Tuesday, January 16, 2018

Fuad: Higher risk causes more deaths from pregnancy locally

 There is a high prevalence of risk factors in the Trinidad and Tobago fertile female population which makes their pregnancies more susceptible to “poor outcomes”.

In a statement in the House of Representatives yesterday, at Tower D, International Waterfront Centre in Port of Spain, Minister of Health Dr Fuad Khan said while Government has put in place many preventive measures to reduce  infant death in the neonatal period,  several studies—one conducted by Dr Bharat Bassaw in 1995, Roopnarinesingh in 1998 in Trinidad and Tobago—showed there were additional risk factors which made women more sus­ceptible to adverse outcomes.

“There is a high prevalence of risk factors for poor outcomes in our fertile population, eg, obesity (32.1); diabetes (19 per cent), adolescent birth rate (32/1000) and HIV prevalence of 1.5 per cent,” he said.

He said these issues were be­ing addressed through the strengthening of primary health-care services and outreach programmes.

Khan said Trinidad and Tobago’s  infant mortality rate had been skewed towards a higher figure because the benchmarks were under the international benchmark. The international benchmark was a foetus of 28 weeks gestation and 500 grammes. 

In Trinidad and Tobago, in the North-Central Regional Health Authority,  it used a foetus of 22 weeks gestation and 400 grammes; in the North-West Regional Health Authority, a foetus of 23 weeks gestation and 500 grammes; and South-West Regional Health Authority, a foetus of 26 weeks and 850 grammes. 

He said Trinidad and Tobago was therefore giving additions to its infant mortality rate that was not supposed to be counted. He said new definitions were being discussed in international fora.

Khan said the neonatal mortality rate had decreased in this country from 20/1000 live births in 2002 to 9.4 in 2008 and 9.8 in 2010. He said the infant mortality rate (the probability of dying in the first year of life) was 24.2/1000 live births in 2002 and had decreased to 13.2 in 2008 and 10.7 in 2011. 

He said the stillbirth rate was also decreasing from 12.6 in 2006 to 8.4 in 2008. The maternal mortality rate was 66.3/100,000 live births (equivalent to 12 deaths in one year), which decreased to 55.3 in 2008 and 25.7 in 2009 and 46.1 in 2010.

Khan said the maternal mortality rate in 2010 was Barbados —51, Cuba—73, Jamaica—110, Suriname—130, United Kingdom —12, United States of America— 21 and Venezuela—92. T&T was 46. 

Khan said Government had identified the health of pregnant women and their unborn and newborn babies as a priority. 

He said this vision in maternal child health is to support a society where women and children enjoy the highest attainable levels of health and no one suffers the loss of a mother or child due to preventable and treatable causes. 

“That has been and will continue to remain our overriding objective,” he said. 

Khan said pursuant to this objective, the Cabinet appointed the Maternity Services Review Committee in 2011, a multidisciplinary team, led by Dr Lakram Bodoe, to review existing practices, identify deficiencies, assess causes of maternal and perinatal deaths, and recommend measures for the improvement of the access to and quality of services delivered to expectant mothers. 

As the minister detailed several other initiatives, he said it was unfortunate the previous government did not see it fit to implement these programmes.