue to try to curtail it and to educate the population,” the Minister said.

Much of the sensitisation efforts are also plugged into breaking down the barriers of stigmatisation and discrimination of vulnerable groups, such as men who have sex with men, and sex workers. “We are trying to break down the barriers against those persons and (give) them as much an equal opportunity of accessing medical care for their treatment in that area,” the Minister said.

Efforts within the disease control unit would not be complete without looking at the work being done in the area of chronic disease. Chronic non-communicable diseases (NCDs) remain the number one cause of death in the country.

Coordinator of the Chronic Disease Control Unit, Dr. Kavita Singh, explained that the Unit is responsible for ensuring there is a multi-sectoral and integrated approach to tackling the four key areas: cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases.

Dr. Singh noted, however, that the development of these diseases is also heavily based on common risk factors, the harmful use of alcohol or tobacco, and unhealthy eating and physical inactivity. The work of the unit, therefore, places much focus on prevention. This includes community-based programmes which directly target the at-risk population.

“We encourage them to form exercise groups and support groups, and next year we are also launching a Tobacco Cessation Programme aimed at providing both counselling for persons wishing to quit smoking as well as medical support through the provision of nicotine patches or gum and other products,” she said.

To attract the younger population, Dr. Singh said, sensitisation methods are taking a form through which this group could easily access information, such as social media, text messaging and other media.

The CDC Unit has recently embarked on the collection of data via a STEP Survey, which is aimed at assessing the at-risk and suffering population in the area of chronic disease.

“That way we are able to target the specific groups that are more at risk. Not that we won’t target the entire population, but we know who is more likely to develop those diseases, and we can do specific programmes aimed at those groups,” she said.

The Survey includes three parts: an interview aimed at determining the risk factors, the collection of anthropometric measurements of the interviewees, and sample collection.

The survey targeted over 3000 households countrywide, and yielded a 77 percent response.

Managing all the elements of the health care sector requires a highly skilled workforce. Doctors, nurses, lab technicians and key specialists who are trained in modern and efficient approaches are the key to improved health services.

Ongoing training opportunities are a priority area for this administration.
The Ministry of Public health conducts ongoing training for medical professionals countrywide, and Minister Norton has said that he is proud of the number of professionals that continue to be trained through these programmes.

But the Minister has admitted that, even with continued training, there remains a significant shortage of nurses not only at the Georgetown Public Hospital Corporation, but countrywide. Acting Chief Executive Officer of the GPHC, Dr. Sheik Amir, has said that the working conditions contribute to the turnover. To avoid this, Minister Norton acknowledged, much effort must be plugged into the improvement of these conditions, so as to promote job satisfaction among the nurses.

“We have got to increase the quality of training they have, but we also have to give them job satisfaction and social security…[we need to] make the nurses feel comfortable on the job… Nurses are the most important pillar in any healthcare system, so if it means a special healthcare package, then so be it,” Minister Norton said.

It is these and other challenges that the Ministry of Public Health seeks to tackle every day in its goal of providing quality health care to the citizens of Guyana. According to Dr. Persaud, however, even with these challenges, the overall healthcare of the country is ever evolving, and there have been significant developments that help to improve standards of healthcare. But the work of the Ministry is never done.

Good healthcare comes not only with adequate training and the appropriate resources, but also with a strong and committed team. These are the concomitant factors that the Government continues to work on to ensure that the population of Guyana enjoys good health as part of enjoying the good life.