By Mark DaCosta- Guyana’s maternal mortality rate remains a heartbreaking crisis, one that continues to devastate families and communities. The rising number of maternal deaths is a glaring testament to the failure of the People’s Progressive Party (PPP) administration to properly manage the healthcare sector, particularly the critical area of maternity care. In a hard-hitting column titled “Mark’s Take” published in Village Voice News on November 3, 2024, Dr. Mark Devonish MBBS MSc MRCP(UK) critiques the PPP government’s handling of the healthcare system, calling attention to the high death toll among expectant mothers and the systemic failures that contribute to this tragedy.
Maternal mortality refers to the death of a woman during pregnancy or within 42 days of the end of pregnancy. These deaths result from complications that arise during or after childbirth, and they are widely considered to be preventable with proper healthcare intervention and resources. Unfortunately, in Guyana, many such deaths continue to occur, and Dr. Devonish’s article sheds light on the systemic problem.
According to the Pan American Health Organization (PAHO), Guyana’s maternal mortality ratio stands at about 111.9 deaths per 100,000 live births, though this figure does not reflect the full scope of the crisis. The real mortality rate is likely much higher, particularly in the hinterland and Indigenous communities, where healthcare services are grossly inadequate or completely inaccessible. Many women in these regions die without receiving the necessary medical attention, and these deaths often go unreported or undercounted due to the country’s vast geographical challenges. According to a non-scientific meta-analysis done by two local analysts using multiple estimates, the maternal death rate could be as high as 169 per 100,000 live births.
This alarming number of deaths has not gone unnoticed. Dr. Devonish highlights a critical report by the Auditor General’s Office, which conducted a performance audit on the state of Guyana’s healthcare system, particularly the Georgetown Public Hospital Corporation (GPHC) maternity unit. The audit revealed several concerning issues, not least the lack of leadership, oversight, and updated clinical guidelines within the maternity department. It is within this environment of disarray and neglect that many maternal deaths are occurring, according to Dr. Devonish.
At the heart of this crisis is the glaring absence of competent leadership at GPHC and the Ministry of Health. Dr. Devonish argues that for any hospital to function effectively, especially in the high-stakes environment of maternity care, a well-structured set of policies and protocols is essential. However, the report from the Auditor General reveals that comprehensive and updated staff policies and clinical guidelines are notably absent at the maternity unit. Without these protocols, maternity professionals are left to rely on outdated and anecdotal practices rather than evidence-based medical approaches, which compromises the safety and quality of care provided to mothers.
It is standard practice in medical settings to regularly review and update clinical protocols, ensuring they reflect the latest medical research and best practices. Yet, as Dr. Devonish notes, the GPHC has failed to appraise and update its maternity protocols on a consistent basis. While it is mandated that protocols be reviewed every three years, the report showed that updates were only done sporadically, leading to outdated practices that do not meet current standards of care.
Compounding this issue is the shortage of qualified maternity staff at GPHC, a problem that has only worsened in recent years. The failure of the PPP administration to address staffing shortages has left many departments understaffed, overworked, and unable to provide the level of care required. It is clear that the lack of proper staffing, coupled with outdated practices and policies, is creating an environment where preventable deaths are occurring at an unacceptable rate.
Dr. Devonish’s article emphasises that the responsibility for these deaths falls squarely on the shoulders of the PPP government. Despite holding power in Guyana for 27 of the last 32 years, the PPP has not implemented the necessary reforms to improve maternal care. The absence of updated protocols, insufficient staffing, and a lack of leadership have combined to create a healthcare environment that puts the lives of women at risk.
The high maternal mortality under the PPP government is not just a statistical problem; it is a human tragedy, one that leaves behind grieving families and communities. Dr. Devonish calls on the government to take immediate action to rectify this situation, starting with the implementation of up-to-date evidence-based guidelines, proper staff training, and consistent leadership at GPHC.
Guyana’s maternal mortality crisis is arguably a direct result of years of mismanagement and neglect by the PPP government. The rising death toll is a tragic consequence of the government’s failure to implement evidence-based medical practices, ensure adequate staffing, and provide the leadership needed to reform the healthcare sector. Until the PPP government acknowledges its probable role in this crisis and makes the necessary changes, Guyana’s mothers will continue to pay the price with their lives.
