Guyana Improving Access and Equity of Immunization and Maternal and Child Health Services in remote areas

19 Sep 2022
Child Immunization

Georgetown, Guyana, 19 September (PAHO)-  Pan American Health Organization/World Health Organization Guyana, FPL/IM Unit, and the Ministry of Health conducted field visits to hinterland sub-districts of Region 8, Paramakatoi, and Bamboo Creek to address issues of equity and access to vaccination and maternal and child health services to the community. The main objective was to review the challenges in attaining the vaccination coverage of 95% and the cold chain system and regional surveillance data to meet the EPI Targets.

Paramakatoi is part of the traditional lands of the Indigenous Patamona peoples. It is the largest and most developed of the Amerindian communities in region 8 and is home to the Patamona, Macushi, and Wapishana tribes. These are highly remote areas; the only access to these remote, dense mountainous villages is by aircraft and via trails through Kato (another subdistrict). Walking is the main form of transportation to any neighbouring location. The team met with the village Toshao and the community members who managed the report. The Toshao and the community members reported the challenges and requested support from the visiting team.

The team also visited Bamboo Creek via the trail, traversing through muddy roads and waterlogged and dusty terrain. The Paramakatoi population is approximately 2000 persons, and the Bamboo Creek population is roughly 800 persons.


Some findings noted that some children had missed vaccinations in various areas due to a lack of vaccines. The inability of the Community Health Workers (CHWs) to reach persons with missed opportunities due to rough dense forested areas and inadequate transportation, among other factors such as persons refusing to vaccinate their children because of religious beliefs that were spreading misinformation mostly on COVID-19 vaccination. In addition, the cold chain solar refrigerator was functioning at the right temperature in Paramakatoi, but the other area of Bamboo Creek needed cold storage equipment. No case of vaccine-preventable disease has been reported in this community. 
The team completed the interventions, including awareness sessions with two hundred and fifty persons, including teachers, primary and secondary school children, and prominent persons in the village. This intervention would aid in correcting the misinformation and myths propagated in the community. Human Papilloma Virus vaccine and other routine vaccines were given to the children in the targeted population. 

Recommendations included the need for better management of outreach sessions so that the children who have missed vaccination can be vaccinated. In addition, there was a need for updated training for TBA since approximately 95% of the births were delivered at home by traditional birth attendants. It is cultural not to let males do deliveries for females.
There was also a need for health information on maternal health displaying services, vaccination schedules, nutrition, childcare, and safe motherhood since no information, posters, or flyers were visible on the walls at these remote health posts.

PAHO/WHO will continue to provide technical cooperation to the Ministry of Health to expand immunization and maternal and child health services to promote health education, improve immunization coverage and promote safe motherhood.