Guyana has made insufficient progress towards improving maternal health and is not on track to reach the fifth Millennium Development Goal (MDG), according to a new United Nations report which has assessed the state of midwifery globally.
Maternal mortality levels jumped to a high last year with a string of reported deaths and a Cabinet sub-committee had been established to address the issue, but to date no findings have been made public by the committee.
Minister of Health Dr Leslie Ramsammy had described 2010 as a “setback” for the national programme saying the spike was the highest in six years.
‘The State of the World’s Midwifery 2011: Delivering Health, Saving Lives’, coordinated by the United Nations Population Fund (UNFPA), named Guyana as one of several countries which are not likely meet the fifth MDG: Improving Maternal Health.
Continued investment in human resources is crucial in order to ensure high quality maternal and newborn health care, the report said, noting that programmes to train health care providers and further promote family planning are also essential to reduce current maternal mortality levels.
The report, which was launched at a meeting of the international confederation of midwives in Durban, South Africa, raised serious concerns about the shortage of midwives across the world, particularly in developing countries where maternal mortality levels are high.
Every year approximately 350,000 women die while pregnant or giving birth — almost 1,000 a day. Of these women, 99 per cent die in developing countries, the report observed. It said too that up to 2 million newborns die within the first 24 hours of life, and there are 2.6 million stillbirths. “The overwhelming majority of these deaths occur in low-income countries and most of them could have been prevented,” it added.
In Guyana’s case, the UN said Maternal Mortality Rates (MMR) significantly declined between 1990 and 2000, from 310 deaths per 100,000 live births to 120 per 100,000. However, MMR more than doubled over the next eight years, reaching 270 per 100,000 in 2008- the report did not capture the number of reported deaths in 2009 and or 2010.
It was reported that Guyana has a high vacancy rate for midwifery faculty and there is a recognized need for more tutors to assist in practical teaching. The current human resources plan does not include costs and projections for the future workforce and this affects the retention of good quality, trained staff, according to the UN.
“The relationship between medical doctors and midwives is reportedly strained and this often causes inefficiency. Although the midwifery profession is considered vital in Guyana, increasing rates of maternal mortality have lowered the demand from the general public,” the UN noted.
The report mentioned that Guyana has made some progress, but pointed out that it has been insufficient towards achieving the targets set in the goal. It said too that the government has expressed its commitment to improving maternal mortality, adding that this country’s programme is supported by a number of partners including PAHO; UNICEF and UNFPA.
According to the UN report, it is a responsibility of governments and their political leaders and an investment that is key to reducing maternal and newborn mortality and morbidity, and it calls on governments to recognize midwifery as a distinct profession, core to the provision of maternal and newborn health services, and promote it as a career with posts at the national policy level.
Governments are advised to invest in human resource management to develop and maintain competencies, manage entries and exits, and improve data on the practising midwifery workforce.
“…A health care system that relies on midwives or other cadres who are less than competent to provide care throughout their professional careers is dangerous to women, newborns, families and communities,” the report added.
‘The State of the World’s Midwifery 2011’ was the collaborative effort of 30 agencies and organizations and hundreds of individuals working at national, subnational, regional and global levels.