Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694834035301.pdf (Guyana)
MINISTRY OF HEALTH ANNUAl.1 REPORT 1994 TABLE OF CONTENTS l 1.0 EXECUTIVE SUMMARY ....................... .

2.0 MOH MISSION STATEMENT AND OBJECTIVES ........ .

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!MISSION STATEMENT ... .

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2 2 OBJECTIVES .

3 3 3.0 AND MANAGEMENT ......... ORGANIZATION 3.1 MINISTRY OF HEALTH ................................... 3.2 GAHEF .................... 3.3 PROPOSED MOH ORGANIZATION ........... AND MANAGEMENT AFTER -GAHEF AND THE MOH ARE FORMAil.

Y INTEGRATED INTO ONE .

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MINISTRY .


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6 4.0 SUMMARY AND REVIEW OF CURRENT 4.1 PUBLIC HOSPITAL GEORGETOWN .

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4.2 PUBLIC HOSPITAL GEORGETOWN: YEAR'S PROGRAMME .

IDB HEAL TH CARE II .

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PROJECT .

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4.3 PTOLEMY REID CHILDRENS' REHABILITATION 4.4 DISEASE CONTROL .

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.. 11 CENTRE .......... 14 17 .

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4.4.1 VECTOR CONTROL PROGRAMME.

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4.4.2 A1DS PROGRAMME........... 4.4.3 HANSEN'S 4.4.4 TUBERCULOSIS PROGRAMME .

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4.4.5 NATIONAL LABORATORY FOR INFECTIOUS DISEASE PROGRA�1E ... , , .

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25 DISEASES 28 .

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23 ....... 4.5 HEAL TH PLANNING .

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29 4.5.1 HEALTH PLANNING 4.5.2 HEALTHSTATISTICSUNIT.

UNIT.............. ............. 4.6 MATERNAL AND CHILD HEAL TH PROGRAMME .

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4.7 STANDARDS AND TECHNICAL SERVICES............ .

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.... 36 ...... 36 4.7.1 STANDARDS UNIT ................................ .......... 4.7.2 DENTAL SERVICES............... 4.

7.3NATIONAL BLOOD TRANSFUSION SERVICE 4.7.4 X-RAY SERVICES .. .

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4.7.5 PHYSIOTHERAPY SERVICES............. 4.


7.6 DRUG PROCUREMENT AND DISTRIBUTION .

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.. 4.8 CENTRAL BOARD OF HEALTH .

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4.9 ENVIRONMENTAL HEALTH UNIT 4.IO NUTRITION AND FOOD POLICY .

4.11 VETERINARY PUBLIC HEALTH.. 4.12 HEALTH EDUCATION.... .

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4.13 FOOD AND DRUGS DEPARTMENT .

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55 56 5.0 REVIEW OF SPECIAL INITIATIVES ....... .... ................ .
5.1 HEALTH PLAN ....... ...................... ....... .

5.2 DISSOLUTION OF GAHEF AND A NEW ORGANIZATIONAL STRUCTURE FOR THE MrNISTRY OF HEALTH ......... .

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5.3 MEDICAL TERMINATION OF PREGNANCY BILL .......... .

5.4 PLANS FOR HEAL TH CARE III ................. 5.5 HEAL TH LEGISLATION ................. 5.6 COMMUNITY PARTICIPATION 5.7 INFRASTRUCTURAL WORK .......... 5.8 TRAINING ......... ................ 5.

9 STRATEGIC PLAN FOR NEW AMSTERDAM REGIONAL HOSPIT..\L .
5 IO MEDICAL CARE IN THE INTERIOR ................... .

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5 8 58 59 59 60 60 60 6 0 60 61 61 6.0 APPENDICES .................................. ........... .

6.I BUDGETED AND ACTUAL RECURRENT EXPENDITURE 6.2 BUDGETED AND ACTUAL CAPITAL EXPENDITURE ....... .
61 61 61 1.0 EXECUTIVE SUMMARY The Annual Report of the Ministry of Health, 1994 reflects the process of change that has taken place at the fundamental This change which now reflect into the following occurred.

Objective, divided GAHEF; report w hich describes budget information.

broad issues sections: activities of the year's activities rather Organization level of the Mission Statement and than specific disease conditions.
is TIie report of Health and and Man�ent of the Ministry for the major program.mes and services; but were not included which were undertaken in the programme; and special initiatives During 1994, the Ministry process was facilitated reorganization from which a new organizational proposed Control, Development, Health Education be managed tl'irough six divisions, that the Ministry programmes should Primary Health Care, Secondary and Tertiary Care, Planning and Human Resource namely-Disease and Promotion, and Special Services.
of Health focused by the completion on reorganization afthe draft of and restruclllring.

the National Health Plan the depai;tments from GAHEF.

It has been chart that includes This Infrastructural on improvement wards and works continued, of the water supply system.

at the Georgetown Overhead have begun to receive an adequate �ply of water.

Hospital, emphasis tanks were provided departments was also placed all and as a result, Reduction areas.
network of infant and maternal mortality However, to be a priority the Maternal and Child Health Department Community also conducted to better provide project €or the introducti Health Workers continued a pilot of many of the maternal and child on of a Home-Based mortality.

This card which has been proven to be useful in reducing maternal and assists her in monitoring her health during pregnancy as well as during by training programme delivery care.
The MCH Department Maternal Records, is kept by the mother period.

her interpregnancy strengthened their A national Oral Health Department Palmolive of Dental Ltd, Guyana Dental Services.

programme This programme Association for primary school children was a collaborative was launched effort with Colgate­ Dental Association.

and American by the /\ national enhance and prosthetic appliance workshop programme and was completed.
This facility for persons and support improve service orthotic would greatly needing prothesis.

the rehabilitation Common themes staff shortages in these programme/service reports w hich are worth highlighting are severe programme autonomy, problem in receiving delays activities in a timely and the need in some cases of clarification and efficient fashion, recommendations of authority.
oflines which causes problems for more administrative in carrying out financial The most serious There are high vacancy rates in some areas (over to staff shortages.

is in relation releases 50% ), and inadequate the number of positions on the establishment in most of the technical areas.

Attempts have provell!

futile .

on the establishment numbers to increase Though there i acknowledged that health great personal sacrifice.

critical if the !99S-2000.


Ministry s room for improvement It is to be hoped that this trend r#.

dedication in the actmties of MOH and GAHEF.

It must be and at into 1995.

This is difficult continues under extremely circumstances workers have functioned of Health is to achieve the goals described in the National Health Plan 2 2.0 MOH MISSION STATEMENT AND OBJECTIVES 2.1 MISSION STATEMENT "Our Mission is to improve the physical, mental and social health status of all Guyanese" 2.2 OBJECTIVES 2.2.
1 Strengthen and Expand Primary Health Care 2.2.2 Improve Secondary Care 2.2.3 Improve Tertiary Care at Georgetown Public Hospital 2.2.3 Strengthen the General Management oftbe Health Sector J 3.0 ORGANIZATION AND MANAGEMENT 3.1 Ministry of Health of Health operated within the organiz.ational During 1993, the Ministry into three major sections, by the Minister of Health, Ms. Gail Teixeira.

who is the Chief shown structural to Minister is Ministry.
The Ministry is These the heads of which report to the Pennanent Secretary.

at Figure and was headed the Permanent Secretary, organised are: (a) The Chief Medical Officer, who is responsible for the supervision and coordination health service delivery.

by a Director.

headed (!)

The Department There are five major divisions that carry out this task, ea Diseases, which is responsible of Communicable Officer of the Reporting ch of which is Executive of for the Tuberculosis.
Control and AIDS programmes; Vector Hansen's Disease, (ii)Regional delivery service Environmental Health in the Regions, Health Unit; Services, which is respotlSl"ble for the technical supervision of health the Maternal and Child Health programme, and the Central (iii)Standards and Technical Services -responsible for the establishment, implementat ion.

and enforcement monitoring technical Service.

programme; services The department of standards i.e.
X-Ray, Pharmacy, Laboratories in both public and private health sectors, and for all and the National Blood Transfusion is also responsible for Physiotherapy and some aspects · of the Nursing Unit which is responsible programmes in building of the planning and management for the development and monitoring capacities, analysis, development and evaluation, for acting as a catalyst and for providing on health-related research, coordination analysis and related for extemal ly�funded projects and technical Unit also reports to this The Statistics advice on development.
(iv)The Planning National Health Plan, for assisting for undertaking health policy centre ofinformation resource assistance, Department, at this facility, and planning; and for human resource allocation, for providing given the who reports on the technical and financial aspects which serves as the national referral and teaching hospital; of health key role of data in care pro\ision and use of health that sen ices (v)Epidemiology Unit which is responsibl e for the generation, analysis dengue alert).
in Guyana is understood and monitored so changes (e.g.

a Cholera data so that the health situation could respond appropriately out-break; a The Chief Medical Officer also has responsil>ility the Guyana Medical Council, Board of Health, The Principal training, General B) The Chief Executive C) The non-health Supplies.
Officer of the Public programme departments certification, Nursing directly and reports Nursing Council the Central Officer who is responsible the nursing standards, transfers of staff and staff promotions, to the CMO.

Board.

and the Pharmacy and Poisons e.g.

The PNO also heads the for all aspects of profession Georgetown Hospital; i.e.
Finance, Personnel, and Administration for three important regulatory b oards/councils: 4 The organizational chart of the Ministry of Health is at Figure I. MOH Organisational Structure Minister Permanent Secretery PHG Others ,--�, Dir Stds/Teeb D1r Planning Comm Dis Statistics I Amain j Personnel I suppoct.
:-TB MCH -Pharmacy !-·Hansen' s I-Environment 1-Dental -vector Control 1 I -Nursing LAids -Laboratories -Phy:, iothe rapy Blood Transfusion 5 3.2GAHEF The organization chart for GAHEF is shown on page 8 md illustrates the functions for which this agency held responsibility different divisions.

among the in 1994.
among the in 1994.

It also shows the reporting relationships During 1994, the agency was in the process of being dissdved an d its functions reintegrated into the MOH, and in the absence reported to the Minister of Health.

94.However, since GAHEF was never audited in is rectify this situation.
office was called ofGAHEF was tabled in Parliament in April, since its o.eeption in 1988, the auditor General's of an Executive Director, the heads of the five major divisions This was not completed The disolution in 1994.

The five major divisions Health;(c) Administr within GAHEF are(a) Health Sciaices Education;(b) Environmental ation;(d) Veterinary Public Health amt (e) Food Policy and Nutrition .
3.3 PROPOSED MOH ORGANIZATION AND MANAGEMENT AFTER GAHEF AND THE MOH ARE FORMALLY INTEGRATED INTO ONE MINISTRY of the MOH and GAHEF continued in 1994.

At a retreat held in Progress towards the integration October, a proposed new organizational structure -which incorporates the functions of both into one organizational and management structure -was developed by senior staff agencies as it currently S1an ds, is shown in the chart on the representing page.

This shows that some important changes iii.


organization and management are following recommended.

both agencies.

The proposal, Six major divisions • • • AIDS/SIDs, Port Health These are: Dental Services, Control, for Maternal and Child s, Chest Diseases for Epidemiology, Public Health and Chrome Diseases; and Environmental Health; and in the proposal.
this division is to be respC11Sible (the TB programme), Vector are included Disease Control: Statistic Health, Veterinary Primary Health Care: this division is to be responsible Health, Food and Nutrition, for the supervision three levels of care that deliver Secondary and Tertiary Care: this divisiOR is to oversee the provision of secondary national development, public key involvement addition, radiology, with the Private Hospitals will be responsible pharmacy and blood transfusion Hospital for the across of standards ex care -and in so doing will have a Board (see chart).
In Inspectorate services i.e.

laboratory, of health posts, health caitres and district hospitals i.e.

the primary heail'I care services; and private sectors to ensure quality (regional referral monitoring aJld enforcement implementation, (ie.

Georgetown Public and tertiary the Division for technical hospital) hospitals) services; -the health services.
It is also to take responsibility 6 • • • bilities ohhis preparation, coordination and Human Resource Developmeni: this division is to assume responsibility planning services of the National Health Plan 1995-2000).
of health (in particular t� monitoring of the Key responsi therefore Planning for the overall implementation division and implementation, Health Education appropriate and medical Special Services: the remit of the divisions They include substance injuries, with the National Committee focus to health promotion programme activities this division physiotherapy, abuse rehabilitation, and social work.
The Director occupational include planning, economic and Human Resources and Health Promotion: ll!llllysis, Development; tmis division tile Ministry, within project give sufficient e mphasis to educational is to ensure tha1 key health services for giving is to be responsible and for ensuring that all health activities: that do not fall within described above are given sufficient attention therapy, speech pathology, the MOH.

mental health.
mental health.

within occupational health and safety, violence.,.i1ccidents and of this di,�sion will also be responsible for liaising for Rehabilitation.

Provision Chief Medical has also been made for Health Disaster Planning, with a C ommittee reporting to the Officer Furthermore, the position ofDeputy Permanent Secretary is proposed.
into one coherent structure organizational The proposed functions that one of the key aims of this structure the National Health Care is designed strengthening Plan 1995-2000.

For example, the creation of a Dh�sion to ensure proper emphasis and c oordination of primary health of Primary Health -the care services of Primary Health Care is a key MOH oiljective over the plan period therefore the functions organizational and management structure.
is to respond to the priorities of the two agency's It is worth stressing.

and objectives integrates defined in too.

the staffing, *** For detailv of facilitylpmgrnmme/Bt>ardldepanment <,'.4H£F, please refer uctions of li1rre11t and ol,jectives of each slwwn in the organir,ational chapter: in tl1efollt>wing Year's .

..Jctfrities".

respon.dbilities to the relei•ant charts.for tke 1\IOH "Summary• t111d Rei·iew am/ 7 Figu!'f!!
2 • Organizalional Chai of GAHEF CURRENT ORGANISATIONAL ARRANGEMENTS AT GAHEF XECUTIVE CHAIRMAN Food Policy Enwottment Director Environ ment Division or Healltl\ Edocaticn leaming �ealtll M:tter ials Unit 8 4.0 SUMMARY AND RE\.lE\V OF CURRENT YEAR'S PROGRAMME 4.1 PUBLIC HOSPITAL GEORGETOWN 4.

I. I Mission Statement quality To provide hospital.
objectives medical, in an acceptable, and attainable target5.." nursing and other appropriate agreeable, efficient and effective care to all persons referred to this manner by the use of optimal 4.

!.2 Main duties/responsibilities Hospital's main fu.

'lCtion in the health delivery system Georgetown tertiary health services tend care services that district and regional hospitals to be relatively and high-cost.

low-volume is to provide are not equipped specialized to provide These 4.
1.3 Staffing Level Medical Staff jl) '" H•-;lman· 4.1.4 Main Funding Sources Georgeto ,n Pul,lic Hospital is funded by the Ministry of Health.

9 � 1 Objectives 4,1.5 /Summa1:y of Main Activities and Ia.t1ets (if set).

{if Objectives and Analysis and Targets not seO Success or Failure OI �:tivt,f>1 !mpnwit tl\t •awt} "' ..-.11ttm au ill wt 11,:.iplllll the Wants and Dq,artm,mlJI ·r;inei: .1.�"''H \'u l:\'-!)n''cl!

l!u, nw� :ill.I IMNr.

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!>:pnwe 1l1t pr�,ctu&IIJ � Wi!rd Mat,!,< Af)U l'l'fl- ;1,td 11t1ef>dam:e Pwt1a11r.

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.\.ulJ,6H�·hllln- nm-�i--111U11MOtl�W�· nrallilui,...--.::mrdtcal"'1h'rlM\t.&.

m.p._..d ( .. -;a new piw:aba\!

toaU'lll.�>T wit.)

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"Jlwfft..W .. ... Olll ..... adt.lte-pipf��'-lllld lhJ._��•uab.11,!,;,!

'f)iV�tlllhe -T!u,}1.#.too .. �lt' adep!p('ftait )' t)�'!1:l'!:!l•l'!:S.r<:"W!cl'.!'!

maJ 11/'ttw, 'llc'lft ffi!pN!,� lhl'IT flUl'IXfllllhty """"""''···- r.. ,.... .. �1,1 ...... ,,..,i...U� ,.,.

;=,f..l ;,,llfl Sid ;.·n:vi.a � -"""Mr?

4.1.6 Workshops/Conferences/Trainin: Courses Hdd or Attended Workshops Held: • An inaugural Guyana's Medical October.
School • A workshop of Health course on "Medicine School, the in the Tropics", sponsored by the University and PAHO, was held of in About 40 people MOH, the US Embassy d, including attende Bethesda physicians Puerto Rico; Detachment, Sciences, from the US Naval for Nurses on "Inter-personal Relationshi ps and Supervisory Management" conducted Mr. Chetram Singh (IDB Hospital Administration November.
by Dr. Fred Nunes (PAHO Management was held in Consultant) and Advisor} Workshops Attended: • The Hospital Administrator structure organizational a two-day for the MOH in October.

attended Workshop to discuss a revised Training Courses Attended: members Ontario, of staff benefited These included Canada.

• Several London, one senior Techniques), Midwife (Anaesthetic and one Senior Biomedical Technician training.
(Central Nurse (Accident department one Senior Nursing), Sister from training at St Joseph's Hospital the Matron (Nursing Administ in ration), Sterilization), one Ward Sister Staff Nursing, one Critical and Emergency one Staff Nurse (Intensive Care Nursing}.

(Theatre (Biomedical Technician's on-the-job 4.1.7 Major Successes/Achievements The major success of 1994 was providing water throughout the hospital.
10 4.1.8 Mai or Problems Fattd and Suggestions for Problem Resolution The major problems below: • faced during 1994. together with suggestions for their resolution.

are listed the situation to the hospital.

because the hospital is kitchen and the space that has been allocated to the Wards by the Ward Maids is not.

However.
a major problem building, and quality of in the is expected to improve and its during 1994 a She is current!y to working on the presentation The of the food from the but the distribution from GAHEF was transferred the matter, in addition completion of the new kitchen will help to resolve many of the problems currently being dietary services remains Service staff is inappropriate and inconvenient Delivering at the National Guard still to the kitthen and kitchen transportztion of meals is satisfactory, Nurses Hostel Nutritiolist investigating food provided.
Given this assistance, coming year.· 1n addition, commissioning, experieJJCed with Dietary Servic�; Transportatio continue to be problems it extremely difficult workers.

The institution done) and Porters will help to alleviate some of the difficulties these caiegories of staff.

There will be an attempt to institute bi-monlll!ly, rather to.

lifting, respect improve patient care.

staffi'shortages Professiooal Late delirery supplies-acot than only twice a year.
In-service transporting n of patients by porters, and the general work of Portering staff, of major concern.

The low salaries paid to porters makes and dedicated honest, conscientious being system" for Ward Maids (currently with experienced this reward system for porters with to attract reliable, of a "reward and communicating indisciplines.

with patients should also in the hospital.

absenteeisum salaries, ability.


training • • o 4.2 PUBLIC HOSPITAL GEORGETOWN: IDB HEALTH CARE II PROJECT 4.2. l Mission Statemeat "To imprnve the delivery of Health Care at the Public Hospital Georgetown".

4.2.2 Main duties/resPfOsibjjjties The main dutieslresponsihilities Bringing Department, Throat and Medical Upgrading the facilities Obstetrics -into one location; of the Project are: Medical Ophthalmology, seven clinics - • 0 Outpatients Depanment.

Surgical Outpatients and Gynaecology, Skin.


Ear Nose and offered in the Operating Rooms.
Recovery Room and 11 Intensive Care Unit; facilities; • Automating the laboratory o Improving the X-Ray facilities; • Improving the receipt and delivery • Introducing Central Sterile tion; and post-infec infection Supply of pharmaceuticals Department to reduce and medical supplies; considerably cross­ the anesthesia facilities through centralised medical gases supply • Improving system; • Improving • Improving offered the facilities in the Kitchen, Laundry, the facilities and Emergency Boiler Departmem: and improving the by the Accident House.
stand-by generators; • fmproving • fntroducing • Improving the telephone two Simplex the water supply, system; system Bed1ifts; drainage and sewerage systems.

4.2.3 Staffing Level l'osi1i<:;n .-\.

!lflirustr'IJ..-,,l!<)!lke:­ L�lll.lWS�·r.,1.11'.

Sl;,ri,qj,:al Amil\<( <;tm,!I ,\,,,,uw� c"",k JillU,.>r A1.._,,,u11�,:·k,tk ,.

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4.2.4 Main Funding Sources Development Bank (IDB) 0$ 800 000 000 Inter-American Government 0$ 975 000 000 Total: of Guyana: G$ 175 000 000 Total Project Funding 1989-95 US$ 3.1 Million Total= US$ 31 Million = USS 27.9 Million from Government from IDB+ ofGuyana 12 4.2.5 Ohiectives /Summ:11v and Targets of Main Activities (if sell.

and Analysis (if O!Jiectives and Targets of Success not setl or Fail ore (>h .-.

:th'<', I are("!

r mal.tse ii1J D,xumem AJvemsemc111.


b-1u11n11er,1 i,,, �ledu:al les ai,J Funmuie .mJ to1 Plmrm...:ew.,.

:al dial Au,.-J h·,�nau,,n LA»hl!sh Lc11ers ,,J , 1,,r .\1e<ll, ·re,l!t ·,d h1•upmc111 :,,,,a.JI L.umdf'' I nm11mem and \cceswne< llltl ,k);I\' n<>11-pNU><111� in ,,a_...,.

,,t'Pt.-..i he\,,ndJune ,,/'J,.-...:wnelllilll.m 19'J� d1uu1)!

De,:cmber l'JW 1,,r supply ,1:ud !-'lul,,e '.


'<icm ,, si�n, »lie, rb<" �<ILUl>Ttlcm "''""'"' mst.ill.l!l<'tl ,mu <'c>!T>111e11>:cnieu1 ,,f ,,..,,rk ;\ITl,·es ,,11 ihe 11t'il"1ldl.1,m ,,f,ht ot Medv.

:al Oa.n \!eJ,:11n's inaaill) ... ,e111,.1tilt aulari.ls 1,, <'<'11111*'1� 11i-<>lih11011 m a.:rnrda!u:e \\tth i.JIC .J!>pr.-i C,•<1a Li; IUH ,;,.
...-·:ird ,>I c,>Nr"'-1 h> ;'><.we< 1),1 4.2.6 \Vorkshops/Conferences/Trailling Courses Held or Attended Workslwps attended: • Disbursement Execution Unit; • Disbursement Execution Unit; • Procurement, procedures, May l 994.

Attended by 4 members of Project procedures.

June 1994.

Attended by 4 members of Project November l 994.

Attended by three members of Project Execution Unit; • Bamako Initiati • Etiquette.

• Etiquette.

ve, June l 994.

Attended July 1994.

Attended by 2 members l 994.


Attended October by 2 members of Project of Project Execution Unit: Execution Unit.
by Project Manager: Training Courses attended: • the Administrative course Officer attended a training in Strategic Planning at the Guyana Management Institute: • the Executive Secretary/ Secretary Administrarirve Accountant • the Senior attended a course Assistant" at the Guyana Management on "Functioning as an Executive Institute: an Accounting attended a course on "Managing at the Guyana Management Department" "' the Assistant Project Management" organised the Project experience centre.
,isited Manager of the in the corrnnissioning attended by the Caribbean Manager Institute: Mount Hope Hospital in Trinidad to new Ambulatory/Diagnos draw on their Care tic/Surgical a course on "Project Bank: Development and Implementation lJ 4.2.
7 Major Successes/Achievements and Furniture, and the award the of • • of 1994 were: of the Bid Document for Medical Equipment of Bids for Medical Equipment and Furniture, Equipment mi Furniture; of a system to register The major successes/achievements Finalisation evaluation contracts for Medical Finalisation commissioner would be ensured; Finalisation Ambulatory/Diagnostic/Surgical 43 bed ward.
and an enlarged ICU/CCU; Keeping the project listed three items the ori�I financial limits Care centre to include in the internal design of the new in the previous so that the quality of changes bulet point.
within ticals supplied of pharmaceu • • pmrmaceuticals with the Food and Drug Accident and Emergency, a despite· the inclusion of the by .mccessful bidders 4,2.8 Major Problems Faced and Suggestio ns for Problem Resolution faced over the year involved inadequate collaboration with 11he Consultant The major problems Architect, Medical Project to ensure occupancy Supplies, the availability of professionals Gases, and Boilers, Medical of trained the availability and operation.
at the hospital to advise on Medical Equipment, and the absence of training personnd when the new Centre is awaiable for opponunities in the Problems could be resolved included signed agreements under agreements.
contracted if contracts attachments better addressed the needs of the Client, and if for local iroressionals to international professionals 4.3 PTOLEMY REID CHILDRENS' REHABILITATION CENTRE 4.3.1 Mission Statement "To provide rehabiliatitive a national care so as to facilitate their integratim into the wider society".
service for all children in Guyana who are in need oflongterm physical 4.3.2 f\.�ain dutiesfresponsibilities are: of the Centre The main duties • • • Providing a a range Providing dormitory, dining, Urging parents the Centre range of rehabilitative of social services schooling and relations from its prcmsion and to benefit and recreation; of children to be more involved of counselling and edllcation; S(!Vices in response fur those clients to the needs of the clientele: - ar the Centre who reside in the functioning of 14 • Strengthening • Making provision disabled the financial well-being sector; of the government for the supply clients.
outside of the Centre by seeking to attract resources of orthotic/prosthetic appliances to physically 4,3,3 Staffing Level II l'w,,,1(111 )� • ., 4.3A Main Funding Sources The main funding Sector Communitv's the Poor.

Futures sources for the Centre Programme for Health Fund.

user charges, and donations from local contributors and Education, PAHO/WHO, Food for SIMAP/IDB.

Lions.

e.g.

Rotary, are the MOH, the Government of Guyana/European 4.3.5 Objectives /Summary and Targets of Main Activities (if set).
and Analysis (if Objectives of Success and Targets not setl or Failure '.

!,m,;\l!u »11·,>&1.

:r;, IW!Cf, ,1.ulv ·hemn, ,,,1 1.1 i!H1,11,..,� ..

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t'ell !u .µ Tht m.ID>W ,,1 Sl<AAIOllli hdd m,.�frmn"\15.11 !

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'tl ,w;1 quanuiy ,,r �'!C2 uu;wo,a.:.

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W II� �h� ��co �">ph>Vtd.

,,1 ,,,n,r ,:':�m�"' f"'', 15 4.3.6 \Vorkshops/Conferences/Trainjng Courses Held or Attended Workshops Attended: • Development of National • 9-day workshop for trainers community.

Attended: Conferences • Leonard Cheshire Director of the Centre; • I. L 0.

Conference with disabilites of the Centre Courses Attended: .
• 2 Nurse Aides are pursuing • 2 Nurse Aides attended Training Policies on Disability; on the rehabilit ation of persons with disabilities in the Fourth Foundation World Week and Conferen ce, attended by on the equalization of opportunities in employmem for persons and the develop ment of National Policy, attended by the Director the training programme for Nursing Assistants: courses at the LA.CE.

for training of the elderly and persons with disabilities.

4.3.
4.3.

7 Major Successes/Achievements Major Successes of 1994 included: • Completion workshop; • Integration of a fully operational national orthotic and prosthetic appliance of young adults and Computer schools.
Electronics assistant in the orthopaedic workshop; in regular schooling at Burrowes School of Art and commenced w ork as a workshop One student • A retired sister consequence there is still and as a has been employed to supervise the mirsing service there has been a great improvement in the services offered room for improvement).
(though 4,3.8 Major Problems Faced and Su1gestions for Problem Resolution Major problems faced over the year were: • Towards the end of the year two senior the facility • The lack of supervisors without continues America.

leaving leadership; migrated orthopaedic technicians to North to plague the nursing area.
This is an on-going problem which has not been solved the recruitment of a retired thtre is still • the quality a need for supervisors of the afternoon of services senior departmental sister to supervise and night shifts; unit has suffered by the physiotherapy offered yet.

There has been some improvement since there is the area.

but with only one full-time thrice-we ekly for 3 hours.
physiotherapy assistant and one physiotherapist who visits One solution the required those already centre, to staff shortages nal background educatio In spite in the system.

to leave because continue professionals and interest, of the overall is increased remuneration.

persons with This will not only attract of the services at the conditions but would also help to retain improvem ent in working of poor salaries .
16 4.4 DISEASE CONTROL 4.4.1 VECTOR CONTROL 4.4.1.1 Mission Statement ''To ensure the effective borne diseases and efficient Guvana" throughout monitoring, prevention.

treatment and control ofVector­ 4.4.1.2 M ain duties/res ponsibilities the VCS is the MO H's main arm for diagnosis and treatment of interfaces basis with the on a collaborative of the Vector Control Service are: and treatment at three points Control: in Guyana.
The unit presently Health Care system; • • The main responsibilities 'vlalaria malaria Primary Filaria diagnosis Hospital, implemented) Aedes aegypti Georgetown Amsterdam (these ocean-going Dengue surveillance: Laboratory five health (the vector diagnosis • • • ships and vessels); New Amsterdam Regional Hospital, centres along the coast; which transmits of Jeishmaniasis.
last two involving the detection and at the waterfronts of Port Georgetown in Guyana: and (currently Georgetown in process Public of being in urban yellow fever) surveillance and Port New Springlands of imported mosquito larvae in 4.4.1.3 Staffing Level ._.,........

nf \.,.·�u,-;.,,,, I�@"!

"'��·::::" ==============i:t,)========jjj '.

;========I I�� n fOL\1 " " 4.4. t .4 Majn funding Sources MOH G$ 12 845 217 EEC/GOG Sector Programme Guyana Geology a PAHO/WHO.
G$ 3 360 000 SIMAP GS I 400 GS 25 917 500 nd Mines Commission: G$ l 500 000 17 MOH Financial Breakdown By Ge ographical Location !Aeatl(ln R-�·,·n 1 Rmi,'},,; k.�11;.,n � R�mon .

Rrit.101111 lhl!JIY<!<> f<el'J,Jf' '" 11Krter� C'>!'

'h,tal By MOH Sub-Head .u,u A»,.-..-an,"eS !.•b-H""ti :Vmn.sLllcit'llm!.u!N ormt,vw h-.

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4.4.

I.5 Objectives /Summary of Main Activities (if Objectives and Ta�ts not setl and Targets (ifset), and Analysis of Success or Failure <fu'i'C!h'"' fari!t'i i;,.

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...., 1.Qf,1ow,,ut,·ffit!l?1""JIMl•IMIM,.i�-•.,• l'lu:V,-s ,�N wlifRJilla�vll,,,'!Wt'I �uthffl Allpejl: '®,)I th1:11 n.'du!itflw ..... Mii l'r<'m 0,1CC1K <'11 liit 11;1:ti»l _i.,utt 1>11!
:tll,;:,IO"n ,·1 rt<IIM 1-f.,,..,e�= Aside.from prt>grammes: ahm,e, it is also implJrtant and fl/aria.

t1gypti, tlte in.formation malaria.

aede.� to report ,m actil'itie.� relate,/ to spedjic Mnlnria Figure !

shows the number of malaria cases detected severe in Regions I, 8, 9 cases detected, Figure 2 illustrates and 7.

P. Falciparum is the dominant type of malaria being detected.

by Region.

This shows that malaria is roost Of that there was a high percentage of failed treatments.
A variety primaquine chloroquine of drugs are currently (7 5 mg) and fansidar.

and pri maquine (15mg).

used in treatment: The most commonly chloroquine, quinine, primaquine ( 15 mg).

inscribed (see Figure 3) are quinine.

Aedes Agypti The table below summarize comparison with 199 3. s activities related to the control of aedes agypti, including a •,,,1f!.>,!
!«1'1f>,,1•u1n '·"' H,•-!reuc,; Al"IMW r,11,,,1,·s..�!1'-tW ",11111(,t, .-1 ae...l!, ':•·ir o,mr /h�l>IIH �,\l•UHC th�l�h,<1<>111.•1:<l H,,u...,,.1;,,,1ml'e lh�l>'f,.

; '>H1 i ;Mftd (·,•m.1111'°"'H"1*1<l'<l •\>Nhuncn<l'-"'l"W • 4 l '<'i1ht1Urf4 1•,,,,mv,; V.•11!

:vt\fr< fn,ll!t,( hi,E(Ji,.1Je u�orl M.lh lhl"" ,\V!/f.W.tt "" ,_ ' "-:ttl(be>:INlllllffl :.i::.

:t, n�1 '"'" ll�'Z).!

: l.� l.ll"io Zill '!

!� .... T.u:1i.mA'11n� .... ,,...- �� ,,� i\hrf� "'J•l)I\ ,., J .... h•!
4 6:'16 Lnfn�,u, ...... , ;774?

"ll!ll ,.., .... _.., •" �!!

� ·''' Figure 4 also shows the number of maritime inspections carried out in Demerara, and Springlands with New Amsterdam for 1993 and 1994.

Amsterdam New The programme requires is to be al.'.i:ieved.

being confined The progra to Georgetown.

special analysis and review, if real success in the control of aedes aegypti mme also needs to become a truly national programme.
rather than 19 Laboratory Work ,tTm T<>WGY Eli WBC Dii-"' ""' �VUICtllll'II -:::- \4'1'<%"11 1� 11.!0CHEMlli'!

'R)' !dMt l«aUVl lm.murm.tl,1,.,,._'ttln Ml!Jan& I Oftll�'ffi>.e ifltl:UU111llU!!

tll()CJf:eM!,:rn,c.\' N-MofTntlldt.e iH " " " ' ' ' ·' ,_ �CAA!

"£> ---·· .. .,_ PA1t.Ul1'0LWY -for.-� l "" I < l'nM�oo �t\Kl&)'M'l1Pk1-4,:;n, wr�1• " " " ..

I - - I ... , w.., .. .__ .I .. • ,_ ,.


4,4.l.6 Workshops/Conferences/Trnining Courses Held or Attended Worksh(}ps attended: • • MOH retreat, list not readily October available (attended by Head VCS); for other workshops.
Training by I person); Work Review (attended for Trainers (attended by 2 people); Management Ctmrses attended: Effective Training Procurement and Stores Managing Financial Counselling Skills Principles of Epidemiology Action-Centred Supervision See above Objectives/Targets Meetings Management for Supervisors ( attended • • • • • • • • • by 2 senior staff); for Non-accounting (attended Supervisors by I person); Applications and its Practical ( attended by I person); table for internal training courses held.
(attended by I person); (attended by I person); (attended by Head VCS); 4.4,1,7 Major Problems Faced and Suggestions for Problem Resolution The major problems faced in 1994, and suggestions for problem resolution, are listed below: to plan ac1ivities properly.

for some years.
for some years.

It could be resolved the budget for 1994 was not known, so it was difficult This has been a problem was informed soon after the budget debate will permit readjustment delays subvention: solution of daily undue delays in the execution of the EC project caused serious disruption of the Plan of Action for the year in progress: of funds from the MOH.

Again, this problem is not new.


One to this problem would b e the provision of a financial in release if the pro1:,'famme what budget has been allocated.

This • • • 20 Headquarters.

1l1is was a new, and temporary, nt of staff to posilions or promotions.

This problem has been staff This is an old problem but it is getting a salaries and benefits ,eview is proposed.

also need to be improved.

In addition, faced in recruiting worse.


and retaining this To sot.·e s fur upward Opportunitie in general working improvements appropriately in the Georgetown of years; difficulties activities problem, Slow appointme present for a number There are tremendous qualified problem, mobility would help; conditions in establishment Difficulty there are linkages: relationships would improve .

Resistance to integration and the development the situation.
·• • • • and maintenance of inter-programme and inter-sectoral too many grey lines.

In this case, a review of present of responsibility and authority of clear lines 4.4.2 AIDS PROGRAMME 4.4.2.
I Mission Statement "To coordinate transmission disease" level at the National the AIDS control activities in an effort to prevent with the associated y and mortality of HIV infectio n and decrease the morbidit 4.4.2.2 Main duties/responsibilities The main responsibilities • establishing of the AIDS programme are: the National and supporting Aids Committee., which is an advisory • planning body to the Aids Secretariat; and coordinating knowledge and improving and counselling information/edu on STDsand STD and HIV/AIDS and treatment of clients: HIV/AIDS; which provide • monitoring services • conducting providing sero-prevalence surveys among specific for more constructive planning.
groups information services including diagnostic in keeping with cation/comm unication programmes -{.4.2.3 Staffing Level 21 4.4.2.4 Main Funding Sources The programme's main funding sources are P '� AHO/WHO and the Ministry of Health.

4.4.2.5 (if set), and Analysis Objectives and Targets Objectives /Summary of Main Activities (if and Targets nof set) of Success or Failure Ohiecth·e1T:1t"2et Establish }-;atiomil AIDS Cnmn'U.ttce Tan!

!et ,\chie\.'ec:I'!
!et ,\chie\.'ec:I'!

Yes rcag:cnts for Laboratoty diagnosis nfSTDs 70% Procure and III\' f'ouduct �_',mptomatic ofSTDs (ktectiou in-sel'\·ice training for hcalth wnrk,:rs in 80'% cducation in school,; in 50% aod East Bank Demeran supplies Conduct STD lll\'IAIDS Gconzeto\\'n Eosur..: a.d,;quat,: clinic clioic R�'ita cononittccs al Georgt:IDWll Public Hor.pital f fosniial al N.:w Amsterdam AIDS Regional lisc non-functiDoing qd ta the (1f condoms tn the GlIM: 80"'o 0°,0 l)iss,:minat.
: l.:2a.\ 11ad other associations a draft policy document to ID<:di.

:,l Yes for their s11 ,..,.istions Broad-baled Aaallnis .rs.ccr.

or F.UUN' Dlood-bued � bmi:d a .hae 1994. n.. Comnrinec's IDBI de is • alh.isory ODC.

aad tbi: lq,:r conuniuc.= is dMlkd upialo im smallercommiaoes: lnformatioo.. � primarily� (b) Fund Ra-.-� &nitsingmooey for tit.

: ,UDS • a comminc.

: KIi" cda:a1dli1wan:a::ss niml!

act[\.iriet;: C�ioa (a) prugnnme:: 0 l.cpi m Elhical • n::spoDSIDh: for kri:Ul!
at policies ml � rdaling ID HIV/AIDS; (d) Can: md .Support.

�for lilnl,:gies couU le impbn:nted for palicu&&.

commitiees uc_,, fim;tioning Ihm: a .a -=cl to develop refen:uce for these comminces.

specific 2llidelilaitenm of The tiilure en .dicve JOO'.

- due 10 shipment det.ys lootiag II �in which support So far chc i.ub- Workshops WCIC� hi:ld.

for uhfl pen;ounel from Regions -1.

6.

7 8. aod IO.. Ttaiaiagwas aotUle in the otkrtegions due to lack nffmd'ts With the limited amber of AIDS .
:ducalors chis 1M co111d DOI be c;uried nur.

ia di' seeoadarv aod communitv hie:11 schools 100% �'as ool dticvcd � to dll�t dda� of lie --titnctUJIUD!

rommine,,.-s � not doo.

: Revitallllation bei;a.iss.

: nfuull/MU.bilily nfliJni: on m.l' progrunmc mauqa's part.

Howevcc.
Howevcc.

ili5 � lhat ll bst-1 ar .5 can b,: 1.:1.itallll� in 1995 A draft policy dDcmn:111 was dra..lic:d and is being n:-.�ed by, nrietv of omanimlORS ud iRdi\ida.als 4.4.2.6 Workshops/Conferences/Training Held or Attended Courses Workshops Held: workshop held for members of the National AIDS Committee.

• • AIDS Awareness attended by 20 persons; AIDS Awareness workshop were asked to disseminate information their commitment; held for journalists.

and they 25 people attended, through the media.


Some have fulfilled Workshops Attended: • Aids Management workshop held in Antigua in June 1994, attended by I person: Training • Courses Attended: "Planning groups".

and Implementation held in October Programmes attended by one member of the Programme.

of Educational in Israel, to Hard-to-Reach 12 4.4.2.

7 .Maior Successes/Achievements The main success Committee.
worth highlighting the Committee This will enable was the workshop held for members of the National better during 1995.

AIDS to tunction 4.4.2.8 Major Problems Faced and Sug:estions for Problem Resmution The major problems faced over the year were: • unavailability several of transportation caused education programmes to be deferred; • there were limited activities in various regions due to the fact that Regional AIDS committees were not functioning.
4.4.3 HANSEN'S DISEASE (LEPROSY) PROGRAMME 4.4.3.1 Mission Statement "To enhance and leprosy into the general health the effectiveness control by initiating leading eventually improve and leprosv and accelera1ing to eradication medical service the process of the disease" of the existing services.
patients in the treatment of ofleprosy comrol 4.4.3.2 :\lain duties/responsibilit ies The main responsibilities of the programme are all new cases before deformities develop: • Finding • Encouraging all patients • Maintaining an effective • Maintaining a care service • Educating to complv with standard and efficient treatment service: surveillance ; regimes; for ail needy leprosy and the community patients about the signs and symptoms providers ot health Disease: Hansen's • Conducting • Servicing • Preparing surveys; area/school 14 dermatological clinics budgets.
monthly; annual reports ILEP 13 Forms.

and work plans yearly 4.4.3.3 Staffing Level /*indirntes position funded bv donor ,igency) " :1 ;1 :1 4.4.3.4 Main Funding Sources I II The main fonding sources are the MOH and the Netherlands Leprosy Relief Association.

4.4.3.5 Objectives and Targets /Summary of Main Activities (if setl, and Analvsis ofSuruss and Targets not set) or Failure (if Objectives 11.>hl., w.unm11.

c'"i.rs,: rHedt<:111 "''•kn"< for lwdllh p;,Ns>nrn,!
• JI mrems, lll.UW,., AS htlll:lh pt'rs>.mneJ tc.

:tw11tl ,,1t&,illm,!ll!I m 111' d.mi• ie.uutt illld .W mini($....., , ·,mctm,t =�;;'J·; .l;c,t,;,m �,w,, r,, :he kH>t,"'1lfl!lm ,�,,iul�v 1lll lin*l!<.mmf::dJJu,smu .

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:rnn 11H;1,;n,,!

t,, d":dm,c, aw.I <H IW,1 jc,t,,,r.,11<11','lff:UIJ>p� !JW'lrtll � relll'llJdi.
prt,JC.,J wul1 i"h" H,1" w,>rli; 1n !he �ys:1em 1 •\l!<'lill!V ,n,,k !l<ftlthih lcduwt.i,ey -� 1n• hatui ttJ.

), W. tot �t·tn Af=ml illlatf( i.-,,� in ,'Iha roqllHed th.I ln<\tio,.1111-, J".LO� 1\# bft9 -...J <n'h a 11m l!llkd besau.i<e ,,fbtaltt �AA 11u:r J\.I� &'t.,'<'l li,,1ures.

AUln-""-'-'-Y bim"uHannrr,;Dt.__ ��tawri.ltd "ITIIIIUffl'llll �, <11111" be mad& b�-ety J\b Thu!llUlfi' N lht-11 t,; dr:,J,.,-rn, "ta.,� am!

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:or a:ll'!JIIOIIUI twn.
'nl'l.Urt\, l)tlt,et V'ISllt Cl> ma@,m -- The lm!t Thursdav ,,f t>t'tl'V ll'll'l'l!hu�11;> � �m:I'!«, aud 1here 1w: J,,,:,tn w,,..,._.. "fr..: .... 11� A lilt>c!WV!Y !e,;:hn,,� m 1epro,1y w.'ft �� Ii..: lll'lp.•rtam 111,t ll\tH: t>t �ll'l!Md:�--(- li"'fflC('flC l!<,;<>!liirfflc<lli<t!qlf�f"l'I- TiwOl-�M!ht J._ MB"" t>trntt'llall� w,;td In........, wpa'\"Mll'- l lept'"'j'"'l'"kfV1.1th-•lttl.t'fl.--......,.., .. -1q-­ �m 'ltllfuiwd� wnhm the, li<r,,ht-, s,.,;;tem M \1;11f1lai11 I• n.rlll Jctm;ir,.
;..�; j>Al'll'd� du,..:o for r,,,ru.., :s. rten11tt <>l \l.rum1m week!\ .

:</Ph&,>k�,.,ij i•e:tlrn<;'J,!,,,.,;�,,r�wv.,1 >t»u..-.

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:nl¢« !/:WC I" � l«•lnlin.

dtrJ,·s r,'Sl�l ,"!, <ht ..,-., hdJ 'lf.fl.11111/rlied lcVffYh<>-1n 1he;,e11\tmfN <Wl,l w;1<,'!.<:11N •:t.i,n,,i< "'<ff ;,,� ,,,,mm,w 1h¢ureq,t,..'tl<re ,b:irn.1�;,; m,>rm<'l!N ,., ,.,,..., :irt:.-,,rJ ,,,,.,,,.,iu:.:.

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T p,.ice:t.� w!w pl'IJf<'I� i.-,r i� .• ,,,wc "IH'"tllliu,,-� .-.,uo,,c,>fl\'>L ,11; •v-r l,.J«tm ,!1111 p41tmtt...lff w.u twl\1<!11,oJ m n•:...m :hct J.1- ..,h,.,scdA>,•,11Ult �Ll,Menan,� ,.\ ,,,.,;,,,n� ,,,,i,,a.t.l,:,,tp,U;t,,:c i>r<>!U-,1f �/Ire .nJ tdll'li:>llu.11 .. ,11 N� ,><'r,t11em�,m i;,,,.J ll.npt"' "'= 11.wc1< 1,, �·"" "� p,1ue"' ,·wt Wf/l't ma 1�,,,,� tire 1= D ruJ\·e i><'fflJ ru,,:1,;e fornl,n,, """"' *" """'1i "f , "hrn.

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: •1.

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,qt} fr,,,,, "'ffleJ •"II� f1l,11,laolt-""ll'!

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an,!

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)L•r::ut,"• 24 4 •.

J.3.6 \Vorkshops/Conference/Trni ning ro11aes Held or Attended Worhlwps Held: • one workshop was held in Januaiy, attended by 15 people.

4.4.3.
4.4.3.

7 Major Successes/Achievements The main success was a high incidence of Hansen's Disease.

of 1994 was the completion ofan area survey at Baracara.

an area where there -t-1.3.8 Major Problems Faced and Suggestions for Problem Resolution The major problems listed • below faced in 1994, together with suggestions for how they might be resolved.

are to work with - a two year old problem.

A new technologist for much of the yeaL However.

one was appoirned in computer.


which makes the work of the programme director much than is necessary.

The provision of a computer is Leprosy work is social work, and the vacancy needs to be filled there was no microscope e is needed: microscop no laboratory October: no working more time-consuming recommended; no social urgentlv dinic is in poor physical recommend approached -.

.

worker.

shape.
.

worker.

shape.

General ed: this will also help improve to fund such a project upgrading of the facilities SIMAP could be is staff morale.

4.4.-1 TUBERCULOSIS PROGRAMME :idd, I :VI ission "To ensure of all cases.

the ultimate and through Statement reduction improved in the incidence of tuberculosis identification the adequate through of all cases of tuberculosis".
treatment 4dd,2 Main dutjes/responsjbUities are: of the TB programme The main duties/res cases through ponsibilities from all symptomatics case-finding activities; and contacts: out surveys in selected infectious sputum smears identifying obtaining carrying teams of trained regular examination further training developing with emphasis on CHWs in hinterland of al symptomatics for personnel within personnel; areas; and riverain at all hospitals; areas of high or unknown incidence using small the Primary Health Care system, • • • • • • • • • 25 • establishing computerised one) for each region.
and maintaini ng a detailed data and reoording system (prefer.ably a 4.4.4,3 Staffinc Level f'l'UI( 'f11!1{!1'(1)i,m, t)t'Jktf fi, wtrn1M11t ;'mdii·IU ffi.

:�r �••Mo(\"� " 4.4.4.4 Main Funding Sources The main funding sources of the TB programme are the MOH and PAHO/WHO .

/Summacy of Main Actjyitje, 4,4,4,5 Objectives and Targets or sen, and Analysis Sum:ss or Failun.'

Hutl"t'ltnv Ill ... -<;,;ern:tar !llil\tffl<)I tjf Objectives and Targets not setl AH""41o!
'S.u�hhft ,,,..... WI!$ p,imil lffllll'l''flnffiL m'A/'ldiile:r_,,,.,,t1 Al� \'l:llled � WlliUWtlfffl �were-� lmpl\Wt llta CJf1Ml'!

'!WhJpC!il IW\'4'ilhn>e¢ N TB U'!

�4 Tar•C'tA�M?

Yu , ..Yw bHw101W 111,wi-�,rra�lllilic 111�� t,, 11l11:<.,m1 f."11.

"tlil!� '""""'ide!iffl.hel'lnlllfUIIJ,ti.ltiteal.h:�� Ya � l\;'rl afl,nu •.e <M!ppWk>�•r'·ololk ,.......,, We..��HMpal.� � � ...... �tto,!lfMlll "'--'llllllndS...."'"� Kmdml.�t�Mdwatt"-.11 w,,cl;,h,.

'f'O'-.llddll •-�l<t� t,;alna ...... � 6, 7, and 8.
Figure 6 illustrates shown in the above table, statistics relevant to TB in Guyana are In addition to the information shown in Figures at the Chest Clinic 24 cases were also notified location.

of TB in Region I.

16 cases were notified 4 at Maruca.

in Georgetown: 215 of the 265 cases notified in 1994 were detected there is a relatively that most notified TB cases are being detected at that high incidence and Hospital.

at Mabaruma, indicating 5 at West Demerara Regional in Lethem.
This shows that most of the detected cases are Figure 7 shows the distribution of c ases by region.

from Region 4, the most populated 10.6% of all notified in this north-western of cases originated Very few cases were detected regions cases originated part of the country.

In addition, in Regions part of the country.

in 1994.

This again suggests in Region 3, 6�o in Region 9, 5.3% in Region 3, 4.5% in Region 6, and 2.3% from Region 5.
7.2% of cases originated 7 and 8: just 3 cases were notified in each oftltese two This is followed by Region l, ,.-here that TB is a particular problem .

Figure 8 provides some information that most cases (just over SOC/a of the total) followed by 62 cases in the 40-59 age group, 36 in the 6o+ age group, and 33 in the under 20 age group.

in the20-39 age group in 1994.

Tbis was on the distribution occurred of TB cases by age group.
This iBustrates 16 4.4.4.6 Workshops/Confereuces/Trahling Courses Held or Attended l¥11rkslwps Held: • • • • • attended by 30 people; by 21 people: West Demerara Hospital: Mabaruma Hospital: Moruca: Lethem Hospital: Soweyo Retreat: by 26 people: attended attended attended attended by 32 people; by 170 people; Cimrses Attended: Tr11ini111( the Gl\10 attended a 3-week December; • one programme Disease Control, CAREC-sponsored course in Basic Epidemiology in November­ member attended Atlanta, a course sponsored by the MOH and Centers ofEpidemiolo.!,ry".
in "Principles for 4.4.4. i Major Suecesses/Achievements • There were two major successes the establishment Moruca (Kindren) the training of workers in I 994: of the diagnostic and West Demerara Regional facilties in hospitals Hospital; in the Primary Health Care system.

• (Lethem, Mabaruma, 4.4.4.8 l\l;Jjor Problems Faced and Sugustions for Problem Resolution Major problems faced over the year, and suggestions • • • for their resolution, below: for drugs.

This has been a problem are listed in I 994.


More financial input supply the acquisition of drugs is required; incidence of anti-TB though there was some improvement there was an irregular several years, regarding in view of the escalating closely with the AIDS programme so that INH therapy cases.

HIV-positive collaboration closer the government graduate Ministry There was little in 1995; medical officer of the TB programme course in J 994, but has not yet begun such training.
needs to be approached of AIDS, the programme regarding success was identified to do a post­ The Public Service programme.

this post-graduate le to all can be made availab in 1994, and there is a need for much needs to collaborate 27 4.4.5 NATIONAL LABORATORY FOR INFECTIOUS DISEASES 4.4.5. t Mission Statement The service does not have a mission statement.

4.4.5,2 Main duties/responsibilities The main duties of the service are: • • • • Service, the G.U.M.

Clinic.

for the prescence of syphilis.
Hepatitis B. technologists and p rivate practioners from the Blood Transfusion serum samples hospitals testing private and HIV; training providing information/training laboratories data to the Epidemiologist providing ordec service is in working and health statistical in the safety techniques workers who deal with sampling; tests: - and other health workers in how to administer necessary for similar at all times to ensure that the Staffing Levd 4.4.5.3 ... n.- l��h, .. ...._ 1_41;.,.,.,�,,l'I ,,iow l'OlllWf Ill ,....
I ' .......,._ .... � " " " 4.4.5.4 Main Funding Sources The main funding s ources of the laboratory MOH.

and 1he are PAHO/WHO.

the European Community, 4.4.5.5 Objectives /Summary of Main Actiyjties and Targets (If set), and Analysis (if Objectives Success or Failure and Targets not set) o ... � h•rl!

'M Tran 'llal 1-ie>lltll Slatt'\1iltli:'*lilr"h�� T ,wn Ub ,ataif It •CAAti<.'
(}ba:ltiry �� �-f'J,Jti:t.• ""'flPl1R,talfatJd � 1,.�-.r .. 1, ,\:t.Jma MM-Uliro.ltlal: -Qtt l!IIIIW1� or ... .-.. u:wdlffl; (·,llll<!li,,� "'" 1t..,l,1111�,·,•111rnm:tt,•f• To .,chlf'Vf'd?

'Ve v."111:tT,, ,.• � t.v ,.. ,� ... \'MIIS h• lbtc - � .. "" "" " lf/�11.tue,..,d .

:,f�•ett1 Vo W!,,,.•nr- rp �- t,.

'>ts;)IW I \>Jill,>\ •.

',>11d1�1 IW,'\Jtt1.

'C' RN{ ,tl\\l l,.lJ,l,\ '· \1,llu.Y 'i*"';it1y .-,,,.1,r,\l ,>f't>tn._t t',ww,,.,,_ prevfll)we nnllnhllW..:, l!l'll:all !\lfu'<l,..UH.'
ti.1/iA Raider 28 iA VDRJ.

�ots.c.-t.F.._ �---.1 i-16<.ieM� -("Altfr mpp.w:-v...«• reci-1 A .. _ I ,_,,_ r.-n--� Tlllllt weie llllfOdllnd D'l lllt � t,.it,,.,r;a,'I) :;; --Titc:�-�Ull.ll•'N'---Uh.

'ftlm.·ar,dl,;i., F---11.

...... "1m16.1fl!lll<t-l.od iw!MKl\'l"-�•U<le ThcBl<Jffled.i.

:alL'M<1(�H,�ai �illltht�'W"rir.

l'l\'1:<X,'45 <l'Jll n,,t,.

........ ,.._.�,_ MW il'-'I �-.._ J.w.k•rei,l ··-tM,•.h'!l•1 ""' !

!
!

!\lll,!,.,., • 4.4.5.6 \Vorkshops/Conferences/Training Held or Attended Courses Worhlwps Held: • Assistance w Secretariat and Regional Health Services; as given to workshops the AIDS held by the G.U M. clinic.

Work.\lwp.\ Atte11ded: • Seminar held by CAREC for Directors by Director.

attended November 1994; of Aids Laboratories in the Caribbea "lational Laboratory.

n. 4.4.5.
n. 4.4.5.

7 Major Successes/Ac hievernen1s The .. major successes of the year were: • • • of automated acquisition addition extension of Tp.

H.A test to Laboratory of RPR tests to as many regional ELISA machine; services; hospitals as possible.

-l.4.5.8 Major Problems Faced and Suggestions for Problem Resolution faced throughout The major problem for the AIDS programme.
without other donor agency funds This problem could be resolved funds by the MOH and/or recovery by a close examiniation provision for tests done.

through of the benefits the allocatio of some measure n of in-country of cost­ the year was the reduction of PAHO/WHO country funds being made for an injection of substitue in-country or 4.5 HEALTH PLANNING 4.5. l Health Planning Unjt 4.5.

I.I Mission Statement overall "To provide necessary policy intervention developme strategies".
direction for health services nt.

identification planning, and analysis monitoring and evaluation.

of health priorities and resulting including 4.5.1.2 M nin duties/responsibilities of the unit are: The main responsibilites with programme planning heads/managers.

health care throughout • in collaboration Guyana: • coordinating agency.

programming/planning MOH, external non-governmental and private to health approach to ensure an integrated sector care delivery.
29 and evaluation and maintaining monitoring establishing between the MOH and the health Regions; • recasting planning.

data in such a way as to make it useful for the purposes of of externally-funded projects; mechanisms for ensuring effective communication 4.5.I .3 Staffing Level Pr,sllkm PH_.d,,r tk:lkl• l!M!t/1.

Ph1:mn1•� !

'!.,ru;ti t,-,,,,,•1•1i<!

Samb!Jt'lnt'm<llon ' ' ' N-bffcf'\� ,, ' " 4.5.1.4 Main Funding The Unit.is PAHO/WHO.
Sources funded from MOH budgetary funds and receives technical from assistance (if set), and Analvsis Success or Failure 4.5,1.5 and Iar1ets Objectives �.mwarv •t M!in ·\t:th1t.ia fH'Olrittth:n and Inst!

not ffll To .......,., R-.u.h.

rn'.fYt(l Wkl «<ll!NI • mall :SIUfU'IIIIY helllt .. t'V'JRS ,·� ... _ fr.m_.,,rt ,l.><;llfflllllr , ·...u..b,.,..,.

""h ,;;,>ntldtarn� - �!WI rek\'\ft �rs.

'1-1111 1lfllPIVll.

mill �- Htr!


:llih l'l::11 d...:nmnd umn:1n�brer1s.-t �'llior \'� �- ht!IW1 ffl'Mr,,wcr -� d� •"'•J.'U\11.. '"

"�lllllll,"tl J"�!>Ve .,,i',<!'ll!

!Uh'1' q:,: ,.,,n)'hlte 111 lltt Hc$lll P\M ,>1,f>ll!\;lf� 1,"!

:.!!�•''1'"1\IJ"I!

,1,,,; v,r1,n:c,11 ,,: >,;.:'�u.u!

nm,1:.JmnH\>( "'"'�'II hf!Wffll PAHOIWift) lift<!

1�,•El'lvtlmf l!,e �t!l\!

S-111•1:,, Jw: If H!i<, uul <•,mJ1ltlt :'i: ""''�' t'(l.-mui ,!.-r:,'f f!!
!ffll<>fllllll'C• tr.mi ,·e� .. �1 .. :s:....U Hufl:h Autnbof�....._ l.lartlWW.,..,..,....

..._ t\� fll,llllh�pr.-·-�v;uli ,;NNl.nllllnJ _ _, ...

r°""t.,m,..,.,.

:irot111«: S::liol!IQI.

Hadlli!Pl11111- .... 4Wtllll�a ·-�!AA'ffl'Ul)IO """-*'-� 1'"'1f 1,•llld!

!.<1>'1'1 U!

� r,;., 4',(Hffl�IC t \,mponNil �"* �e.i iii<!

m.:,i�t>'l'e.. t.i� .... f ,·,;,t1,,ill_with J/4111,•mf,>f'l'l"lmt'll !Mlflf'llld i,!

!ll !IIIMk'Mlllr_..

.

;,,ffl,�l!

!C,l l!cakhe.,m,l!M.


'11 Courses Held or Attended 4.5.l.6 \Vorkshops/Conferences/Trajning Held: Workslwp.� • "Implementation of National Health Plan" workshop for MOH Directors and other senior managers.

December; W(}rkshops Attended: • "Poverty and Human Development", a Government ofGuyana1World Bank­ sponsored April; workshop, • "The Bamako Initiative", • Senior management sponsored MOH staff retreat.
held at Emerald and management, October, Towers; by UNICEF and MOH, September: to discuss structure issues of organizational attended: C'tmferenceJ "Women.

by the Director; Health and Developme nt".

sponsored by PAHO/WHO and held in Barbados.

attended 30 Tmini11,: Cour�e.�: • The Director Health Planning London.

Ontario.

Canada.

spent October-January on a three-month in training attachment techniques with the Thames Valley District Health Council 4.5.1.
7 Major Successes/Achieveme nts The major success process consultative areas on deficiencies to be included.

of the year was the revision of the dRfl: National Health Plan documem in a 4.5.1.8 Major Problems Faced and Suggestions for Problem Reso!urjon skills There has been a degree of improvement in the managemem/planning managers.

so as to enable budgeting.

the need for more management training managers to become more proficiem but there is still in t111e skills (on-the-job, workshops etc.)
and of programme planning of programme A major proportion management in programming, strategy plan, which \I.ill aid in reinforcing planning planning, implementatio n and budgetary functions.

oft he perceived planning/management deficiencies will be addressed in ilie inw-est and sustained capacities UNIT 4.5.2 HEALTH STATISTICS 4.5.2.1 Mission Statement "To provide statistics on a tirnelv basis".
decision-makers and other appropriate with reliable parties and accurate health 4.5.2.2 Main duties/responsibilities The main responsibilities • • • • • • • Returns; of the Statistics Unit are: the official notification of Births; the official notification of Deal hs; l mmunization Notification maintenance maintenance Daily Ward Census reports from hospitals: data entry and analysis Diseases; of Communicable of an In-Patient of Out-Patient of Primary Returns: Diagnostic index; Health Care reporting form.
31 .

4.5.2.3 Staffing Level ·- �umffl III f'u�lllun �Sti!U.<t><:hlrt SllDllKllll\ Sult!.<tic:alOAAer .SUlltllll.

:al ('Jnl; ll �ltl<.

'lerl::l F-·11111t'lcrt l l " ' ' ' �,t("1la11dt$ " ' ' ' " 4.5.2.4 Main Funding Sources The main funding source for the Unit is the MOH.

4,5.2.5 Objectives /Summary of Main Activities and Targets fif set}.

and Analysis Success or Failure (if Objectives and Targets not set) �Re;.

::;,rt c 'd1ect.

l.'<W.

'.>,�11,1191 Tii�-M�Ni'!


,.� ,,'ldt llQ</ �me, on c,,o,p1111:r(IU!Jts M Ille Yd!

: .i,l"u>!ffiB w<1rk Wl!S �('>('>1pkif!J Koow� ptne.i ,.._'IKtl"IWI@ !WolJi!t&j,:; l# • !

'AHO n,'lufoll AJir.itlW of Su=,.

�-...U- -00- ""'1fk.diaplaldCCI ,.....-.�-dilla�,;,llld be � lffl•"Olltpw«r.at.r lha1 lollU'qtr-mai � , '»l.Jc,1.

e,m am!

>'.Nii: <kmM """'\fuid h> tl:c Minn,,i,· m l+M Yd, �I/"._,( the a,nl.

was <1<.>ne on ,-,•mp111n thu,dm ,·,,Je am:.�"'"' Rm-tmrt.in t\Jile\'T $.
!11, ,,i<J¢ anJ lftffi�ltt 1,, � t(>f 19?!

�,,n1p111tt.

cnd.:i'.

'fllple<( l',ll;J w,>rl:sheet<.

uonfoi!\Wr.

;,,:unru: ,nike for I� m'O!I U.c O,:n,;r,11 • ..:,,Me Ye--..

l·•,..�,J,.

'lle and ttlltr,�tt,., Y«-•,Y''•<>!W,,rk<l,,ne S{!nd �; i,, C".RF.C No ••Wh .\!•�,,!

n11<,rH ,1mt u:,:a fr,,m hn.m1mm11.10tt Reiumh•nm< :,, YI!\!
, 1111)•·4 1•i ;nfl'fflllllm m1ercd ,m r,,m('DI« TrJru1fer Ill.I u:,·,m'e>I L\•1n�111e; lhl!p!e1e I)�-·� ,w rr,.,m ll!t !h�pllals t,,,J,;;,; f;,1 1"'94 tl1m life domg1� tn� YIOl • ·,1f'io ,•itlu;; ""'t d"� t,llm,l.1n, c.itkc,.

Mu miJ n:nnv; fh,rt1 !m111�al5 ( 't-1.

*<hi lilld enter "111,> �-..mlpnttt ,._"CJVitd a ·;;sm M·.llltt fa.

:o�� s.i:,;nm1n,,n "nlhc o;JJ.� \l,'ard Yu .

OJ"-'• ,11' rlus w,•rk tl.:>111!


a» (>lll{l:JllWI >!ll"OO�, Yu• !>Nl'�oft111K WMk d..>ne ('{ffil"'U 1111 1995!a.a!f th.- - Lau:� u W3'1,-�.

n:atum·m • 1u,n.e1 Tr��tvtdl>y��"ta»�·�-� w .. u ..

,�b,,�..,.

;emilll!S'.>�;tkt- w,:,rt,, 11,on.,)( d,'l\i: N'l<aJsl' ,,rw -..w11.1.

hrtf!tlWl'd •'f'<�N100 _..., Genmat � o,m .,rw-, rahertiml kf<""" JS") l'l!X OOue due 1,, n-i i.,em.

:t; ,,__ � drdinil.nlm.wi1Jtt'.\R.E'C'.li1111dl��ot•·,rt � Unit sut>lnl!Ud rwpoffll ® QIIIII.
twit tbtn- - ck� in W, � *'1.idi neaif:old HI bt doa:lttdl:n ihey 1"ft - '"CA.RB:' \'j!f}' �Wl'l'Mff�·duWlby PAHU�m--<n�nfofor�=-�� Soodic1fnOJWs�mdd&e�oflllp-(,-.
�-t>!flffl,f!IIOll'll!illlff"bllhl.��a&J llli'IIVl!r!O!l t .. Li&tS'.UOIUUll!Wn olda:r.�flAfiiW>l�lu ,··---'-e wort DI 199-1 VffYf�"l115W;;,,d.a;�M'.d:iisdaaCflU1,' llffllrmltedie 1"lff Held or Attended 4.5.2.6 Workshops/Conrl'rencesaraining courses Workslwps Held: • Basic Statistic s (3 l st October-4th November), attended by 6 persons; Training G111rses Attenileil: • • Advanced Underlying Attended Course in Mortality System, and Statistician Statistician c by Senior Statistician Indexing, Medical held in Research Triangle Cause of Death Classification, and Statistician; held in Richmond_ Virginia.
Classification (MICAR) and Retrieval by Senior Attended Park, North Carolina.

32 4.5.2.7 Major Successes!Achiev..wients The major successes of the year were: reporting • better • • • more health I 00'% coverage improved on the Daily Ward census; submitted in Immunization of out-patient facilities reporting data reporting and entry; from health statistics centres.

the Primary Health Care reporting form.


4.5.2.S i\fajor Problems Faced and Suggestions for Problem Resolution The ma.ior below· problems faced during the year, and suggestions for problem resolution.

are listed finance insutlicient visits to the Regions.

provided inadequate training not enough use made by managers to the Statistics staff training is required.
was not always meant transportation This could be resolved if a specific available budget Unit, who could then plan field visits and especially in data-processing for necessarv for travelling accordingly, further data analvsis at all redater .

was • • 4.6 i\IA TERNAL AND CHILD HEALTH PROGRAMME 4.6.1 Mission Statement "To deliver optimum care to pregnant women.
ensuring sate motherhood and healthy childhood" 4.6.1.1 Mahtduties!res1>011sibilities are: of the MCH programme The main responsibilities pre-natal, care for neonates; intra-natal • providing • providing • monitoring • providing maintaining surveillance vaccination of EPI diseases and post-natal care for women: grmvth and development services in children for pregnant women and children: up to their fifth birthday: 33 4.6.t.2 Staffing Level ,�indicates Central Unit) - M- J{nilb Vlffl('r Staff Midwife Midwtk Nl1111in&� Nnr'ft Al<le C\1mmuml', H� Wrutu Birth Altentlam ,-.
oc• l'<untn.R �ur,erviwr" �oOker"" Dnwr • �,:m ARQ1111:1'11" Acl:OWIIS t."ltrt.

� r, .

,....., �\c"aatl!ldft HO position in MOH'sMCH - .,, " " .,.

D " .

• • • • • • • • Numb« llt f'11sltlan " " .. " "' " IOJ I I "' ' ' ' ' I l 4.6.1.3 Main Funding Sources The MCH programmes Rotary International, and the European Community.
major funding sources are the MOH, UNICEF, PAHO/WHO, CID/\, 4,6.1,4 Objectives /Summacy and Targets (if set), and Analysis Success ot set) of Main Activities (ir Objectives and Targets n or Failure T" -- blrlt,f iaHft Sfl'I WlOOObWbuW b.1ow '.!l)l).

'100 600 live ,_ W.nuty4.nQ �.ci,i,::a,rJ rerc:rM�lc<Jelof Rtdll,:e Nmnal mMt&btr trom 130tlOO ooo liVe mruts to "'"""""' Redu«' m.l'lw ml.
"<ltbly ran m>rn <IIJHl{IOO llw bin.he to bdow - ,'1>\·-= - f.Mu.re •-llSl: M"""'4 Reduce Je\<tl or !<tvmi miUl'llltriti.m 10 belnw 1 Unabltlfl IIIKl:ftllin Morutor P'Owt.h :x.d Adue•1!d �,>SlUTlllrtlllt� Amlin \ilil.'�U!!

'l!l'fl <>f�i.hffil!ICII MllintW.!

!lJtt'<'\*dJen�,: of cttlldren m �h ;\,.

:h:urffll -�« \UV$� A<:hiewd '"·'- .,._,._.

<:a • .,..,.._._ illlilMlllltaDffllll-- - -.,............_...., Umpy.

'-l�k> llrilr;l.:dlllma ... _.

�-cfOafltbydraioo no.


'( tiy« oftequal--,d � ......... &IHI� IIIOIIIM: ... <'40.- ...,_...._of�-·--lllitWnlelad .... Mel{ _... .. pR-nlhl intm-R!Ul-- and ---... ""' ofdl.lldtak._.� ---� Qfilllm.wu:moo and etlidenl - 0.-.,.

H1:1tk WQlbraill Rtpiw 7.


S: ••-tt-1 M--� du�snd 4,6.1.5 Workshops/Confere nces[frajning Courses Held or Attmded Workslwps Held: • 13 "Expanded Programme of Immunization" workshops in each region and sub­ region; • 9 "Control ea; diarrho • 6 Primary Health people were trained; of Diarrhoeal Disease" workshops to improve case management of Care workshops to facilitate data collection -a total of295 -The figures for ''Number from Regional in Position'' supervisors.
and "NumhcrofVac:::mcics'' Unfortunately daW: from Regions are for Regi,Jns 2.

3.

4.

), 6.

7, 9, and IO.

The I and 8 w�s not 3V',.rilahle at the tinlt!

,,!

data was coHcctcd writing.

34 Workfltops Attended: • "Breastfeeding Promoti on", held by UNICEF, .utended by MCH Officer; Programme of Immunization XI T edmical Advisory Group Conferenct.
Commission for tile Certification of Poliomyelitis L'onferences Attended: • Expanded August; • 3rd Meeting oflntemational August; Eradication, • Development of • ICPD, April; • EPI Managers Meeting, November.

Broad Based MCH Programmes; 4a6.
t.6 Major Successes/Achievements of poliomyelitis, measles, diphtheria and neo-natal tetanus was The major successes of the year were: • the incidence maintained at zero; • a house-to-hou Region 4 resulted • 120 volunteers se vaccination in 3000 school-age campaign held on four Sundays in November in children being vaccinated; health workers identify from 12 NGOs were trained children the PAHO award for immunization: for vaccination; to interpret cards to help vaccination • a staff member received • an MCH manual for field staff was developed: • an EPI manual for field staff was developed; • a National for the Certificatio and submitted Report to PAHO; n of Poliomyelitis Eradication was prepared • a Home-Based Maternal Record was introduced as a pilot study in health facilities in Region 3; • an evaluation of the status of solar systems at health facilities was completed.
4.6.1.5 Major Problems Faced and Suggestions for Problem Resolution Major problems faced by the programme over the year were: • inadequate human resources to deliver care on a regular basis in hard-to-reach communities; • inadequate transportation: I, 3, 6, there are not enough land cruisers, deliver care in Regions 7, 8, 9 and I 0: boats or engines to • mal-functioning • inadequate and non-functioning solar systems is required at health areas where aircraft funds for periodic visits facilities; to geographic and where there are no regular scheduled air services.
35 of risk and the to be taken when high-risk conditions to their levels do d\:velop; with respect mechanisms of referral including home visits to ensure that at all facilities communication do proceed to higher level care e.g.
providing health to emergency evacuation senices Solutions to problems • • • • • • include: faced by the programme education in client providing rapid access improving facilities; the quality of care at major referral there is 24-hour facilities, improvements measures significantly clients coastal where these do not currently exist; improving transfusion surgery, of high-risk ensuring through management protocols; providing teaching improving processing.
and by making available complications; on-going rounds and case reviews, the information system through continuing medical ensuring by providing facilities capacity to perform emergency emergencv critical care pharmaceuticals for the management a standardised approach to the management of high risk pregnancies education through didactic lectures, especially where there are poor outcomes: improvements in retrieval and 4.7 STANDARDS AND TECHNICAL SERVICES 4.7.l STANDARDS UNIT 4.7.1.l Mission Statemrnt "To establish system must function".
and monitor the norms and standards within which all components of the health care 4.

7.1.2 Main duties/responsibilities The main responsibilities of the Standards department are: • • • services and programmes.
establish relevant with the heads of technical to their functional norms and standards and and administrative the Chief Medical in consultation norms and standards with reference to technical, standards establish norms and standards health indirect managerial and advise reporting schedules which in all institutions services.
area; the demand for services, identify the support necessary for meeting these Officer accordingly; enable a continuous monitoring (public and private) that of agreed and provide direct 36 4. i .1.3 Staffing Level hJt:,·1,,,­ :-,,,,re:,i"' 4.

7.

1.4 Main Funding Sources The funding source for this department is the Ministry of Health.

4.

7.1.5 Objectives and Targets /Summarv of Main Activities Of set\.

and Analysis (if Objectives of Success and Targets not set) or Failure .

;enn.e, <'!

1a.
;enn.e, <'!

1a.

:hmn1.I 1c1 flN_Ptr bwx .-r ,·,,tnl1'\'rt1K,1h«tt ::<>� �·"'� ,ve h,w,, Jh" 1>111n ,r.e,c >;,;pertorn 11.,n11, o mt,,m1 ,M w,.1�,J .u,d s,,11uiarJ$ WOJh !M re�; ,,,dmi;al ·" .,.�,·J)IHIUW!

en�,� 11,.11 �,.,,,,_..,, '.

', ,�m-..-.,, •• ,�1,u-1,�·l ,u,,.

; tlK h,-.. d� ,·: :t',hm,;aJ ,.

:;11>;.,.1,e,: .. .i!l) v.11./, llc.Jtl, \l,:c m,1"1.t ,ni:rn, ,'flt.he ttJ;h•t,· ·· O>H!.!

,-1.,,1,.:.,, ·· ' ···· illf,''t�,·, - , i'<r , ,,,i: Fedm,11,·.\l u.,,J .,,i.rt\lhN'W"• pro:�(ll!lf>nul\: ,,.
hc,!Nf> ;,,n,,unw:.

,,h,rn·e1<1w, ni<i .uid dui:,< j-..,,..,, r:h<t,Jh>r , !,r,,"f.11 J,� i'"' 1h f""')'11:tl< l11•1•1c<,,,r,11., ,u,U ,u,J n,IIK.

(t l-<"<ue: ri:1�·11s , wln<11e, pf)).,;.11,'; nil, rt�J�,1 ; -·�\-:::.,tl'.U:ll;,'t\• t,: do11.l..'1mem: ai,<J reLuttl 1,,..pr.,·«,rnt1 h' 111'44>: ,q:ah,t:,._•n,< "!I f'r1"111e :,• !h� u< ""f•h\t, I•, 1,11,>11rs er,· 1>;!.J:1111: :o iht1r ,·ar� "' !

"".,.

"'� wul )"llh .u ll.>sp,:4, ,, ,,,w,hr.H hc'')'UCl.-i.

,n�;,ec0 \lm,>lte (,,.

• .

�ors,�,.r�0u ...


;,.

;,>mc:<4'!<l <l�l(<j,\ W,!f� ,,.I!\·• f>lll>at�i'yllemw.ll'n,��.,...,1 Jl,t' h>l' l�W;,f<; >"-"-1"1""' Tl;.i,.e 06.1lllxai ,;er.,,'rS,h.X �,-�1-•:y ,,(St.tldmJ., wal r�d=W �- 1nrr!I"' �, .. Jer :ne I.Af;,,.1M ,,,�r"<:n1e·� iN we-re 11\#U� �•fH� !

'm-.

rh1�p1,.i-{ R<lfl'!l.hl:v;'I\� 'fntrt de��hvm,l ,;1hatt rk'\lld, r,,._-W<,e1ce.1c, (•�Im aldf-.)

� ""'' ln�wr,xt <h:ll br,-.

: "'" �iutw,!

Jiu�,...,.

,:,,,-,-.


{ 111,iw»alll� 1:�� =11;· Jid *" reiJH.ue 1,�,'JU>f wtw '""" ,!did'll!Illt<i ,,, " "h,;-pe.

:""''*' ,,>ns<l#trl.l 1,, "l.:<�11 ,mil ,I·, 1,u 11!� :v,1· ,!!!

;:;ti,= t'J�W.�;:: 4.

7 .1.6 '.\I ajor Successes/ Achievements The major success than seven years.
Health A set ;Jf minimum developed of the year was that private Recommendations standards with respect according hospitals were inspected for the fiist time in more were made to the Minister of to licencing to which hospitals should operate were 4.

7.1.

7 Major Problems Faced and Suggestions n Resolutio for Problem Two major problems are faced by this department: lacks trained has improved personnel.
This has been a problem • the department in that it is now recognised the situation made to address it to some extent The appropriate staffing and adequate • the department parameters the MOH must clarify is a relatively and terms of reference is essential for appointed staff; been established new one, having as a problem level what the exact functions have not yet been agreed of this department training are to be.

only in 1991.

Clear upon.

To resolve this issue.

for several years.


and steps are being though needs to be detennined.

4.7.2 DENTAL SERVICES 4.7.2.l Mission Statement "To provide appropriate and prosthodontic both professional dental and para-professional preventive, care to the population through the endodontic orthodontic.

periodontic.. National Health Serllice.

utilising surgical, restorative.

staff".

4.


7 .2.2 Main duties/responsibilities The main duties Curative services are also provided of the programme are providing preventive care, including oral health education.
4.7.2.3 Staffini= Level Region I: No dental staff Region 2: Region 3: I Senior Dental Surgeon Region 4: 2 Dental Surgeons I Dental Nurse 2 Dental Aides Region 5: I Dental Surgeon I Dental Nurse l Dental Aide Region 7: l Dental Nurse I Dental Aide Surgeon Officer Dental Coordinator 2 Dental Surgeons 2 Dental Nurses 3 Dental Aides I Principal I Oral and Maxillo-facial l Senior Dental Surgeon I Training 4 Dental Surgeons 12 Dental Aides 9 Dental Dental Surgeon 1 Senior Surgeon 1 Dental I Dental Nurse 3 Dental Aides No Dental Staff Nurses Region 6: Region 8: Region 9: No Dental Staff Region I 0: I Dental Surgeon I Dental Nurse 1 Dental Aide Total Number of Dental Surgeons 19 Total Num:ier of Dental Nurses = 16 Total Number of Dental Aides= 22 Areas which are significantly arid Matthew's Kaituma Paramakatoi, Mahdia, 9).
(Region populated but which severely 1 ); Waramadong Ridge (Region and Kumaka (Region (Region 8); and Lethem, Aishalton.

7); Kato, Monkey Mountain, Sand Creek and Annai lack services include: Mabaruma.

Port 38 4.
Port 38 4.

7.2.4 Main Funding Sources The main fi.mding sources are the MOH and Colgate Palmolive Company 4.7.2.5 Objectives /Summarv and Targets (ifsetl, and AnalymofSuccess or Failure of Main Activities (if Objectives am Ta rgets not set) the year dental During below illustr number of extractions number of prophylaxis ates.
There was an increase performed increased service work was almost exclusively as the table the in the volume of work done compared to 1993: from 42 615 in 1993 to 76 368 in I 994. and 1he focused on extractions.

increased from l 270 in I 993 10 3 02 l in l 994.

Uve1fifi l .

, ' , ' .

, " ;,, l<lfA!.

7'umbff ,n 1'ttn1ctooMt :,: 7�¥ ',., •/,"it> _to -:1) )SW !f'\$l 51.W 1,116 I J3: '" � l61l n•P fmm 4J62�m J'l�Ji !

'ln .... -1' S1llav " J� " \03'1 " " " ,, " ' I 41ffi<\WW1111\Jm l�m 19',�!

rr-11\11n.""
rr-11\11n.""

. "

�\/J l :un IP .. " ,, " " Jif.

!J HII' !rnm l�!ml'J9Ji to the work summarised above, Oral Health by Colgate-Palmolive In addition primary school children, Guyana Dental was launched prevalence hygiene through and (b) children's' ability in November.

The programme (a) children's' to take responsibility of oral diseases increasing Association, sponsored a National for their own oral health.
aims to reduce the of oral awareness of the importance Education Programme for with the Guyana Ltd. in collaboration the American Furthermore, and the Guyana Dental Survey, continuing Association, for dentists have scheduled a programme and dentaJ nurses, education and oral health for a National Overseas Volunteers Oral Health education.

Dental Association, in col!aboration with Health Preliminary recovery in dental services.
discussions were also held at senior levels on the possibility ofintroducing cost­ the ead of the year another for dental services.

This important deveklpment was of a five year and the wll!

'k is being done with the assistance of the crafting wc,rk programme Towards annual MOH Plarming Unit and is designed to operationalize !he National Health Plan.

4.
7.2.6 Workshops/Conferenc es/Training Courses Held or Attended Workshop.� uttended: • National Health • MOH Retreat Plan Consultation revised to discuss Workshop, March (attended MOH Organizational Structure, by I personi; by (attended October 39 Principal Dental ficer); • Poverty and Human Development, April (attended by 2 persons)" 4.7.2.7 Major Successes/Achievements The most notable achievements of the year were: benefited from a much m ore consistent • services supply of anaesthetiCSc and needles from the Central Bond.
1994 was the first year because ofa lack on three occasions closed of a National • the launch (in 1993, for example, due to a lack of supplies); Oral Health Education of materials for some time that no clinic was forced to close the National Dema.l Centre was Programme for primary school children 4.7.2.8 Major Problems Faced and Suggestions for Problem Resolutioa The major problems below: faced over the year, and suggestions for how they might be solved, are listed personnel, there are significant disparities in the of dental • despite shortage the severe distribution of staff in relation Administrative system, difficult.
On the whole, Regional procure services • the oral health to population.
which makes national Executive the required in their respective education aspect of dental conditions regions; This is mainly planning because of the Regional dental staff very of the locati<M>of Officers have not worked assiduously to and/or fortification of Dental for the establishment tremendous void in the back-up system of curative lack of manpower, given greater assist in the quality national priority if these problems are to be lessened.

of curative services; equipment, instruments and materials.
e5e itself Health will have to be could Cost-recovery Dental services has been emasculued because of the suffers from care.

Curative in the improvement • there are few opportunities for staff to benefit from continuing educa!ion.

4.7.3 NATIONAL BLOOD TRANSFUSION SERVICE 4.7.3. l J\1ission Statement The Sen·ice does not have a Mission Statement.

4.
4.

7.3,2 Main dutjes/responsibjJjties The main duties/responsibilitie blood to patients of wholesome s of the service are: • provision • provision of adequate supplies of blood to patients country-wide.

country-wide; 40 4.7.3.3 Staffing Level ""'""'' :\1�41 Dll't<i,,, ( ·1.wf r.,hn»k,;,:<1 �iu0rTedH1� tab,ua,xv Alili:s l);>JM' AIW!dli.llUI f\<.>rt,'t ,\t,1,1d r,nver I ,li>flr-•,'rv ,\t(ttWll!U -"'-�"'""am 11:.e,;ru:;mtnt <Jff;.
;er '\umb« hi l'orJtlnn I ' I ' ' ' ' " ' " '.\na,a,« rn \"�<..,.nnM ,, ' " " " " " ' ' ' Main Funding 4.7.3.4 The main funding sources Sources of the programme are the European Community and the MOR 4.7.3.5 Objectives /Summarv of Main Activities and Targets lif set), (if Objectives and Targets not setl and Analysis Success or Failure ('""�erTa f� F!t,..�,,(h,o,:><I Lmure lldtq,mu:Jmf'llhes fll-<XAfflil"n'll y,.

,,, r.1,,..«t,J1kll)uma1 �1·� ,li;.


:�hes are ,ai� ,\nal\lils-Oi':.OK,ttss.cf"ahrto .-\ll me t.k'-"1 r""l!CIU ne.

:� h'r re.._wme-il'o·ll.lut'41: Thllf� \ldlllil��\t"fl >Jf�IIX--1<'1 .. )-,;lu,,.,,-.,r, H!l»f!Wi!$\>!I 1tu, ,h'>fl<if t>.ue \llll.lmim ;1,1,u tn.

:re,v<t ntv�;,,1, Mv,ld \"111Kl< m K<nc,,n� C ami 6 "" N,;; dnH Tlwlk'lfl..r1-�il:!ar,,,.,m cn1111ah,«1�e/J.

;ns Lack ,11' t>as:i, h•i,t.

:red !ht <11,1'ri,)fnmnr ,,1,te,ot i,.

;111J:"" mtfillll'UJu:e u me.:l!


'K'n·.a,d 1>llllnlll ��""'' 1,.1,, ·'' "''"'.._,Un�-iul n,• �.Jrn"'\c 4.7.3.6 Workshops/Conferences/Training Courses Held or Attended attended: Conferences • the Medical Transfusion.

Director attended a conference of the International Society of Blood 4.

7,3.

7 Major Successes/ There were two major successes donation products, Achievements and the fact that 80% of blood and blood product in 1994.

These were the continuation of 100% safety in blood were met.
demands Faced nnd SugBestions for Problem Resolution 4, 7.3.8 Major Problems Major problems • cor.tinu ed inability faced by the service, and suggestions for their to effect efficient autonomy overall was given to the service: administrative are listed belmv resolution, This could be management some prO!

:,rress has been •de\avs if more financial resolved made in this direction; in disbursem disbursement is needed; • staff vacancies no accountant.
of finances • effective and outreach maintenance activities; of laboratory equipment.

ent of funds and assistance from the EC -more expeditious -there has not been a driver The employment for the mobile of these peo ple is needed unit for one vear, to ensure and there is proper administration 41 4.

7.4 X-RAY SERVICES 4.

7.4.

J Mission Statement The service does not have a mission statement.

4.

7.4.2 Main duties/r:npo nsibiljties of the service The main responsibility in making diagnoses.
doctors is to provide adequate lp:lality that .issist radiographs 4.7.4.2 Staffing Level - Loc.,ll11n OiNT�o,.,,11 l>\lhl!.

H,,.ooal -«- J><niliul'I ... '"'"�' H,.

...,, X•Ra-.·Tmuw:mn � a: ,..,w A!ruotr>Jam f<rl!.lNJal :'.onl,1"' Rttl..mlli H,�--mo:111 ·� i,n f.lelT!tnltll RttK>n.il • '{-R:f,.· fc.

:htti,;iwt :X--R.>i,· rr.t111K11111 h« Roidi,•u:1 T�1uul.11111 ll,1rltl\'-'rll narl::r.l,'m Tect11w:tan N--111� ' ' ' ' ' • I I ' • ' 1\qff!IW< ..r \"s-caucir:,.

;: " .. ' ' " ,, " ,, " 4.


7 .4.3 Main Funding Sources The main funding source of the X-Ray service is the MOH.

4.

7.4.5 Objectives and Targets lif set), and Analysis Sucms or Failure /Summarv of Main Activities (jf Objectives and Iar:ets not setl If§!

·-•�Ho@•>•M ... ,><,U • raimn,;N Ra,h"1uapllm and Y.ftay tedwU,,:1- A#""<.....i !

!

'<111111,u .-\,Je-c,:,UQ �uppl;: ,,1 \'h!

!m.t<:al,,, film11 and dmp ,,1 Rw.h,• '"" WORK PERf' ,E.\t\.

',Ct:: t .. >)l'JtOW'"'TI p,,, 1, ,,,.

; .


';l)O(,I_I pitt,emsh• ...-!_ t,t ':,f_.

,.J.

� Ar.isi:�ru-1,-, ,,.,.,,.

!<aye.I md il,"MWJ.

4 r,oo pum,,,, hex.

;,, -,da,t; RQJ/>11,\l, I ., .. ,.. :, , •1 put,,mts ;., bl!

X-k� Wt>LI( �urrarn K�mll H,11<pn&1· "•"' 4 HOO ?CJ61U h> i.. i,:.

To ACll�•tf! ""

,� 11,,, Partly� "" "" "" N,• 42 �•IITtndy ll,,J.1'# lr.llm<l .B ;,;-R.iy ,vu(\lll An:dnl!.
vf Sllr:tt1;l.l<'lllklft' '-•• cm� 111<4<"ll'"'hm it\ t ·u <m,ktb .n -�tn19'M '.\,.ill lt\'l!IIJb!t: AJ:tlkl'Ul,'Jl !

!Vfllalllli!l aicqllllt i;,xl,; 0f .uomou.

: ,·lle"1tl<;ii,..,.

!ud1 l'll1*rt!

'IM!d Thcnwm �11,,n>lf:""' <"/Jt:!lU(al;i hlll.1 w ht Wefl!

� tll!eft "''"' >111 "1'-"f:f,:riPI film :u·c .

.

Shon�!absel!feCblm <:<f liaff u..�nrn ,:,re4wpme1; tt,-i,lll;W,)Wl, ,,( e,1111pmeru llr�•wn ,;,fequif'll!ffl!

4.
4.

7.4.6 Major Problems Faced and Suggestions for Problem Resolution The majcr problems faced are listed below: of old equipment; • breakdowns of staff: • shortages • indiscipline • shortages and absenteeism among some staff; of some drugs and film types.

-t7.5 PHYSIOTHERAPY SERVICES 4.7.5.1 Mission Statement The department does not have a mission statement.

4.

7 .5.2 Main duties/responsibilities [ [.

The main responsibility level.


These services services at a national of the physiotherapy services include: care at the national referral • in-and out-patient is the provision of quality physiotherapy and regional Suddie Regional and West Hospital hospitals (Georgetown Public Regional Hospital, Hospital.

Demerara • provision • Provision • physiotherapy New Amsterdam Hospital; Regional classes; of ante-natal of reeducation input in the training classes for children; programmes of the School of Nursing.

4.
4.

7 .5.3 Staffing Level l'osi1io11 Samc,r Phv•w1hera;uS1 4.

7.5.4 Main Funding Sources Funding the MOH.

comc·s from '" 43 Objectives and Targets 4.7.5.5 /Summa1·y of Main Activities (if set).

and AnlllysjsSuccess (if Objectives a nd Targets not set) or Failure No specific objectives or targets Service work of Physiotherapy s over the year.

were set for 1994.

However, the table below swmru1rises the IAKa!lntt 0e,._,,...et,:,il-1\Publt..·lt.
,; \\-e<10emenll'llR�H SndUlt Rel(l<'lllll H0111i1al N.!w ,,,-�am '" f'lvlm<" Reid RdtabLld.lllmn \ '!ll!tre . ""'

I) • ,:lu!K Ctoad *1d pments-• � PQ,blic � sp.,11, ctm1c, Rttiimlll J-w.�11,llll M) fimtUI c.uUar .. Hou,e :ll•trtlwr llf 0ITT'"'ik'tlttSttff (U.t:\ '.!t9(t%111"1e.

N..tlff of 1•-llnits _.


,., " " " 1).dinicd-'andpalllllll:.-a�publk-··-· 4.7.5.6 Workshops/Confer ences/Trai ning Courses Held or Atte nded Education Sessions: Continuing • October • November • December 1994: Ms. H. Morton "Mc Kenzu's Approach to Back Care"; 1994: Ms. H. Van Ryn : "Physiotherapy 1994: Ms. L. Stephenson: in Obstetrics"; Electrical "Trancutaneous and its Nerve Stimulation uses\ Worksl,ops Attended: • Clinical Physical Physiotherapist.
Education Workshop Therapy in conjunction "From Diploma with University to Degree", of McGill, held by Jamaican?'>?

of Canada: attended by Principa l 4.

7 .5.

7 Major Successes/Achievements The were two major successes physiotherapists: physiotherapist for a more limited recruitment UK for a two-year period, of five months.

period technicians from Cuba in May 1994. of two physiotherapist one VSO from the worth mentioning in 1994.
The first was the recruitment of two The s econd achievement was the and a Jamaican-trained 4.

7.5,8 Major Problems faced and Suggestions for Problem Resolution The major problems faced over the year, and suggestions • ,'here are severe staff shortages for both physiotherapists for a number of years, This problem has been present progressively worse.
opportunities for continu widely ing education to improve To improve the situation, and update for upward mobility/promotion available; • Poor availabili better preventive ty of equipment and poor maintenance is needed; • Difficulty in acquiring maintenance supplies; below: for their resolution, and physiot are listed herapy but the situation is getting need to be reviewed (b) need to be expanded and ( c) opportunities need to be more and knowledge assistants.
(a) salaries skills practices: some new equipment and 44 4.7.6 DRUG PROCUREMENT AND DISTRIBUTION 4.7.6.I Mission Statement "To provide bv ensuring leadership that appropriate to the functioning policies.

of the pharmace utical services throughout the country standards and procedures- are in place and operating".

4.

7.6.:?
4.

7.6.:?

Main duties/respn,sibjijtjes The main responsibilities of the Pharmacy Department -including are: drug selection, manag,:ment activities •drug supply procurement, distribution and storage: • policy activities -i!lc!uding development and implemelllation of drug policy, of pharmacy implementation training plan: workshops • regulatory on the l1ealth functioos.

: the Chief Pharmacist plan.


and monitoring is a memb� of the Pharmacy and Poisons Board and the Hospital Inspectorate Committee; •education -including training workshops and training of pharmacy assistants.

4.

7.6.3 Staffing Level ,, 4, 7.6.4 Main Funding Smces The main funding source provided by IDB through for the Pharmacy the Health Care II project.

Department is the MOH.

Some support has also been 4.7.6.


5 Objectives /Summary of Main Aetivities and Targets lifset), (if Objectives and Targds not set) and Analysis Sucqss or Failure .. 45 4.

7.6.6 Workshops/Conferences/Training Courses Held or Mmed WorkshtJps Held: • Workshop on Wound Closure products (sutures, suture needles)· 25 members of staff attended, including the Senior Minister of Health; Course.,: Training • it is worth noting that the Royal Pharmaceutical Society infbnned the Pharmacy Department mana!,iement.
Names as yet no response that they were conducting of pharmacists a has been received.

a distance learning project on drug supply nd storekeepers were submitted to the Society, but 4.7.6, 7 Major Successes/Achievements Two successes are worth highlighting more interior pharmaceuticals in 1994.

Distribution on a more freq uent basis.

There was also a much higher locations and medical at all locations.

supplies level of activities were able to reach into 4.
7 .6.8 Major Problems Faced and Suggestions for Problnn Resolution The major problems faced, together with suggestions for their resolution., are listed below.

• lack of qualified staff(managerial, technical and administrative) to manage the logistical system.

training Improved salaries would go a long way towards solving this problem.

More activities for staff already within the system would also help; • there are infrastructural problems at storage locations.
The implementation of the IDB Consultant's report on the Central Pharmacy Bond would alleviate problems there; • inadequate and communication hampered disrributi on.

More flexible transport policies transportation make distribution need to be adopted to alleviate logistical problems • this would much more cost-effective.

4.8 CENTRAL BOARD OF HEALTH 4.8.

I M issjon Statement "To make provisions for promoting the Public Health of the country".

4.8.
4.8.

J. t Main duties/responsibilities The main responsibilities of the Central Board of Health are: when so required ( · • To advise the Minister on all matters connected with health in the country; • To take all such measures as may be desirable 10 secure the preparation, carryi ng effectual 46 out and coordinatio • To have and exercis •.'.
'lake n of measures conducive to public health; e the general ns with respect superviSK!ll and control of all public to the causes of disease authorities; sanirary and litera&we s. distribute investigatio practical health services as it may information, and make provision of persons for the training and certification for Health; be deemed necessary in the interest of Public • To frame regulations, and if necessary issue orders by the Ordinace and for the general ns of this Ordinance the provisio for the due and effective and of sanitation, to If deemed advisable.
furtherance enforcement into effect.

of the duties generally prescribe, which any duties imposed for carrying things among other shall returned which it may consider necessary, be performed.

the time and manner in 4.8.1.2 Staffing Level Persons that sit/Organisations that are represented on the Board are of Regional Development; Officer (Chairperson); Georgetown; New Amsterdam; •Chief Medical • Ministry • Mayor and Town Council, • Mayor and Town Council.
• Guyana Water Authority; • National Congress • Mayor and Town Council • Medical Practitioner; • Hindu Dharmic • Central • Guyana Nurses • Women's • Lands and Surveys.

Islamic Organisation Association: of Local Democratic of Linden; Organisation; of Guyana; Sabha; Councils; 4.8.1.3 Main Funding Sources The Board is funded by a subvention provided by the state.
4.8.1.4 Qbjectives and Targets of Main Activities /Summm-v {ff set), a11d Analvsis Success (if Objectives and Targets not sell or Failure 1 lteJ.11lh h1t1mflre..�d "'H l>�-f"'"""*U�!"

m«mlle'fll h->r lhe<r �'lfllffll!fl"' ,;.,mi 47 4.8, l .5 Mlljor Problems Faced and Sugi:estions for Probkm Resolution experienced In working towards There have been problems Authority.
and Planning anxious lots to a nation not always basic infrastructure is inaccessible developments pathways being met People are erecting instal led.

As a result, and, most importantly, and the Ceatral between Central Board of Health its own objectives -the requirements structures illegal living people Housing -to build houses/provide house are Board ofHealth l and before 1::Ssentia lots, in such areas are vulnerable ro flooding, Such of the Central on their there is often no supply of pure water.
are also not being discussed with the Board.

for more housing Problems industries.

have also been experien ced with the authorities responsible for licensing tmlles and This is often done without the Public Health necessary Certificate To resolve Health and other government departmen ts is needed.
these problems, improved collaboration and cooperation between the Cenl'ral Board of 4.9 ENVIRONMENTAL HEALTH UNIT 4.9.1 Mission Statement and improve of the population: "To promote status disposal: environmental general water supply, and industrial conditions food safety and hygiene; sewage pollution".
and agricultural health which impact on die health waste solid, disposal; 4.9.2 Main duties/responsibilities of the Environmenta ng water supplies l Health for quality Unit are: and safety; The main duties • Monitori • Monitoring inspected which food is stored, of all foods intended for human consumption its wholesomeness to ensure quality: th!
: food is for prescence of disease, prepared, displayed, distributed, of sewage and excreta and fat; and the conditions served and consumed; disposal to pre\:ent ds of facilities under • Monitor designs v.:1ter.

fo'.ld, and standar • Monitor disease and soil contamination; waste disposa solid transmission as to collection, vermin etc.
; rodents, by breeding of insects, l systems storage and disposal to prevem pf disease; • Surveillance • Monitor • Ensure • Organising • Fom1ulation of industrial enforcement pollution and agricultural health Health of public laws and regulations; Assistant of commWJities; the Environmental health an environmental training sysrem.

information programme: 48 --- ----------- ----···----- - -------- 4,9.3 Staffing Level l'!

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and Tarim tifset), of Main Actiritjes 4.9,5 Objectives /Summarv �-�1,w f'ul.it:,.· �:1; L;.,wr llOO R�11,ul1Jiv'lll , .• Ttr<>NA1:�?

On1t1•ru,·t- t ar,r<1 <".,J4,.1 f,,rmlli� d.11.il m th<: k.t!U<)IIII r, fJ<Vlr,'lmJ�Jal lkaltl1 ,,1· ""'' 81\ 1noninenta.
lkallh lnfl1!m!lllv.1 ,,..em So and Analysis of Sumss or failure /if Objectives and Targets wt set) An!tlm 1>r t.i,�•-•r" ,:,;,uullSII, Dnfl � !"'

been PNl!ltlll'tll l1 IS �-..rrfflll} i>tffi"- rlMOW(ld i..vmdUfflilwtfl•�1od111�2 1J., lwmllrl IWOW'(lf ll'V�k•<:� d;:ub<l:a lariil�J J..:l!J �,.u.

:u.in ""' tinJ mtl\ .. ,vff.

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:k ,,1 -l.9.6 \Vorkshops/Confm:nces/Trainjng Courses Held or Attended Conferences Attended: • a Conference ofEmironmental Health Managers held in Dominica Officer and the Regional Environmental was attended in June Officer Health by the Chief Environmental from Region Health 7; Training l'ourses Attended: • 3-week Epilnfo Training Health Officer.
Environmental course held in November/December was attended by the Chief ,f,9.7 Major Successes/A(hievements The major success Regulations_ of the year was the completio n of the review of the Public Health Laws and 4.10 NUTRITION AND FOOD POLICY 4.10.l Mi�sjou Statemeat and advise "To assist and to formulate and nutrition".
the Minister on all matters pertaining and implement policies and plans in relation to a national to all matters food and nutrition connected with food policy, 49 4.10.2 Main duties/responsibilities The main responsibilities of the programme are: •ensuring • providing a high standard of nutrition nutrition general educati for all age groups; on for the population through nUlrition community programmes; • serve as the Secretariat •assist in the development for the National Food and Nutrition and in-service training of all Public Council; Health Staff as well as staff of other agencies, in the principles research in applied and operational and practices of nutrition; related to nutrition, with particular • participate reforence • developing foods; to indigenous and implementing a Nutritio nal Surveillance system 4.I0.3 Staffing Level 4.10.4 Main Funding Sources • The main funding UNICEF.
of the Nutrition programme and FAO (ICN/NPAN activities) sources are UNESCO/NORAD, PAHOIWHO.

and Targets 4.

I0.5 Objectives /Summary of Main Activities tif setl.

and Analysis Success and Targets not set) (if Objectives or Failure i.et !

llil"'-1.IW':"h,2"1 Libflll'i' f�'ll�bh>J:, ii h,>J,w tk•·W1•mem T 11nt1 Act!lt'w'ti'/ '" mi\illc' <111fruwnaJ lll:tus ofp,.,plP>Jll,m � J""� t�1p1,wim1enr ,,t' Ot./Hi<tl k.alu,:n,'<> l/,; �1<u-m:e anJ f•r�mce of �11ronk 1,em,,mu,!
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hW!II Pffl\'MCl _\jj ATI'VOJC•, 4.10.6 \Vorkshops/Conferenm/Traioing Courses Held K Attended Works/top.� Held: • Workshop their skills • Workshop for cooks aoo supervisors at West Demerara Regional in planning, for decision-makers preparation and presentation of therapeutic diets; and relevant them to issues r.e.
breast-feeding; sensitize government and non-government sectors to Hospital to improve • Inter-sectoral for health • Workshops breast-feeding; workshop to develop a National Pan of Action for Nutrition; personnel in all regions to up-grade knowledge and skills regarding Workshops Attended: • the Director attended consumption surveys a workshop in Jamaica; • one member of staff atrended on the .planning and implementation of food a UNICEF workshop on the "Triple A" system in Georgetown ; <.
:,mferences Attended: • the Director Jamaica; for Nutrition; attended two conferences: the Caribbean in the region to discuss Meeting Co-ordinators Plans of Action National Nutrition in and the meeting of focal points Trt1i11i11g C'tmrses Attended: • one member of staff attended a one-week training oourse on "Team Management of Diabetes Mellitus" in the U.SA.
; • one member of staff attended a course on "Food and Nutrition Programme Planning" in Trinidad; • 2 staff members attended a CAREC-sponsored Epidemiology course November­ December; Training (vurses Held: • Continuing lectures • Training diseases.

for women's education and demonstrations for health personnel in Regions and church in Albouystovm.

groups on food and nutrition West Demerara.
2 and 3 on the dietary Norton Street and management of chronic issues· Buxton: 4.10.7 Major Successes/Achievements Major successes/achievement of 1994 were: • increased patient management • continuation of diabetes of nutrition and hypertension; surveillance bulletins; educarion systems were established in order to promote the dietary 51 Anthropometric of repeat • completion • establishment • development • obtaining of a National of a National the cooperation g Committee; Breastfeedin Document; .
Breastfeeding Policy of the relevant in the development sectors survey of primary school entrants; of the Nutritional Plan of Action; of Community • establishment activiti nutrition-related Nutrition es in those regions.

Officers in Regions 3 and 4, hence strengthening 4.

10.8 Major Problems Faced and Suggestions for Problem Resolution The major problems below: faced over the year, together with suggestion s for their resolution, are listed • transportation continues division would solve this problem.
use, based on projected vehicle Officer at the MOH; to be problematical: a strict a special Alternatively, submitted activities with a driver assigned could be prepared for to the Administ by the Division schedule vehicle rative to the • there have been no government counterpart funds available to conduct general programmes.
It would be useful if there were specific also be useful if there was a review system current • from October is very bureaucratic there has been no Nutrition of the present from the programme's Auxilliary ations.

of displays/demonstr and the conduct system for disbursing funds, as the point of view; Worker to assist in prepartion, data when filled, These positions.. programmes .

collection, allow the technical officers adequate time to plan and organize programme allocations.
nutrition It would 4.11 VETERINARY PUBLIC HEALTH 4.11.1 Mission Statement "Reduce veterinary zoonoses skills and knowledge".
and foodborne diseases through and intoxications the maximum utilization of 4.11.2 Main duties/responsibilities The main responsibilities Public of the Veterinary Health Unit are: • the prevention and control ofzoonoses, principally TB, rabies, leptospirosis and salmonellosis; • collaboration with national and international agencies in the prevention, control and eradication • assisting of all zoonoses; in achieving a food supply that is safe, healthy, wholesome.
pleasant nourishing, and inexpensive; • reducing • assisting loss and damage in the production in improving conditions for competition of foods: and marketing on the national and internation al food 52 market, so that there is a reduction ill rejections by importing countries.

4, 11.3 Staffing Level la V� Publk lk,lth OtlktT l'o'litkm f>nnc1 ,;,,I Ve!en!Ulf¥ � ti<lWll Otf1cl'I' r>e l!.<IV \'eh:mmrr 1'111/llr ·ttt.or,llf\' f'utl�, {'foi,r\'o.icnria.r1· \ · otcnn,in· 1'111>1.i,; Sc,;rci.in, T\ ,,,.
H�lh Ollka tStruo:rl H;:akh Otlk<11 f'1,t,ijc lrewth ,\>'JH,ant lidllil ,.._11111 Numb«ln� I 1 I .

. '

I I :-.umb« nf \.IICIIJKX$ I " " ' ' ' " 4,11.4 Main Funding Sourees The main funding sources of the clepanillfffl are the MOH and PAHO/WHO 4.11,S Objectives and Targets /Summary of Main Activities <if set), a..t Analysis (if Objectives or Failure set) and Targets not Success hti,<'I ""1 Oli!<•,:tlw- I :w111te r ... >d Pi,H,;u,.,, :1d1,«4d:ulJtet: and the 11,mt1'11l � ul.lll.
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*111 rhis� tllftllOl"I • -- �<ali)'Zlll!I <If <>flhe 4.11,6 Workshops/Conferences([rajnjng Courses Held or Attended Wtrislwps Held: • 2 workshops on "New Veterinary Public of PAHO -one focused on regulation regulation legislation, on "Quality of the Haz.ard Analysis Critical Control • I workshop of veterinary and bovine tuberculosis of Seafood and Fisheries Point System control Control and eradication; Products Health Act and Legislati public health, on", wilh the assistance one focused on (HACCP)"; with the introduction W<rislwps Attended: • "Principles • PAHO Veterinary veterinary in November, of Epidemiology" Health Public services public health by Principal attended (attended by Principa l Veterinary Public Health Officer); seminar, and its effect on veterinary focusing on the theme of privatisation in health: public held in Tobago Veterinary Public Health Officer; structure, held at Emerald Towers in •MOH retreat on the MOH's new organizational Public Health attended by Principal Veterinary October, Officer; 4. t t. 7 Major Successes/Achievements Major successes industry, the timely responsible diseases for the first time.
of the year were the introduction of veterinary of the HACCP system health data for consideration provision in the f"ish and Seafoods by the consultant public for the revision of the Public Health Laws, and the collection of data on food-borne 54 4.ll.8 Major Problems Faced and Sui:gestjons for Problem Resolution faced over the year, togethff with suggestions for how they might be The major problems resolved, below: are listed transportation, sometimes • inadequate the Unit would prevent vehicle to • lack of identification • delays in or no funding for important when it WllS badly needed.
The assignment of a m any of these problems; cards for the Unit to be recognised on field visits; field work: improved communicati on with MOH administration is required; in enforcing • difficulty regulations: early amendment of the Public Health Act is needed.
4.12 HEALTH EDUCATION 4.12.J Mission Statement educational support to all health "To provide includes planning and implementing educational social and behavioural methodology, design and development interventions, This support and medical programme activities.
and oommunities and research into the training of health of educational workers materials, in factors that contribute to health problems.• 4.12.2 Maio duties/responsibilities The m ain responsibilities of the Division policy-makers about t status the awareness • educating the health • increasing and the quality are: he role that health education could play in improvement of oflife oflhe population; of health workers about their role in shaping people's perception and understanding about their responsibility for their own health; to develop knowledge • facilitating members of the community and skills that will help them to achieve the health goals they have set fi>r themselves; • develop programmes that integrate varioos health services/programmes intll comprehensive packages that focus on the individual as a whole person.
4.12.3 Staffing Levd - 5lfflo3" Hwllh lil!UCWl"f He.ill!h &111<.lli<"' fld.llh &Ja.

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l'tllMkf' llfl V-ltdelo I • • • " " ' fr I I 55 4.12.4 Main Funding Sources The division's main funding sources are PAHO, UNICEF and the MOH .
Objectives 4.12.5 /Summa[Y o[ Main Activities and Targets (j[ set), and Analysis Success or Fllilure Targets not seO (if Objectives and t .,_,., Yu y,.

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� SQQ p� miud1t1 Y,o Dal!lpll: llld -"fnl him IHca dorw._ bot ... nwcil lotl!lllf 4.12.6 Workshops/Confereoces/Trnining Courses Held or Atmwed Workslwp.s Held: •3-day workshop on AIDS for women from NGOs in imerior regi ons.

A network bas since been established; • 5-day workshop and conference for 90 CHWs to discuss problems and identify requirements for continuing education.

4.12.
4.12.

7 Maj or Problems Faced and Suggestions for Problem Resolution The major problem Division except though funding agences.
faced in 1994 was that no funds were allocated to the Health Education 4.13 FOOD AND DRUGS DEPARTMENT 4.13.1 Mission Statement "To ensure that safe, sound, quality and nutritious wholesome water and safe cosmetics reach potable the consumer" foods, safe and efficacious drugs, good 4.13.2 M11in duties/responsibilities The main responsibilities of the department are: activities; control; • food quality • food inspectorate • drug quality control; • drug inspectorate • water quality •food contamination control; activities; monitoring; 56 • forensic services for the Police department.
4.13.3 Stalling Level ''"'""" 1 ,,re,,,..., " 4.13.-1 Main Funding Sources The main funding sources of the depanment are the MOH and PAHO/WHO.

4,13.5 Objectives and Targets lifset).and of Success or Faihm /Summarv of Main Activities and Targets not seO Analysis /if Qf!jectives Tests tests 414 food chemistry ln 199-1.

146 microbiology (target tests ( target microbiology tests was 600), 14 water chemistry 110 drug chemistry tests tests (target was 800).

no drug were done.
no drug were done.

(target tests and 24 forensic was 600), 509 cccise tests (target was 600), was 600), Food Inspectorate Division In 1994 the division continued to inspecJ food factories, markets, supermarxets and storage bond.

Drug Inspectorate Division Drug, cosmetic and device factories were.

inspected and licenced.

Drug importers.

registered.

pharmacies.

emergency shops, patent shops, and 130 drug products were More could have been done with a greater availability of transportation.
stalT and inspection kits 4.13.6 \Vorkshops/Conferences/ C01irses Trai11i11g Held or Attendl'd attended: Worlulwp.\ • Nationa • Universitv l Plan of Action workshop; of Guyana -Instrumenration workshop.

for Nutrilron Conferences attended: •Conference on food labelling; Training courses attended: • Food chemistry • Food micro-b hands-on iology hands-on training; training.

4.13.

7 Major Successes/ Achievements There were two successes which are worth noting.
registration registration product, were implemented.

of importers and imported commodoties, and a drug, cosmetics A food importation programme with and device 4.13.8 Major Problems Faced and Suggestions for Problem Resolutioa The major problems faced over the year were: • inadequate •insufficient •inadequate •power outages.
laborato numbers transportation; ry supplies and relevant instruments; staff; of trained technical It is suggested freedom to solicit revenue the laboratory, the flexibility that the food and drugs department be made an autonomous funding from international agencies.

This would facilitate body with greater the refurbishing of to pay attractive remuneration packages to attract earned could be used for maintainance and resupplies.
quality staff and retain and it would grant 5.0 REVIE\V OF SPECIAL INITIATIVES initiatives were undertaken in 1994.

These included a great deal of effort Health of a National of Health of both agencies.
There was enactment the reintegration of structure of a new organizational was made and the definition Plan, progress oflegislatio n of towards also action on were held on the contents of a Health of Pregnancy, initial work began on the updating/development discussions the development of special A number towards GAHEF into the Ministry incorporatin the Medical Care 111 project,and included the development Moruka for the first g the functions Termination the establishment participation of a Strategic Plan for New Amsterdam of community as a coherent Hospital, ten years ago.
strategy and the posting in the health to of a doctor sector, time since the hospital was constructed oflegislation.

Other initiatives 5.1 HEAL TH PLAN of a National the establishment were held throughout Following meetings February it was recognised a consequence.

completio membership going beyond the National Health Planning Co-ordinating this team established the developme on one Committee Health Planning Committee 1993.

Plan.

In too slow.
Plan.

In too slow.

As in September Health would make the process to facilitate Team was established four Task Forces Committee the timely with broad-based but ultimat ely n of the Plan.

In turn, a five-person nt ofa National that reliance 1994 to further itself.

for (a) the d,e,velopment assessment of Principles of the current and Statement of the existing health to it.
These task forces were responsible ( c) an analysis designed s (b) an epidemiological delivery responsible Values, and Mission and Vision health situation and objectives to move the health sector these task forces drew on the findings ofa series of consultation Coordinating participati the Regions, to the formulation Team in almost on in plan development since their views, These workshops on the part of those most directly ideas and experience all of the Regions.

of a meaningful s were felt plan.


forward over the 11ext five years.

The work of W()rkshops organised by the to allow for were designed involved in to off'er an invaluable in health delivery contribution system a11d ( d) establishment of goals The Coordina very hard throughout Committee Planning Plans for all national the final chapter 1995-2000 objectives that progress accountability period.
with related ting Team, the Task Forces and the National the year, and a draft National Plan work began in August.

departments and programmes.


These implementation Planning was adopeed by on the development Committee the National In addition, worked Health oflmplementation plans operationalize Health of the Health Plan, with details goals and objectiwes to be achieved over the More specifically, the Implementation Plans specify mission activities and tir:ne lines for their achievememt, methods responsible and persons (so that there is towards objectives for achievement can be measured), of objectives).
statements, of verification (so Health of the National The development the first time in 20 years the Ministry participatory process international local and Peace Corps and IDB).

involving some organisati has a Plan.

Moreover, 200 people, ons (for example Plan is a significant achievement it has been developed for the Ministry.
For through a very from a number of and it has received high praise WHO, the Cart<7 Center, Emory University, 5.2 DISSOLUTION OF GAHEF AND A NEW ORGANIZATIONAL THE MINISTRY OF HEALTH STRUCTURE FOR ation ofGAHEF into the Ministry ofHealth the completion Progress towards the reintegr year.

The Dissolution awaits already signs of better in October, Ministry Order went to parliament in March, of the necessary Public ration.

collabo Service Ministry One indicator but official procedures.
of this was a successful incorporating there are However, retreat held two-day tile functions of both the at which a new organizational structure of Health and GAHEF was defined.

over the continued integration administrative 5.3 MEDICAL TERMINATION OF PREGNANCY BILL Bill received its Second Reading in Parliament of Pregnancy Termination The Medical 1994.

At this second reading to July the February 1994 the Bill had been significantly Committee presented House for its first reading.
the Bill was sent to a Select Bill was revised based on submissions Committee of the House, where from all concerned parties.

By July its report in November, amended and Regulations and in December the had been drawn up.
The Select revised Bill was placed in the in January from 5.4 PLANS FOR HEALTH CARE Ill While the Health Care II project involves Ambulatory/Diagnostic/Surgical Care Centre, the construction of a new ·concerning the content that the project, to be financed by [DB, should focus on the construction of new wards at Georgetown of a potential Hospital.

Public initial (iisamio ns were held during the year Health Care III project.
One possibility bei ng discussed is 5.5 HEALTH LEGISLATION the year work has continued on the revision Throughout 1953) and the Mental Health Act (dating from 1907).

Pr<>!

!ress on the development in the new areas of Hospital work has been accomplis Assistance.

Accreditation hed under the WHO Intensive and HIV/ AIDS has also been made.
This legislative Cooperation Programme of Technical of the Public Health Act ( dating from oflegislation 5,6 COMMUNITY INVOLVEMENT of health care can be significantly The delivery part of community established Regional The aim eventually is to establish such committees Hospital, Hospital Leonora District at Georgetown Hospital, members.

Over the year Management Committees West Demerara Regional .
at all health Public have therefore been Hospital, hospital and the national psychiatric enhanced when there is active facilities New Amsterdam at Fort Canje.

involvemenl on the to the formation of these committees, work.

Leonora District In addition infrastructural the Lions Club and Futures Fund, Public of Calgary.
Hospital while refurbishment community participation has also been evident in was completely refurbished with the assistance of of the Paediatric Ward at Georgetown Hospital has commenced with assistance from the Beacon Foundation and the Rotary Club 5.7 INFRASTRUCTURAL WORK During the year work on the refurbishment efforts between the through collaborative family provided Bahais and a private refurbishment Hospital, Unit, Mahdi began during the year on the rehabilitation on the rehabilitation Basic Needs assistance.
Fort Wellington Psychiatric of the National ofSuddie Trust Fund.

a Hospital, Moruka Hospital and Matthews Ridge Hospital were developed.

Work of Suddie and Fort Wellington and with EC assistance, Hospital with the assistance of the Caribbean of Leonora and Lethem hospitals was completed MOH and NGO!;.

In the case of Lethem Hospital, the In addition, project proposals for the Hospital.

Bartica Hospital, the National Dental A number of health centres were also rehabilitated with the assistance ofSIMAP.
5.8 TRAINING A midwifery programme has been developed a six-month programme training and it should help to improve the skill levels Health Workers · this is of health \\(lrkers in for Amerindian Community these isolated is scheduled ln a ddition, to commence aitthe end of 1995. communities.
the Medex curriculum was revised and a new programme 5.9 STRATEGIC PLAN FOR NEW AMSTERDAM REGIONA,L HOSPITAL Until 1994 all of the regional hospitals w ere managed without develop a strategic assistance the guidance of a Strategic Plan.

In 1994 an initiative plan for me New Amsterdam Regional Hosptal.

This was achieved with the at the hospital.

Mr. Chetram Singh.
Mr. Chetram Singh.

of a former administrator (West Demerara, Suddie, Lind en and New Amsterdam) was taken to 5.10 MEDICAL CARE IN THE INTERIOR A doctor was posted to Moruka in 1994 • the first time the oos,ital there has been staffed doctor since its c�nstructm over l O years ago.

by a 6.0 BUDGET IMFORIHATION 6.1 BVDGETED AND ACTUAL RECURRENT EXPENDITURE Umh:et I kad imft!t,wi F.spNWitUN' (GS:) .
\rtual £qwtNfftu,rO(�) lc1l1h \IUll:Stf'" .,fl \ltntslt}·..-nkal1b t ,.,.,fflb.ls \ hnistry of (kallb • • 1th1.

"f Prt'llml- .

x.-tooal .<lie& 780000 .�,, :;1z.ooo HIU:!000 .>�UIOOO 536301000 10.1496c 000 9�o .\«mil Kc:IM'ftUilUN' ;ts% B··-'-�....i £1-aditurc.• """· •n.�.

6.2 BUDGETED AND ACTUAL CAPITAL EXPENDITURE .\<:twal F.:qM'ndtt.•·t0$ Milliom.J l«'m 11-'l.."rttd li:qk'tttfiture (ta'lut'-• 9'r-800 l�IB - 30000 � 500 ll I k1k11,·.m: t i.:1Jr�• I J,,.,vit•I l"Joj«;t • <',llNtUl:tioa ilf fl.:\I."
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