Page 70 - Demo

The Programme for the Reduction of Maternal and Child Mortality for Jamaica (PROMAC)
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with an increased focus on generating research evidence on preterm births. Significant resources have been devoted to this movement through bodies such as the Global Alliance to Prevent Prematurity and Stillbirth and the Global Coalition to Advance Preterm Birth Research (GCAPR).
The Jamaican situation
Existing data from a 2008 death evaluation study conducted by the Planning Institute of Jamaica (PIOJ) indicated that the leading cause (91%) of under-five year-old mortality was infant mortality and the majority (80%) of infant deaths occurred during the neonatal period (the first month of life). Of the neonatal deaths, 87% occurred in the first week of life, owing mainly to prematurity and other complications of the perinatal period.
The impact of non-communicable diseases (NCDs) has slowed the rate of reduction in maternal mortality. Deaths from direct obstetric causes declined by 49% between 1987 and 2006 because of improved health management and improved access to obstetric care. However, over the corresponding period, there was an 83% increase in deaths from indirect causes, negating these gains. Improved management and care of the critically ill newborn or women, in keeping with local and international standards, is a critical linchpin in the post-MDG era.
Programme goal & description
The University of the West Indies was contracted by the Ministry of Health, under the direction of the Planning Institute of Jamaica, to deliver the following:
Training: Development & delivery of curricula for new postgraduate specialists in Neonatology, maternal/foetal
medicine and critical care. The project provides 86 scholarships for the new postgraduate programmes - DM programmes in Paediatrics, Anaesthesia and Obstetrics & Gynaecology, MScN Nursing Education, and a course in Obstetric Ultrasound.
Research: Incidence, Risk Factors and Outcome of Prematurity in the Jamaican Population: PROMAC.
This study aims to identify risk factors for prematurity, such as socioeconomic status, lifestyle, clinical, oral health and environmental exposures in a national sample of 3000 Jamaican women in 24 – 36 weeks of gestation. Data will also be collected on the health status of neonates.
Programme outcomes
The trained specialists will provide care for the vulnerable populations of critically ill mothers and neonates. The research findings will inform government policies and programmes for the development of appropriate interventions to judiciously monitor and treat high-risk pregnancies and strategies to decrease the incidence of pathologies which may contribute to prematurity. The findings may also have implications for the management of these risk factors in other developing world settings, including the Caribbean.
Potential impact & applications
The programme is expected to have a significant impact on health care delivery by supporting the reduction of maternal and neonatal morbidity and mortality in Jamaica. With a multi-sectoral reach, programme applications will inform and strengthen the following aspects of policy, service and planning:
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