By: Minister within the Ministry of Public Health, Dr. Karen Cummings, M.P.
THE Ministry of Public Health views the health and wellbeing of all persons living in Guyana as a national priority. Through the seven programme areas that are under the umbrella of the ministry, sustained efforts are being made to ensure that we provide the best quality public health care within the scope of our ability.

The public health sector received a budgetary allocation of $35.9 billion, an equivalent of 11.9 per cent of the 2019 national budget, which represents a $2.6 billion increase from the 2018 allocation. The Ministry of Public Health remains committed to enhancing the quality of care we provide to the people of Guyana.

TOWARDS THE RENEWAL OF PRIMARY CARE
Since 2015, following decades of stagnation, potentially transformative changes in primary healthcare are proceeding in several areas within the Guyanese public health sector. These changes – primarily collaborative and interdisciplinary models of care delivery and quality improvement programmes – have been encouraged by an improved fiscal climate, and growing political and public concern about healthcare access and quality.

However, while transformation has begun within the public health sector, much remains to be done to address Guyana’s now-improving healthcare performance, relative to other CARICOM countries. Processes are particularly needed at the regional and central levels to collectively engage the full range of key stakeholders in providing policy advice and informing the articulation of clear policy direction for primary healthcare. Critical areas for investment include integrated health information systems, quality improvement processes, interdisciplinary primary healthcare teams and group practices, and systematic evaluation of primary healthcare innovations and ongoing system performance.

REDUCING THE PREVALENCE OF NCDs
All our programmes continue to deliver optimally even against the myriad challenges we face. During 2019, Guyanese can expect to benefit from a more robust and responsive public health system. There is still a lot of work to be done within our society to raise awareness of a number of public health issues. While much emphasis has been placed on HIV/AIDS, there are other areas of great importance that require sustainable activities to bring about behavioural change and healthy lifestyles.

One such important area is that of Non-Communicable Diseases (NCDs). An exorbitant amount of our public health budget is spent on NCDs. Reducing the risk factors associated with NCDs will surely reduce the disease burden caused by NCDs, resulting in the reduction of premature mortality and morbidity in Guyana. Through a combination of population-level primary prevention and individual-based primary prevention strategies, we can meaningfully address the reduction of NCDs in Guyana.

The short and long-term disability from the onset of NCDs leads to a decrease in the working-age population’s participation in the labour force and contributes to significantly reduced productivity. Most likely, NCD’s effect on production and productivity will reduce per capita gross domestic product growth, especially in Guyana where we have a growing economy dependent on sources of human capital. Taken together, the evidence suggests that a prerequisite for national development is healthy ageing, which in turn requires effectively tackling NCDs. In this regard, we need all hands on deck!

Improving the quality of Regional Health Services
The Ministry of Public Health, through the Regional Health Services Department, continues to monitor the quality of public health care being offered throughout the 10 administrative regions and put measures in place to drive its improvement. Strategies are being implemented to ensure our rural communities receive quality and affordable access to healthcare.

As a Ministry, we are continuously looking at ways to raise local government and other local stakeholder engagement to make our policies more effective, and curb the unintended consequences of policy and programme implementation in regional communities. Currently, the ministry is sending specialist doctors to the regions so as to better serve those most in need of specialized care. Though specialist doctors are not in large supply, we are doing our best to prioritize and serve those areas of high demand for specialist care. In addition, medical outreaches have also been done in some remote areas like Waipa, Karasparu, Paramakatoi, and Kamarang, among others. These medical outreaches will continue throughout 2019.

There have been efforts at establishing, and in some cases, refurbishing regional health facilities to ensure they are structurally sound, fit for purpose and aesthetically pleasing. The provision of adequate accommodation for medical personnel within the regions is attracting the attention of the ministry as we embark on regional infrastructural works in 2019.

ADVANCING MATERNAL AND CHILD HEALTH CARE SERVICE DELIVERY
Guyana continues to make improvements in the area of Maternal and Child Health (MCH). In 2019, we intend to build on the gains made and ensure that mothers and their children benefit from the public health care they require. Currently, Guyana continues to benefit from an Inter-American Development Bank US$8M loan for an MCH project that is contributing significantly towards the reduction in maternal, perinatal and neonatal deaths in Guyana.

Some of the key components of this project currently being implemented are the improvement in the supply chain management for new types of contraceptives, drugs, and blood products. Moreover, there is the upgrading of maternity waiting homes, the addressing of health literacy to improve MCH health literacy in a significant way, the training of more health workers, and the engagement in substantial capacity-building within the entire MCH Unit.

The delivery of MCH care, particularly to the hinterland population, is being done in a structured manner and is aimed at reducing morbidity and mortality rates to a bearable minimum. Furthermore, the ministry provides an integrated health care package for mothers and children that includes immunization, antenatal and post-natal care, family planning, management of malnutrition, prevention and early treatment of disease, all delivered in an efficient primary health care system.

Conclusion
Quality assurance is a key component in the delivery of quality public health care to the people of Guyana. At the policy level, we are shaping policies that will ensure that we have a public health care system that delivers value for money, the best possible patient outcomes, and adequately serves the people of Guyana. While there remains much work to be done, the Ministry of Public Health remains committed to maintaining a high quality of health care service delivery by constantly measuring the effectiveness of the programmes and institutions that provide it.

We will ensure that all our programmes and health facilities are operating in compliance with established regulations, policies, and laws, both at the central and regional levels. The development of internal strategies to support quality healthcare delivery and the overall health of the community we serve will also form part of our strategy moving forward.
In 2019 and beyond, I urge all the hard-working staff of the ministry to exhibit behaviours that correlate strongly with our commitment to quality and improved patient care outcomes.

Let us be drivers of our quality improvement efforts. Be courteous, be polite, be professional, be caring. Through our actions, we will naturally be the promoters of quality public health care. Let us together work to ensure we have a pubic heath care system that is the pride of Guyana.