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MOMS COUNTRY PROFILE: GUYANA

Presenter: Maria Francois

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GUYANA 2 Area:215,000 square km Population: 751,000 (2002 census). Official language: English. Ethnic Groups: East Indians (43%); Africans (30%); Mixed (16.7%) Amerindians (less than 10%); Religion: Christian (57%); Hindu (22.5%); Muslim (5.8%). 70% of population live on coastal plain; the rest are scattered in the hinterland regions.


HEALTH FACILITIES TYPE Health posts (level 1) (rural/hinterland) Health centres (level 2) (urban and rural)

3

NO

SERVICES

187

136

District hospitals (level 3) (urban and rural )

21

Regional hospitals(level 4) (rural and urban)

4

National referral hospital(level 5) (urban)

Midwives provide MCH services at some of these Hinterland facilities Antenatal, postnatal, child health and family planning provided primarily by midwives Normal deliveries done by midwives; referrals done Normal deliveries (done by midwives) and CS High-risk clinics; referrals done

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Comprehensive maternal and child health services ; Equipped for emergencies


EDUCATION /REGULATION/ASSOCIATION EDUCATION

REGULATION

ASSOCIATION

Post Basic Midwifery (12 months)

General Nursing Council (GNC) prepares examination for the midwifery programs

Midwives Association of Guyana (MAG) was formed in 2009. Membership stands at 85.

Single Trained Midwifery (Direct Entry) (24 months plus 3 months internship)

GNC admits to the register of existing midwives persons who successfully completed midwifery training.

Recently accepted as a member of ICM It is a sub-association of the Guyana Nurses Association (GNA) which is a member ICN

All students are taught using the same midwifery curriculum and sit the same State Final Midwifery examination. A midwife from any category can be employed at any hospital. 4


MIDWIFERY WORKFORCE 5

NUMBER AND PER 10,000 POPULATION Number of midwives and nurse-midwives/10,000 population

8.0

Nurse/Midwife

218

Nursing Assistant/Midwife

187

Direct Entry (Single Trained) Midwife

137

Medex/Midwife

65

Number of nurses/10000 population

10.0

Number of physicians/10,000 population

6.9

Number of OBGYN specialists

8

Vacancies exist for 155 midwives

All categories of midwife included

Nurse/midwives and RNs

Source – Medical Board


SELECTED LIFE-SAVING SKILLS FOR MIDWIVES NOT DONE NO

SKILLS

1

6

YES

NO

COMMENT

Perform forceps or vacuum assisted delivery

X

Midwives are taught

2

Perform manual removal of placenta

X

these skills

3

Remove retained products of conception using Manual Vacuum Extraction (MVA)

X

in the midwifery school, but practical skills are limited.

4

Insert IUDs

X


SCOPE OF PRACTICE INCLUDES 7

NO SKILLS 11 a Prenatal Care 11 b 11 c 11 d 11 e

Labor Care Delivery Care Postpartum Care Pre and Interconception Care

11 f Family Planning 11 g Neonatal Care

YES NO COMMENT X X X X X X X


NATIONAL PRIORITIES and POLICIES for MNH 8

 Reporting maternal deaths and audits  Updated curriculum in nursing schools  Training in ALARM and EMONC  Adequate supplies of emergency obstetric drugs  Procurement of neonatal equipment


CHALLENGES 9

 Inadequate teaching/learning materials  Inadequate midwifery tutors  No tutor trained to Master’s level  No incentive for tutors  Hospital deliveries in region 10 inadequate to

support clinical experience of students. Midwifery students are therefore assigned to the main hospital (Georgetown Hospital) on a rotating basis.


EXTERNAL SUPPORT 10

Support from UNFPA for consultancies in 2009- 2012  Constitution of the Midwives Association  Assessment to determine baseline number of midwife graduates and national needs  Baseline assessment of the current situation and status of midwives in Guyana (Scope of Practice)  Conduct assessment of the Midwives Association using MACAT adapted by International Confederation of Midwives (ICM)  Draft Scope of Practice for Midwives (2012)


RESULTS OF RAPID ASSESSMENT 11

 Scored 19 out of a possible 39  Strengths = 3 points

- Curriculum based on fitness for purpose, updates implemented and regularly reviewed - Realistic map of midwives known…. Efforts in place to meet needs … limited provision for midwifery practitioners to participate in CEP/ advanced education and/ or research development, management, policy, leadership programmes


Recomendations 12

 Improved teaching/learning resources (eg. Modern    

skills lab) Realistic student intake to facilitate clinical practice during midwifery training Enhanced infrastructure of schools Enactment of mandatory continuing education for re-registration of midwives. Local and overseas training for midwifery tutors with assistance from external agencies.


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THANK YOU 


Moms country profile guyana