Preserving maternity gains

JUST IN time for Mother’s Day, Health Minister Terrence Deyalsingh had a special gift for the nation. He confirmed there had been no maternal deaths during childbirth for the year thus far. The fact of no deaths would be remarkable enough on its own, but it must be placed in proper context. This year represents the third successive year in which there have been substantial gains in maternal healthcare, signalling a profound shift within our healthcare system. Mothers everywhere stand to benefit.

Before 2016, the reports of mothers dying in wholly avoidable situations seemed never-ending. Lawsuit after lawsuit was filed, story after story written. The degree of pain caused by appalling levels of negligence and mismanagement was unimaginable. It was as though nothing had been learned from decades of studies and reports, including one done by the University of the West Indies in 1991, which found the leading causes of death included “inadequate antenatal care and substandard clinical management.”

But from 2016, a remarkable shift began. Maternal deaths went down, with some suggestion that the rate of three or four a year placed this country on par with developed countries. Deyalsingh attributed this to a “whole new culture change.” Key in this is the fact that the Pan American Health Organization/World Health Organization was invited to audit the country’s health systems.

The improvements in 2016 were no flash in the pan. In 2017, the gains continued with similar rates. The minister reported the lives of several mothers had been saved through the implementation of new protocols and measures. Confirmation that progress has continued for a third year means the healthcare system has now effectively raised the bar and will henceforth be expected to maintain these standards going forward.

Key in this will be the management of the Regional Health Authority system, which is set to gain from an injection of an additional $121 million due to the mid-year review of the budget. The funds will largely be used to help authorities settle debts, but there will undoubtedly be a knock-on effect from the perspective of the end user, including expectant mothers who rely on public health services.

The larger issue, however, is the need for the State to address lingering challenges such as the lack of synergy between the public and private health sectors when it comes to patient records. This matter is key in not only cases involving mothers, but patients more generally. Now that maternal deaths have been brought under control, perhaps this is the next area that the Health Minister should tackle.