Training starts to curb unacceptable neo-natal death rate
Guyana Chronicle
April 17, 2002

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HEALTH Minister Dr Leslie Ramsammy said Monday that the high rate of neo-natal deaths, 17 per month at Georgetown Public Hospital (GPH), is unacceptable and his Ministry is working on a programme to deal with the problem.

The reported incidence “is simply too high”, he told participants at an Integrated Management of Childhood Illnesses (IMCI) workshop, begun at Ocean View Convention Centre, Liliendaal, East Coast Demerara.

Ramsammy said children’s health depends on a number of factors, including healthy pregnancy and he called on pregnant women to take proper care of themselves while urging the relevant authorities to ensure that the mothers have access to quality pre-natal care.

He expressed the hope that, with the additional training in IMCI, health workers participating in the two-week seminar will be equipped to make significant changes in the prevailing conditions.

The course was organised by Ministry of Health, in collaboration with Pan-American Health Organisation/World Health Organisation (PAHO/WHO) and United Nations Children’s Fund (UNICEF).

IMCI targets children under five years of age, focusing on their health status rather than the diseases, which occasionally affect them.

According to Ramsammy, Guyana has placed the health and development of children as a priority objective in the attempt to reduce poverty.

He said, each year, more than 130 million children are born worldwide but close to 11 million of them die before reaching age five.

“These are not statistics we should be proud of,” Ramsammy acknowledged, saying the Guyana situation is not much different, with an average of 18,000 new births annually and about 300 dying prior to becoming five years old, from various “controllable diseases”.

He said, like in other parts of the world, this country is faced with diseases that range from acute respiratory infections, malnutrition, malaria, acute diarrhoea and HIV/AIDS, all of which can be controlled.

Ramsammy said health personnel must recognise the causes of the ailments and deal with them.

He said more than 5,000 children were treated for worm infections last year, 20,000 for acute respiratory infections, 9,000 for acute diarrhoea, 2,000 for scabies, 3,000 for asthma and 1,500 injured in accidents and within the home environment.

Ramsammy hopes a significant dent would be made in the infant morbidity figure and more emphasis put on prevention and management of illnesses.

He agreed, however, that there is need for greater effort on the part of all stakeholders and said the training being provided anticipates community participation in ensuring children adopt healthy lifestyles.

The Minister said, if all are not involved and playing parts, the programme will definitely fail and special steps should be taken to get especially parents to accept their roles.

PAHO/WHO Representative, Dr Bernadette Theodore-Gandi said IMCI reduces missed opportunities for early detection and treatment of sicknesses that, while not the main reason for consulting the health services, can escape the notice of health workers, with the consequent risk of worsening and leading to complications.

She said the treatment provided through IMCI includes a strong disease prevention and health promotion component, the benefits of which spawn broader vaccination coverage and better knowledge and practices in terms of care and treatment of the target group in the home, thus contributing to healthy growth and development.

The system is geared to improve the quality of care in health facilities, enhance the process and promote family and community practices in support of healthy children.

Theodore-Gandi said WHO and UNICEF began developing the IMCI strategy in 1992 and introduced it to the Americas in 1996 as the principal tool for improving child health.

She said, in 1999, the forty-first Directing Council of PAHO passed a resolution urging member states to adopt it and expand on its implementation.

Later that year, following mandates from Summit of the Americas and First Ladies Conference, PAHO and its partners launched a new plan to reduce child morbidity and mortality and improve growth in the Americas.

The Healthy Children: Goal 2002 Meeting, held at PAHO Washington D.C headquarters in December 1999, aimed at reducing 100,000 deaths of children less than five years old by this year.

By late last year, the policy had been adapted and implemented in 17 countries in the Americas and evaluations conducted revealed significant improvements in the quality of care given children under five years of age by staff with IMCI training, Theodore-Gandi reported.

She said the assessments showed, too, that the approach was effective in improving the knowledge and practices of parents and family members with respect to disease prevention and health promotion, in encouraging early consultation when illness strikes and in promoting adherence to the prescribed treatments.

The diplomat said evaluation of the mortality figures for children under five years of age showed a significant impact in the form of a rapid decline in the total deaths from causes targeted by IMCI.

Assistant UNICEF Representative in Guyana, Dr Sreelakshmi Gururaja also addressed the Monday forum.