Significant Progress Under PROMAC

The Government has recorded significant progress under the Programme for the Reduction of Maternal and Child Mortality (PROMAC), since its launch in 2013.

The Programme, being spearheaded by the Ministry of Health under a GOJ-European Union (EU) bilateral agreement with funding support of approximately €22 million, aims to combat infant and maternal mortality by improving five focus areas.

These are Newborn and Emergency Obstetric Care, Quality of Primary Healthcare Services and Referral System, Health Workers Training and Research, Support for the Target Population, and Institutional Support for Project Implementation.

PROMAC Coordinator, Dr. Simone Spence, who tells JIS News that significant work has been done under each component, indicates that the Ministry is now looking to advance work to establish nine High Dependency Units (HDUs) for the intensive care of babies and mothers in five facilities.

These are the Bustamante Hospital for Children, and the Cornwall Regional, Victoria Jubilee, St. Ann’s Bay and Spanish Town Hospitals.

They will comprise 65 HDU beds, 22 maternal and 43 neonatal suites, and accompanying equipment.

Dr. Spence, who is Acting Director for the Ministry’s Health Promotion and Protection Branch, says construction of the HDUs has started, with ground recently broken for Units at St Ann’s Bay and Spanish Town.

Additionally, she says the Ministry has procured equipment to improve access to diagnostic and laboratory services, including blood tests for mothers during the antenatal period

Dr. Spence further tells JIS News that primary healthcare sites and community hospitals are being rehabilitated to improve the quality of service delivery and the referral system.

Meanwhile, six ambulances, which the Ministry acquired under the Programme, will be assigned to four healthcare centres and two community hospitals.

These are the Mandeville, St Jago Park, Annotto Bay, and Savanna-la-Mar health centres, and the Chapelton and Alexandria community hospitals.

Other areas of focus include health workers’ training and research, support for the target population and institutional support for project implementation.

The PROMAC Coordinator says fellowship studies in areas such as neonatology and maternal foetal medicine are being offered at the University of the West Indies (UWI) Mona.

“We have supported the Doctor of Medicine Programme in terms of scholarships in the area of anaesthesiology, paediatric obstetrics and gynaecology as well,” Dr Spence inform, adding that short-term scholarships have also been awarded in ventilation, obstetrics and ultrasound.

She further indicates that nurses have also received training in Post Basic Midwifery, Neonatology and Critical Care Nursing under the Ministry of Health in-service programme at the University of Technology (UTECH).

“We have trained 100 nurses in total now in Post Basic Midwifery, as well as critical care; about 40 nurses in the area of neonatology, and we have trained over 1,000 primary healthcare team members – doctors, nurses and other allied health professionals – in terms of neonatal resuscitation, customer service and how to manage high-risk pregnancies,” she stated, adding that dieticians and nutritionists have also been trained to manage high-risk pregnant mothers.

Dr. Spence highlighted the importance of providing quality care for mothers and newborn babies.

“It has far-reaching implications, and what better way to sustain a nation than to care for our mothers and to care for our newborn babies,” she said during an interview with JIS News.

She said that without the agreements and corporate support, it would be difficult “to achieve the level of transformation that we are looking forward to achieving at some point in the near future”.

Meanwhile, Dr. Spence says public education will be strengthened to heighten awareness of maternal and child-health issues.

“We have a partnership with the National Family Planning Board (NFPB) to look at increasing this awareness through training and building capacity within the community as well as within the public health system,” she points out, noting that patients’ rights and the advocacy in maternal and child-health issues will be done in partnership with the UWI.

“Under the NFPB component, we have done a number of training sessions… and we’re looking forward to launching the communication campaign in terms of increasing awareness in the target population,” she adds.

Dr Spence further advises that staff members in the Ministry’s central office and the Regional Health Authority have also been trained in project management, inventory management and the EU’s rules and procedures.

Senior Obstetrician at the Spanish Town Hospital, Dr. Alexander Onyonyor, says one of the main benefits of PROMAC is the provision of training and capacity building.

He notes that doctors and nurses at the facility are happy that they “have something else in the fight against maternal death in the system”.

The Spanish Town hospital, which serves areas in Portmore, Clarendon, Old Harbour and St Ann, has received an ambulance, an ultrasound machine, computers, X-ray equipment and other medical items.

Additionally, Dr. Onyonyor says a trained Perinatologist is now on staff at the hospital and discloses “plans to train more, and this has improved the quality of care that we deliver to our patients”.

He says the institution’s High Dependency Unit is completed, and “the hospital’s ability to manage high-risk patients will be improved”.

“I think the ability to care for someone, to create a positive outcome is something that all healthcare practitioners want and look forward to. Therefore, if we have all the resources we need to deliver the best quality care, I think many of us will be extremely happy,” he adds.

Dr Onyonyor points out that “our capacity has certainly improved” and expresses the hope that, over time, “we will see the benefits of these changes”, adding that “PROMAC, in my view, is a step in the right direction”.