Health Sector Monitoring …18 maternal deaths recorded in 2014

-  Need for more enforcement, punitive actions –Dr. Luncheon

By Kiana Wilburg The need for more enforcement of the laws governing the Health Sector and the fact that there were

Cabinet Secretary, Dr. Roger Luncheon

18 maternal deaths recorded in 2014, were some of the highlights of a press conference held by Cabinet Secretary, Dr. Roger Luncheon at the Office of the President yesterday. Dr Luncheon was at the time, reporting on the observations of a special Cabinet subcommittee of which he is a member and which is tasked with monitoring the health sector. The Head of the Presidential Secretariat asserted that during the second term of former President Bharrat Jagdeo, Cabinet had undertaken to monitor the education and health sectors. By the end of 2011, the monitoring of the education sector had come to an end but Cabinet continues to formally monitor the health sector. He said that this should not be misconstrued to mean that Cabinet does not monitor the other sectors. Luncheon said that eight Cabinet subcommittees provide on a monthly basis, the monitoring of issues affecting certain sectors. As it relates specifically to the health sector, Dr. Luncheon said that attention was paid to children mortality, maternal mortality and the licensing of health facilities. Regarding the health sector’s report for 2014, the Cabinet Secretary said that it was submitted by the Ministry of Health, reviewed by the monitoring group, discussed by Cabinet in January and completed in February. On maternal mortality, the issue here he said, is “not so much the numbers” although Cabinet was assured in the report and by the Minister of Health, Dr. Bheri Ramsaran, that Guyana had indeed achieved the Millennium Development Goal in that regard. Dr. Luncheon said that the records would show that there were 18 maternal deaths in Guyana dispersed among public and private institutions. There were 10 alone at the Georgetown Public Hospital. On the reporting compliance of the Private Institutions, Dr. Luncheon told media operatives that Cabinet did have some concerns that these health facilities were not doing recordings in a timely manner as prescribed by the laws. However, the Head of the Presidential Secretariat said that it is a bit different with the findings on child mortality. He said that charts and tables showed observations for those under five and then specifically with newborn children. Dr. Luncheon said that as it relates to neonatal mortality, Dr. Ramsaran explained that this had much more to do with attempts by the Ministry of Health to enhance efforts to allow for the salvaging of what ordinarily might have been deemed unsalvageable births. He noted that Cabinet was also distressed by the reports on neonatal deaths but felt that the Health minister was appreciative of its concerns as he spent a considerable amount of time explaining that notwithstanding the Neonatal Intensive Care Units, they were indeed dealing with a population with inherently high mortality. However, most important for Cabinet, Dr. Luncheon said, was again, the flaws in reporting between public and private sector facilities. The Cabinet Secretary expressed the belief that there is perhaps, a cultural norm apparently against fundamental tools used in the evaluation of infant deaths like post mortems. He said that the report commented on the considerable difficulties that exist in getting parents, and perhaps, institutions to enforce those requirements to have post mortems done. Another concern of the Cabinet subcommittee, he said, was the Health Ministry addressing the issue of culpability, meaning who or under what circumstances these deaths occurred. He said that the Cabinet expert group generally expressed their findings and made certain recommendations. Again, Dr. Luncheon stated that Cabinet had to face those instances and while it is fortunate that they weren’t many, he said that there were instances when either the autonomous Medical Council or lesser frequently, the High Court, disposed of the recommendations of the expert group as they sought to have disciplinary measures against mal-practicing professionals. In facing this apparent hurdle, Cabinet he said was also faced with another issue which had to do with an approach on ensuring maximal enforcement of the laws. Asked if he believes the neonatal deaths could be attributed to faults in system and if there were recommendations for punitive action against defaulters, he said he would hesitate to speak on faults in that regard. The Cabinet Secretary said that the report recognized that some deaths were unavoidable but for those deemed to be preventable; a number of fingers were pointed at institutional deficiencies, to malpractice at the level of professionals involved in the delivery of care to pregnant mothers and perhaps poor record keeping. Nonetheless, Dr. Luncheon articulated that the “long and short” of it is that recommendations from the expert groups on this matter need to be enforced. “I am part of that small committee empowered to address the issue of enforcement and perhaps want to see stricter application of the law, more forceful application, more unambiguous interpretation of powers bestowed on the group or on parties to whom the group makes referrals in enforcing decisions,” Dr. Luncheon said. The results may look bad but he emphasized that indeed, if neonatal science were to be introduced and enhanced, it does hold great promise to reduce the neonatal mortality, he said. He said that Dr. Ramsaran had provided to the Cabinet subcommittee, a menu of measures to be taken in this regard, which include, training and the procurement of those facilities.