Rohan D’Souza part of project in Guyana focused on enhancing the country’s obstetric survey system

Rohan D’Souza joined a team of experts from Canada and the United Kingdom on a visit to Guyana this April. The team led a series of workshops focused on enhancing the country’s infrastructure for reporting, reviewing and reducing maternal mortality and morbidity.

Members of the Canada/UK team included Chair of McMaster University’s Obstetrics & Gynecology Department, Jon Barrett, Chief of the Department, Byron DeFrance, Chief Scientific Officer of the Society of Obstetricians and Gynaecologists of Canada (SOGC), Jocelynn Cook, Professor of Maternal and Child Population Health at the University of Oxford, Marian Knight, and McMaster Associate Professor and Co-Principal Investigator of CanOSS, Rohan D’Souza.

Upon their arrival in Guyana, Natasha France, OBGYN Residency Director at the Georgetown Public Hospital (GPHC), led the team on a tour of the GPHC – Guyana’s largest hospital and main referral centre in the country for maternal health.

Following the tour, the Canada/UK team led a series of workshops with members of various departments at GPHC that provide care to pregnant and postpartum women and people, as well as representatives from other regions in the country and the Ministry of Health.

In the first workshop, the team discussed the elements and benefits of maternal mortality and morbidity reviews, confidential enquiries, and obstetric survey systems. Dr. Knight shared an overview of the UK’s Confidential Enquiry into Maternal Deaths, which was established in the 1950s, and the United Kingdom Obstetric Surveillance System (UKOSS), established in 2005 – both of which have contributed to a significant reduction of maternal mortality and morbidity in the UK.

Dr. Cook led a discussion on the SOGC toolkit for maternal mortality, which provides guidance on conducting confidential enquiries into incidents of maternal mortality.

In the second workshop, the group worked together to better understand the barriers and facilitators to establishing a maternal mortality and morbidity review system in Guyana.

Dr. D’Souza led a session focused on reviewing a recent case of maternal mortality in Guyana, and demonstrating how to move the focus from determining who was responsible to an in-depth analysis of the systems-related issues that led to the unfortunate event, and the development of Specific, Measurable, Achievable, Relevant and Time-Bound (SMART) recommendations to prevent similar events from occurring in the future and to guide clinical practice going forward.

In the final workshop, the team worked together towards reviewing relevant sections of Guyana’s constitution pertaining to the review of maternal mortality and discussed what needed to be modified in order to facilitate more evidence-informed reviews without apportioning blame.

At the end of their visit, the Canada/UK team met with Guyana’s Minster of Health, Dr. Frank C.S. Anthony, for an overview of the week’s events and to discuss next steps. The team is excited to continue collaborating with Guyana’s government and healthcare practitioners to advance maternal health and well-being globally, and to one day welcome Guyana as part of the International Network of Obstetric Survey Systems (INOSS). The team plans to assist GPHC as they begin training assessors for their obstetric survey system.