…but drug procurement still a headache

Fixing the loopholes in the procurement of drugs for the public health system remains problematic, but the Public Health Ministry said it has made notable achievements in the areas of reducing suicide, maternal and child mortality deaths.
Delivering a two-year report for the ministry, Minister within the Ministry of Public Health, Dr Karen Cummings told the Guyana Chronicle that they have been making progress in reducing the number of suicide cases. “Since we have established our Mental Health Unit, we are on top of it.” According to her, the number of cases of suicide for 2017 is down.
However, she said suicide cannot be tackled by the government alone- all must be involved. “We hope to build our health promotion unit, so we can have programmes on the air with focus on the careful and safe use of pesticides.”
“Right now we are training our doctors, Guyana has about four psychiatrists, now we will be widening the base,” she added. The World Health Organisation latest report on suicide showed that Guyana was no longer the suicide capital of the world having fallen to fourth place. According to report there has been a notable decrease of suicide between 2012 and 2015.
According to the crude data on the WHO’s website, which was last updated on April 4, this year, as at 2015 Sri Lanka had the highest suicide rate in the world at an estimated 35.3 per every 100,000 inhabitants; Lithuania was second with 32.7 per 100,000; the Democratic People’s Republic of Korea (DPRK) third with 32.0; and Guyana fourth with 29.0.

HIV/AIDS
Turning her attention to HIV/AIDS, Minister Cummings said the Public Health Ministry knew that there would have been a reduction of funding from donor agencies, as such, “Government will be taking up the slack in a phased approach.” There are approximately 7000 persons living with HIV/AIDS in Guyana. Though there have been new cases, Minister Cumming said the country has moved from being 4th to 6th in the Region with a high prevalence of the disease. “We have identified more cares because we have been more proactive, going to places, training more persons, so what you would find is that the numbers would increase because we are going out and find more cases.”

Procurement of drugs
In the area of procurement of drugs and medical supplies, Minister Cummings said the Public Health Ministry has taken a decision to decentralise the process. Under the new procurement system, financial allocations are distributed across the regions as a first step at improving the programme budgeting of health costs at a regional level. Procedurally, the monies are warranted back to the Public Health Ministry from the regions to facilitate centralised procurement and the benefits of economies of scale and requisite quality controls, Minister Cummings explained.
“We (at the Ministry) are more or less a quality control, oversight body but the delivery of services really occurs at the region and we would not want to micro manage, we want them to build their capacities,” she posited.
However, the implementation of this new procurement system has brought with it a few challenges which have led to the perception that there is a drug shortage. According to Minister Cummings, due to a breakdown in communication and poor delivery systems on the part of some regions there are cases in which drugs and medical supplies take longer to reach their destinations. In making her case, the Junior Public Health Minister alluded to a recent case in which the Suddie Regional Hospital had acquired drugs and medical supplies from the Materials Management Unit (MMU) for distribution to other secondary facilities such as the Charity Hospital but the process was delayed without any proper notification.
In response to these and other challenges within the procurement system, the Public Health Ministry has been building the capacity of its medical personnel, particularly the pharmacists and assistant pharmacist to allow for better acquisition of drugs and medical supplies.
Additionally, Minister Cummings said the Public Health Ministry is moving away from sole sourcing. The system being used for the procurement of drugs and medical supplies ultimately breaks the monopolistic arrangement which existed under the People’s Progressive Party/Civic (PPP/C) Administration. The new bidding document is designed in such a way that it allows companies of all sizes to participate in an open and competitive process.

Shortage of nurses
Another issue engaging the attention of the Public Health Ministry is the shortage of nurses and specialised medical personnel. A recent visit by the Parliamentary Sectoral Committee on Social Services to the Georgetown Public Hospital (GPHC) revealed that there is an acute shortage of nurses. The problem, the committee was informed is the same for other public hospitals.
To encourage more nurses to remain in Guyana, the Ministry had taken the decision to reintroduce the payment for overtime for nurses.
It was noted too that the ministry has modified the curriculum and is collaborating with the Pan American Health Organisation (PAHO), the University of Guyana and a Brazilian University to raise the calibre of nursing tutors. The partnership will allow for lecturers and nurses to be trained at the Master’s and Doctoral levels in the field of Nursing. Eight lecturers and nurses with first degrees will be selected for the Master’s Programme, while five persons, who have already acquired their Master’s, will be selected for the Doctoral Programme.
A team from the University in Brazil will be here in Guyana by July, 2017 for the final selection. The Faculty of Health Sciences has already shortlisted the applicants. The first batch of nurses and lecturers will commence their studies in September, 2017. Major emphasis, she said will be placed on specialization as such nurses will be trained in neonatal care, accident and emergency, radiology and public health.
Just recently, Government of India approved a line of credit which will enable the modernisation of three primary health care facilities in Guyana. About US$17.5 million will be provided for the improvement of Suddie Regional Hospital, the West Demerara Regional Hospital and the Bartica District Hospital.
In addition, Minister Cummings pointed out that Government has secured a US$8M loan from the Inter-American Development Bank (IDB) for the execution of a programme that will reduce maternal deaths in Guyana.
According to the Bank, this programme seeks to improve the quality of care at 140 health facilities and in 88 communities, benefitting at least 140,000 women and 9,000 newborns per year.