Dawes: $4b programme failed to curb death rate among infants, pregnant moms

Opposition Spokesperson on Health and Wellness Dr Alfred Dawes says the health of mothers and neonates is at risk due to an inadequate public healthcare system in Jamaica.

Dawes, who has been sparring publicly with Minister of Health and Wellness Dr Christopher Tufton over the lack of resources at public-health facilities, said the Government has failed to implement and maintain an adequate healthcare system.

However, Tufton has rejected as “mischief” the claims by Dawes, arguing that his opposition counterpart has failed to acknowledge the gains achieved over the past four years.

Dawes’ criticism comes after a Gleaner report last week about a mother left in pain due to the death of her newborn. The baby, who doctors advised desperately needed a ventilator because of his premature birth, died four days later at May Pen Hospital in Clarendon because the facility did not have one of the life-saving machines.

The opposition spokesman pointed to the Programme for the Reduction of Maternal and Child Mortality (PROMAC), funded by the European Union to the tune of €22million or J$4 billion, which, he suggested, has been botched.

The agreement was signed in Kingston on November 21, 2013. Implementation was to last 48 months after the last date of signing.

‘Contracts were signed’

Dawes said the Government previously indicated that implementation was to take place at several health facilities, including the Mandeville Regional Hospital, where three maternal and six neonatal beds were to be set up. Two isolation high-dependency beds were also to be in place.

Further, he said six maternal beds and four neonatal beds were earmarked for Victoria Jubilee Hospital, and four maternal beds and 10 neonatal beds were to be established at Cornwall Regional Hospital.

The Bustamante Hospital for Children should have had eight neonatal beds and two isolation high-dependency beds.

Four maternal beds and six neonatal beds were to be set up at Spanish Town Hospital, and there should have been an intermediate care unit capacity increase from 12 to 17 beds and a minimum care unit bed capacity increase from 18 to 26 beds.

St Ann’s Bay Hospital was slated to benefit from four maternal high-dependency beds and six neonatal high-dependency beds along with a paediatric unit increase of six nursery beds to 20. Two operating theatres dedicated to maternal patients were also to be in place.

“So we know that the contracts were signed. We know that the money was allocated, and we know exactly where the high-dependency units for mothers and babies should have been built out. It is not hard for us to look and see where they are now,” said Dawes.

He said that despite the donation from the EU, the country is still left in a situation where there is a dire shortage of intensive care unit beds and high-dependency unit beds for adults and neonates.

“So the stories that we are seeing are not unexpected because they reflect a systemic issue, and a big part of that systemic problem is that we have maintenance issues and we have accountability issues,” said Dawes.

He noted that PROMAC aimed to reduce maternal and child mortality rates but said this failed, mentioning at the same time that this was also due to “other contributing factors”.

The medical doctor said that over the last eight years, there has been a steady climb in the number of mothers dying during pregnancy and delivery.

Mortality rate higher

He said Jamaica’s mortality rate is the highest it has ever been in over 30 years, and the neonatal mortality rate is higher than it was 20 years ago. Additionally, he said the number of children under five who are dying is higher than it was 20 years ago.

“So there are measured consequences for failure to implement and maintain an adequate healthcare system,” said Dawes, who said the issue did not amount to one that is monetary.

He said it is a matter of priorities, policies, and proposed solutions. He said failure to acknowledge this means that the “broken system” will continue to produce horror stories.

Data from the Pan American Health Organization (PAHO) showed that between 2006 and 2020, infant mortality in Jamaica decreased from 21.1 to 16.7 deaths per 1,000 live births, a decrease of 20.9 per cent.

The maternal mortality ratio for 2020 was estimated at 98.9 deaths per 100,000 live births, a reduction of 19.1 per cent from the estimated value for 2000, PAHO said.

Tufton, in a swift response to Dawes, said he could produce a report to “clarify any misunderstanding or address any mischief as it relates to PROMAC”.

“The fact is that many hundreds of Jamaican mothers and their neonates were involved in complicated pregnancies, and deliveries have been supported by the PROMAC equipment, and where the buildings exist, through the PROMAC facilities, and we can provide better particulars on that,” the minister said.

“I cannot imagine that any informed Jamaican, and particularly the Opposition, where it should be their duty to see what is happening and understand what is happening, could be claiming that somehow the public-health system has not [seen] and is not seeing the greatest level of reform since Independence. To hear the Opposition make the claim that somehow the system needs reform without a recognition that the reform is, in fact, taking place and tangibly where Jamaicans are benefiting, it tells me that they are either refusing to see or there is an attempt at mischief,” Tufton added.

kimone.francis@gleanerjm.com