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Prepares to turn focus to SDGsBy Desilon DanielsWith 86 days left before the world notes its progress in the attainment of the eight Millennium Development Goals (MDGs), Guyana still has a way to go to achieve the health-related MDGs.Minister Karen CummingsNonetheless, Minister within the Ministry of Public Health, Dr. Karen Cummings, has said that the Ministry is nonetheless working, assiduously, to achieve the goals, not only before the deadline but beyond it.In 2000, a total of 189 world leaders adopted the Millennium Declaration at the United Nations (UN) Millennium Summit. These leaders agreed to the eight MDGs, which are aimed at overcoming poverty and related targets.Three of the eight MDGs are directly related to health. These are Goal 4 (reduce child mortality); Goal 5 (improve maternal health); and Goal 6 (Combat HIV/AIDS, malaria and other diseases).Dr. Cummings gave a rundown on Guyana’s progress in terms of achieving these health-related MDGs.Guyana has made good progress in reducing the rate of under-five mortality. However, she said, more progress was needed in specifically reducing the under-three mortality rate, she said.Guyana’s achievement was noted by the United Nations Development Programme (UNDP) which noted that Guyana had achieved the goal of reducing its under-five mortality rate by two-thirds, between 1990 and 2015, since 2008. According to the Health Ministry data, under-five mortality reduced from 120 per 1,000 live births in 1991 to 17 per 1,000 live births in 2008.In explaining Guyana’s difficulties in reducing under-three mortality, Cummings noted that improvements were needed in the neonatal care offered to mothers.“The fact is, neonatal care is bad in Guyana,” Dr. Cummings said. She explained that with poor neonatal care, children are born with a very slim chance of living.“Many times they [the babies] come to us very tiny and they die,” she said.She emphasised that more specialists in the field of neonatal care is a necessity going forward. She said too, that improvement in human resources is needed along with improved health system capacities.Public Health Minister, Dr. George Norton had previously said that neonatal deaths were also being driven up by high infection rates in hospitals.Dr. Cummings also noted steps undertaken to reduce the under-five mortality rate, including improved primary care and a stringent immunisation process.Meanwhile, in terms of achieving a reduction in maternal deaths, Cummings noted that significant progress was needed in this area.One of the targets of Goal 5 was to reduce maternal mortality by three-quarters between 1990 and 2015. Another target spoke to achieving universal access to reproductive health by 2015.According to UNDP, Guyana has made significant progress in both targets. Progress is seen in the decreased maternal mortality ratio from 270 percent in 1990 to 86 percent in 20012.In order to achieve this target, Guyana would need to have reduced its maternal mortality rate to 67.5 percent by the end of 2015.Additionally, use of contraceptives increased from 32 percent to 46 percent, an indication that more persons are planning their families and using services.According to Cummings, despite the progress Guyana’s maternal mortality rate is still too high. She said that the rate was being driven up by pre-existing conditions mothers existed before entering the hospital.She said, too, that there is oftentimes lack of good primary care. These conditions, compounded by an “overwhelmed” public healthcare system is not helping the situation.“We’re trying but the healthcare system is seeing an overburdening of its main facilities. Nonetheless, we’re working assiduously to deal with maternal deaths,” she said.She said that efforts that are working will need to be amplified throughout the country. Sharing that Linden has not had a maternal death since 2009,Luke Moore Jersey, she said whatever is working there must be identified and replicated.She said that training will be a necessity to tackle the issue. She said too that increased efforts will be made to provide family planning services to the public.Realistically, she noted that some of the target health areas might not be achieved by the end of 2015 but that will not mean the ministry will stop its efforts. She emphasised that even the attainment of the MDGs will not be enough. Particularly in regards to child and maternal deaths, Cummings stressed that not a single person should be lost in the healthcare system.Overall, UNDP noted that Guyana has maintained “steady progress” towards the MDGs over the years.“Guyana has advanced in its efforts to reduce hunger, increase access to social services and benefits, improve enrolment in and completion of primary education, increase empowerment of women and achieve environmental sustainability,” UNDP said.“The pace of progress may be insufficient to achieve some of the targets for 2015,” UNDP added.Preparing for the SDGsMeanwhile, when questioned on the Ministry’s preparations for the Sustainable Development Goals (SDGs), Dr. Cummings indicated that the ministry has already been working on some of the areas.At least one of the 17 SDGs speaks directly to health; this is Goal 3, which focuses on ensuring healthy lives and promoting well-being for all at all ages. Within this goal are 11 targets, including to strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global risks; substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing states; and achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all.According to Dr. Cummings, the Public Health Ministry has already been addressing the entire life cycle, from childhood to adulthood. She further indicated that a strong focus on geriatric care is coming on-stream.“We’re looking at family health now as a whole and we’re also looking to have doctors trained specifically focused on geriatric medicine.”She stressed that funding, training and keeping people on “the cutting edge of their work” will help immensely in the attainment of both the MDGs and the SDGs.According to the UN, countries across the world will have the opportunity to adopt a set of global goals to end poverty, protect the planet, and ensure prosperity for all as part of a new sustainable development agenda. Each goal has specific targets, which are to be achieved over the next 15 years. The SDGs, which comprise of 17 goals, will come to an end in 2030.