The Government of Guyana has asked the Inter-American Development Bank (IDB) for a total of US$160m in loans to upgrade the health sector and a US$60m component is set to roll.
Divided into two phases and two tranches of US$60m and US$100m respectively under the IDB’s Health Care Net-work Strengthening project, the first set of monies will be released shortly, even as government anticipates approval of the other phase to forge ahead with plans.
“The envelope from IDB is US$160m. The first phase is US$60m and that first phase will start shortly…we have plans for the overall strengthening of the health sector to eventually offer world class health services and it is why we asked the IDB to help…,” Minister of Health Dr Frank Anthony told Stabroek News yesterday.
According to the project document which the IDB posted on its website in May and then early August, it stepped into help following requests from government to assist with its 2022-2030 plan that it said is being developed.
The US$60m will be supported by the IDB through a Sector Condi-tional Credit Line for Investment Projects (CCLIP).
“The project aims to improve the health of the Guyanese population through increased access, quality, and efficiency of health services by improving health outcomes associated with low and high complexity procedures, by expanding the capacity of strategic hospitals; by extending coverage of diagnostic, medical consultation, and patient management services, inclusive of the country’s hinterlands, through digital health; and by increasing the efficiency of the public health system, by strengthening key logistic, management, and support processes and inputs,” it added.
The project will target infrastructure improvement and expansion in three priority hospitals: the Georgetown Public Hospital Corporation, the New Amsterdam Hospital and the Linden Hospital Complex and has three components.
Components
Component one focuses on supporting hospital health services networks and US$48 million is dedicated in this regard.
“This component will finance inputs to allow the hospital network to function more efficiently by expanding capacity at two strategic level four hospitals, thereby relieving pressure on the main national reference hospital (level 5) to provide lower-complexity services, while also increasing the ability of this facility to fulfill its mission in handling specialty referral cases,” the project document states.
It outlined that activities to be funded by this component include: infrastructure rehabilitation and expansion at the New Amsterdam Hospital (level 4), Linden Hospital Com-plex (level 4), and the Georgetown Public Hos-pital Corporation (GPHC) (level 5), considering energy and water efficiency and climate change risk reduction features and the purchase of essential medical equipment and furniture for these facilities.
“Services for architectural and engineering design and construction supervision; and … Equip-ment inventorying, corrective and preventive maintenance of infrastructure works and medical equipment and improvement of installed maintenance capacity,” are also listed.
Component two focuses on strengthening digital health and US$7.2 million is set aside for this.
“Given the success of the MoH telemedicine initiatives and the further potential that they and other digital health interventions show for innovation, this component will ensure financing for the country’s plans for a digital transformation in health.
‘Electronic Health Record System’
Strengthening and expansion of the current teleradiology and teleophthalmology networks, plus other telemedicine services are also listed with special focus to the country’s hinterland areas, including its socio-cultural adaptations.
When the project is done, public hospitals in the project should have “preparedness for the selection and implementation of an electronic health record system and software maintenance and support.”
Most of the public hospitals here still use manual records that are susceptible to aging and destruction from natural disasters and other elements.
Anthony believes that having this system will enable health care provi-ders from one region to access records of patients transferred from even hinterland areas, quickly and safely.
The IDB notes too that digital health can reduce the emissions of greenhouse gases by reducing travel for health care and hardware purchases will follow best practices to reduce Information and Communication Techno-logy emissions.
Component three which addresses promoting health sector management and efficiency has US$3 million set aside.
It is stated that the monies will support this country’s National Stra-tegic Plan for Health which targets several key parts of the health system that promote improved quality and efficiency in the delivery of health services.
Supply chain management “expansion of warehouse capacity; software and hardware for electronic supply chain management system; training of staff in supply chain management) and pandemic and emergency preparedness (analysis of COVID-19 response, Emergency Operations Center plan, simulation exercises, laboratory equipment and diagnostic tests procurement, and biosafety/biosecurity assessments),” are among areas listed.
In addition to the three project components, the project will also support project administration and programme monitoring and evaluation at a cost of US$1.8 million. These resources will support the MoH in programme management and assessment of its effects. It will finance specialized consulting services for project implementation, costs associated with the Project Executing Unit (PEU), and evaluations of project implementation and impact.
The Minister of Health said that he wants it made clear that the monies are needed to complement upgrades planned for the sector, as a lot has already been expended on the sector over the two years he has served. “A lot has been done for the health sector already…this is just to add and some of the issues that are noted in the report have been rectified. One example is that at the New Amsterdam Hospital, there was a huge post in the middle of the operating theatre and that had to be broken down and the room rectified,” he said.
“That hospital had to be repainted…,” he added while pointing out that at other hospitals there are noticeable infrastructural changes, as he pointed to hospitals that will see additional and noticeable upgrades.
Anthony said he was zooming in on the New Amsterdam hospital because he had seen reports which paint a picture that the hospital was in a derelict state.
Pointing to works done at the New Amsterdam Hospital and what is reflected in state spending last year, he said that there was the construction of the Maternity Ward Phase 2 for $90m, construction of the Storage Bond at the New Amsterdam Hospital – $13m, construction of the Regional Infectious Unit at the New Amsterdam Hospital – $45m, adjustment of the Sewer System – $13m and adjustment of Plumbing System for Sewer System – $13m to name a few.
As part of capital projects also, Anthony said that there was the rehabilitation of the oxygen system at the New Amsterdam Hospital for $38m.
“But some notable ones include the road at the back, the washroom facilities that are being done right now, the mortuary freezer, the chemotherapy building” are still to be done, Anthony said.
‘Strategic plan’
According to the document a National Strategic Plan for Health 2022-2030 is being developed which intends to promote a model based on the principles of Primary Health Care through an Integrated Health Service Delivery Network approach to achieve universal access and coverage.
Anthony said that government never made public the plan because when it took office there was a draft but realized that it did not cater for some of the changing medical technological factors and infrastructural plans, and it was being redrafted to cater to this.
He echoed that its emphasis would include essential functions such as a healthcare delivery model, governance, financing, human resources, delivery of services, evidence-informed decision making, supply chain, emergency preparedness, strategic partnerships, occupational safety and health, and preferred health programmes and health determinants, and that to address other key areas for improvement, the MoH is preparing a Health Infrastructure Transformation Plan and a Human Resource Development Plan.
“We have a draft but had to rework it because, even as we had that many of the developments would supersede that draft. We are revising the whole thing,” he said.
Anthony informed that by mid-next year the plan would be completed, after the draft is analyzed by a number of medical and other stakeholders.
