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Guyana is one of the few countries in South America that has already achieved the Millennium Development Goal Four (MDG4) which speaks to the reduction of childhood mortality by two thirds by 2015. And according to a study conducted here by a number of Canada-based doctors,Nike Off White The Ten, this achievement was realised by the implementation of a number of preventive programmes.However,Air Max 97 Undefeated White, the study entitled “Quality of Hospital Care for children in Two Regional Hospitals in Guyana: An Observational Assessment”, was able to deduce that the laudable feat was done without addressing acute paediatric care and therefore has not met the standard for providing optimal paediatric care.Dr Narendra SinghThe doctors Jenny Smith, Anya McLaren, Julie Johnson and Narendra Singh of the University of Toronto, along with Dr Andrea Hunter of the McMaster Children’s Hospital presented their revealing findings when the Georgetown Public Hospital Corporation (GPHC) hosted the Sixth Guyana Medical Scientific Conference recently.The study found that the majority of children are cared for between the main hospital in Georgetown and four regional hospitals. But detailed in the most recent MDG report is the fact that the shortage of skilled human resources was particularly severe in the hinterland regions of the country.  It was noted too that one of the key priorities identified was the improvement in quality of care, particularly for children below one year of age.And according to the doctors,Cheap Air Max 95 Sale, “currently, there is minimal data regarding the healthcare resources and staffing available in these rural areas and the quality of care provided to the paediatric patient population.”Moreover,Off White Nike Vapormax 2018, the study executed a needs based assessment at two regional hospitals – the Linden Hospital Complex and the New Amsterdam Hospital – during the period April 22 through May 3, 2013. The primary objective of the undertaking was to define the adequacy of the current healthcare facilities to care for acutely ill paediatric patients.Ahead of the study, Research Ethics Board approval was obtained from the Humber River Regional Hospital in Toronto, Canada, and the National Ethics Review Board in Guyana for an on-site needs based assessment using the World Health Organisation (WHO) generic assessment tool.With consent, hospital staff and caregivers were interviewed and information collected through direct observation and analyses of health records. Summary evaluation scores from one to five were assigned for designated domains based on the fulfilment of standard criteria. A score of five was given for good practice complying with standards of care while a score of one indicated totally inadequate care and absolute scores were converted to percentages.The findings of the study were able to uncover that the quality of paediatric and neonatal care at the two regional hospitals was found to be inadequate in multiple domains. For instance the hospital summary score for the Linden Hospital Complex and the New Amsterdam Hospital were 74 per cent and 78 per cent respectively. This was despite the fact the fact that the Regions have well-run tuberculosis and HIV programmes with case management summary evaluation scores of 95-100 per cent.Case management of other conditions such as severe malnutrition and fever were however unacceptable by WHO standards (60 and 70 per cent respectively).In fact, it was revealed that the essential paediatric medications were frequently unavailable and lab services were insufficient to support basic diagnostic work-ups. The scores for these services were less than 60 per cent and it was uncovered that the essential equipment for emergency paediatric care and the layout and physical structure of the Emergency Department was also insufficient (40 to 60 per cent) according to WHO standards.As a result, the study surmised that despite achieving the MDG 4 in Guyana, two regional hospitals have not met the standard for providing optimal paediatric care. It was therefore recommended that the implementation of management protocols,Adidas Stan Smith Shoes Sale, such as fever and malnutrition,Adidas Shoes On Sale Cheap, appropriate medications,  basic lab facilities and the development of a ‘child friendly’ emergency room, have the potential to further decrease the under five year mortality.