Since Guyana signed the global pledge last year, there have been a number of achievements, including: the completion of the first national stakeholders’ forum to raise public awareness of the pledge and to create a supportive environment for partners to support government to address infant mortality, (MDG 4) and maternal mortality, (MDG 5).
Guyana seems to be on track to achieving its MDG 4 target; to reduce the under-five mortality rate by two-thirds by 2015. Currently, the focus is on expanding and strengthening partnerships with other UN agencies, civil society organisations and the private sector to support interventions at the national and local levels to enhance maternal, neonatal and child survival outcomes.
Guyana’s Demographic Health Survey (DHS) in 2009 showed that a total of 40 children out of every 1,000 born alive, die before age five. 38 out of every 1,000 do not survive their first year of life, with 25 (66%) of these children dying within the first month of birth. These causes of deaths are preventable and treatable. The causes of neonatal deaths include respiratory diseases, bacterial sepsis (that is, infections of the blood), and congenital malformations (that is, birth defects). In contrast, their mothers died from preventable problems, namely haemorrhage, infections, respiratory problems, severe anaemia and retained products of conception (fragments of foetal, placental or membrane tissue).
In addition, these neonatal deaths mostly occur in two settings: hospitals and homes, which suggest that health care workers and parents/caregivers have a significant role to play to improve neonatal survival. The actions required to improve neonatal survival include: improved quality of health care, and developing personal health skills of parents/caregivers to recognise danger signs of sick children and to seek immediate medical care. In Guyana, acute respiratory infection (ARI), mostly pneumonia, and diarrhoea are the two highest single causes of death for children under five years. Both of these childhood illnesses are not only treatable but preventable.
Typically, it is the poorest and most marginalized children who fall victim to these easily preventable and treatable diseases, children who live in the rural and hinterland areas. Complications due to preterm birth and during childbirth are also key causes of child mortality.
There are many simple, affordable and effective solutions and innovative ways of saving children’s lives and it must be ensured that those who need them the most - the most vulnerable and the poorest children and families, are receiving them.
For example, since the 1970s, oral rehydration salts (ORS) therapy has been the foundation of treatment for the life-threatening dehydration that can result from diarrhoea. ORS is inexpensive and is available in various packet sizes and assorted flavours to encourage use by children.
Other readily available solutions that can save Guyanese children’s lives include proper breastfeeding, vaccines, nutritional supplements (Sprinkles and other iron supplements) safe water and sanitation, and medicines especially Oral Rehydration Salts, and insecticide-treated mosquito nets. All aspects that affect a child’s life must be addressed: it is not only about health solutions. Poverty reduction, more and better education, protection of children including birth registration and ending child marriage, as well as achieving gender equality are all important elements that will contribute to the survival of children.
Guyana has witnessed remarkable progress. There has been a 30% decline in deaths in children under five, between 1990 and present. [While in 1990, as many as (1,222) children under-five died, today the number has fallen to (409).] Guyana’s Maternal and Child Health (MCH) Programme has established a number of integrated programmes, namely, Maternal and Child Health/Expanded Programme on Immunization (MCH/EPI); and Prevention of Mother-to-Child Transmission (PMTCT) of HIV.
Whilst savouring this good news, it must also be remembered that the world is still failing more than 18,000 children globally
In September 2013, a three day conference on A Promise Renewed for the Americas was hosted by the Government of Panama, and led by UNICEF, PAHO/WHO, and UNFPA in partnership with other key international development agencies. A team from Guyana, headed by Hon. Minister of Health, Bheri Ramsarran attended the A Promise Renewed for the Americas meeting.
The meeting concluded with the development of a framework to accelerate the elimination of preventable maternal and child deaths in the region, which primarily affects poor, indigenous, rural, and other marginalized populations. Twenty six Latin American and Caribbean governments, seven international partners, and numerous civil society organizations signed the Declaration of Panama committing to this call to action.
The framework and declaration emphasize the need for a renewed focus on child and maternal health issues which has waned in recent years. While Latin America and the Caribbean is one of regions closest to reaching the Millennium Development Goals on child and maternal health by 2015, Inter Agency Group for Child Mortality Estimation (IGME) found the region to be the one with least progress in the past five years.
Remaining challenges to the achievement of the MDG’s on child and maternal health by 2015 include the implementation and monitoring of maternal health programmes in the hinterland regions, to ensure access to quality care. Inequalities must be addressed in order to ensure that every child has the opportunity to be born healthy, and to survive and thrive, especially those children who are hardest to reach.
With less than 800 days to go before the Millennium Development Goals deadline in 2015, these actions will be critical to make sure that more children survive past their fifth birthday, and get the chance to realise their full potential in life as well as ensuring an end to preventable maternal and child deaths in Guyana and the region as a whole.