MOMS COUNTRY PROFILE: GUYANA
Presenter: Maria Francois
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)
District hospitals (level 3) (urban and rural )
Regional hospitals(level 4) (rural and urban)
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
Comprehensive maternal and child health services ; Equipped for emergencies
EDUCATION /REGULATION/ASSOCIATION EDUCATION
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
Direct Entry (Single Trained) Midwife
Number of nurses/10000 population
Number of physicians/10,000 population
Number of OBGYN specialists
Vacancies exist for 155 midwives
All categories of midwife included
Nurse/midwives and RNs
Source â€“ Medical Board
SELECTED LIFE-SAVING SKILLS FOR MIDWIVES NOT DONE NO
Perform forceps or vacuum assisted delivery
Midwives are taught
Perform manual removal of placenta
Remove retained products of conception using Manual Vacuum Extraction (MVA)
in the midwifery school, but practical skills are limited.
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
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
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.