GINA, GUYANA, Thursday, December 22, 2016
In 2016, the Ministry of Public Health, through its seven programme heads, worked to ensure that quality health care was provided to citizens countrywide. The public health sector is currently being transformed through a number of strategic interventions that have been crafted to meet national goals.
Successes include, the reduction in infant and neonatal mortality rates at the Georgetown Public Hospital Corporation (GPHC), reduction in maternal deaths, increased access to public health services for adolescents, the establishment of the National Mental Health Unit and the opening of the first public health cardiac intensive care unit in Guyana.
Meanwhile, challenges that remain include, the shortage of nurses, increased demand for Yellow Fever vaccines due to a change in travel requirements by other countries and, the availability of drugs and medical supplies.
$28B for both capital and current expenditure, representing 11 percent of the 2016 national budget, was allocated for the health sector.
Staff: Doctors, Specialists, Nurses
Approximately, $172M was expended on the training of medical personnel and health care providers. The Ministry engaged in a number of training interventions to equip medical practitioners with the skills needed to dispense their duties in an efficient manner.
Progress in improving the overall quality of healthcare was up scaled in 2016. Patients continued to experience increased access to qualified medical professionals as the number of physicians per 10,000 persons increased from 14.1 percent in in the first half of 2015 to 20.3 percent in the first half of 2016. Additionally, the number of nurses per 10,000 of the population increased from 31.4 to 31.8 percent in the first half of 2016.
Capacity building exercises were made possible through a number of collaborative efforts while 79 newly trained Cuban doctors were incorporated into the public health system. Specialists’ doctors from among this batch were recognised and deployed to hinterland areas to complement upgraded and improved health care.
At the end of 2015, there were a total of 651 Government Medical Officers (GMOs) in the Public Health System. In 2016, an additional 93 GMOs were added, bringing the total now to 774. A total of 838 nurses were in the Public Health System in 2015, while in 2016 an additional 130 nurses were added, bringing the current total to 968. There are approximately 2,587 Public Health Care workers providing services throughout Guyana.
Under the new system of drug procurement and distribution, the Ministry of Public Health found it challenging throughout the year to have constant supplies of drugs to far flung regions. Most of these regions are still adjusting to the new system and this resulted in shortages and delays in delivery.
“This new Open Competitive Bidding process was used for the first time in January 2016 after many years of selected tendering with one supplier. The major challenge faced with this new process was the evaluation process using the “line by line” approach, which was time consuming with over twenty bidders participating in the process, some for the very first time.” Minister of Public Health, Dr. George Norton has explained.
Even as the availability of drugs at health facilities continues to be a challenge, it has been noted that financial expenditure, wastage, irrational use and inappropriate reporting via the Combined Received and Issued Vouchers (CRIVS) are some of the factors that impact the accessibility of drugs.
Work is currently ongoing to improve the systems for procurement and distribution of drugs.
All deliveries of pharmaceuticals and health products procured through the Procurement Unit of the Ministry are made to the Supply Chain Management Complex (SCMS), the MOPH central medical stores located at Diamond, EBD.
At the beginning of 2016, there was an upsurge in suicide. Such was the shocking rate at which suicides were occurring that President David A. Granger summoned an urgent meeting in January 2016 with several ministers of government to chart a strategic course for combating the scourge of suicide in Guyana.
An inter-ministerial forum was convened with involvement of some international partners, out of which a National Task Force on Suicide was established. This Task Force met throughout the months of February and March to establish a strategic framework for tackling suicide in Guyana with the aim of reducing its rapid rate of occurrence.
At the Ministry of Public Health, there is the National Suicide Prevention Plan 2015-2020, which is integrated with the National Mental Health Action Plan, 2015-2020. The National Suicide Prevention Plan will provide the necessary guidance in all sectors and to all stakeholders, which will lead to positive change in the society. It is also expected that through strategic engagements with stakeholders from several ministries and agencies, there can be a coordinated effort, which will serve to reduce duplication, resulting in activities that are well targeted and effective.
Mental Health Unit
In 2016, the Mental Health Unit conducted numerous outreaches and suicide prevention programmes in churches, schools and communities, including at Seventh Day Adventist churches, J.C. Chandi Singh Secondary School, Port Mourant, and Corentyne.
The Mental Health Unit had also collaborated with the Ministry of Education to carry out Strategic Psycho-Social Interventions for Adolescents in 11 Secondary Schools across Guyana. This Programme was organised by the Guyana Psychological Association and the National Communications Network (NCN). The programme saw the random screening of 1,250 Grade Nine to Twelve students for suicidal tendencies using Beck’s Scale.
Stress and Mental Illnesses, Conduct Disorder, Sexual Abuse and Mental Illnesses were also topics discussed at forums at the Cyril Potter College of Education in Regions Three, Four and Six in collaboration with Ministry of Education.
Zika, Malaria and Chikungunya
There have been 35 lab confirmed cases of Zika and 135 cases of Chikungunya. Meanwhile, there have been three confirmed cases of microcephaly related to Zika in pregnancy.
The MOPH has developed an action plan for Zika in pregnancy. The Plan includes; early detection, adequate post diagnosis management of mothers and children, reduction of the incidents of infection in pregnant women and surveillance and reports of suspected cases.
Zika testing also commenced in Guyana which eliminates needing to send test samples to the Caribbean Public Health Agency (CARPHA) in Trinidad and Tobago.
The government intensified its vector control efforts in the wake of the Zika threat propagated by the Aedes aegypti mosquito. Fogging exercises and net distribution were carried out during the year. Additional interventions were undertaken with the aim of minimizing the incidence of Zika and other vector borne diseases such as dengue, malaria and chikungunya.
Meanwhile, Chikungunya does not remain a threat to the local population but measures are stressed to be taken into consideration to prevent the spread of the virus.
Malaria has received much needed preventative awareness promotion ensuring that Guyanese are equipped with the necessary information needed to not be infected with the virus.
In an effort to heighten efforts towards the early detection of malaria, a pilot project was rolled out in 2016 which saw the training of miners in Region Eight to use malaria rapid testing kits and to administer treatment for uncomplicated cases of malaria. Ninety six miners from mining areas such as Black Water, Jumbie Creek, Micobie, Kanawaruk were trained.
Maternal and Child Health
The Maternal and Child Health (MCH) Department of the Ministry of Public Health successfully completed the switch from Trivalent Oral Polio Vaccine to Bivalent Oral Polio Vaccine as part of the Regional Endgame Strategy for the eradication of Wild Polio Virus Type Two.
The region of the Americas, of which Guyana is a part, was declared free of endemic measles on September 27, 2016. This is the first region to be so certified.
There was an outbreak of Diphtheria in neighbouring Venezuela in October. However, Guyana was able to prevent a cross-border Outbreak. Outreach activities as well as on spot surveillance training for health workers were conducted in Regions One, Seven, Eight and Nine where 1,262 doses of the vaccine against Diphtheria were administered.
The MCH department increased vaccination coverage across the country by 90 percent as of November, 2016. Every opportunity was untilised in ensuring that there is full vaccination coverage throughout Guyana. Some 13,867 doses of the various vaccines were administered during Vaccination Week.
In 2016, some 111 health care providers were trained in Effective Vaccine Management. Other trainings include Vaccine Preventable Disease Surveillance Training for 102 health care providers in Regions Two, Six, Seven, Eight and Nine.
According to Ministry of Public Health’s year in report, other achievements were as follows.
Thirty-six (36) foreign medical missions facilitated through the International Desk,visited Guyana 43 times in 2016. In excess of 10,000 Guyanese benefited from services provided by these foreign teams. Aid received for 2016 were from the USA, Canada, and Great Britain and one team from the Caribbean.
Clinical services from which the public benefitted ranged from gynecological surgeries and treatments, cardiac related screening, treatments and follow-up care, family medicine, corneal transplants, cataract surgeries and screening and treatments for various cancers such as cervical cancer.
The value of foreign aid received through the International Desk in 2016 was in excess of US$1.4 million. Resources donated included medical equipment, medicines and supplies and educational material and aids.
Guyana was able to further lower its Infant and Neonatal mortality rates because of collaborations with the Guyana Help the Kids Charity which was able to provide over US$300,000 in medical equipment and supplies in 2016 for maternity wards and infant and Neonatal Intensive Care Unit (NICU) wards at GPHC and our regional hospitals.
The first Public health Cardiac Intensive Care Unit (CICU) was recently commissioned at the Georgetown Public Hospital Corporation (GPHC). Services offered at the facility will be free of charge while cases requiring surgery will be referred to the Caribbean Heart Institute (CHI).
Approximately 90 percent of the Guyanese population has access to the Dental Health Services offered by the Ministry of Public Health. The Cheddi Jagan Dental Centre now offers Specialised Dental Care in the following areas: Maxillofacial Surgery, Prosthodontics (Dentures), Periodontics (Gum Diseases and Surgery) and Endodontics (Root Canal Therapy).
In 2016, some 3427 persons benefitted from Nutrition education activities conducted by the Food Policy Division. These included Parents, students, teachers, Community members, Teenage mothers, Senior Citizens, Police officers and persons within the workplace setting.
Collaborations were also done with Ministries, workplaces, Non-Governmental Organisations, Faith Based Organisations and Community Based Organisations to conduct public education and community based nutrition sessions to provide skills and knowledge in the preparation of nutritionally balanced meals for the family.
In 2016, eleven) hospitals were accredited with baby-friendly status. Guyana is the only country in the English speaking Caribbean with hospitals accredited with the Baby-Friendly Hospital status.
However, there are still 20 more hospitals which are still to be accredited. These include the Mabaruma, Leguan, Fort Wellington and Port Mourant hospitals. The aim is to ensure that all health facilities, more specifically hospitals attain Baby-Friendly status.
$31.2B, which is 12.5 percent of the 2017 National Budget has been allocated to the health sector. This allocation goes towards establishing an efficient and modern health system locally.
$2B is set to be invested into infrastructural upgrades and maintenance to health facilities. This will facilitate the construction and rehabilitation of comfortable living quarters at health facilities for on-call and live in healthcare providers in areas such as Barmita, Bartica, Kamarang, Mahdia, Port Kaituma and Annai.
Another area of focus includes the upgrading of local laboratory facilities as well as the construction of new laboratory facilities ensuring that there are adequate mechanisms in place to ensure food safety as well as other aspects of health services.
$465M has been budgeted for the procurement of supplies for these laboratories. This is aimed at reducing the country’s dependency on foreign and overseas testing.
It has also been recognised that Non-communicable diseases, Mental Health and Zika health issues will require a multi sectoral approach to have them eliminated and prioritise improvement in public health.
By: Delicia Haynes