Decline in maternal mortality in Guyana observed after development and implementation of obstetrics and gynecology residency training program.

BACKGROUND

Many countries in South America and the Caribbean face an unacceptably high maternal mortality rate and a shortage of Obstetrician Gynecologists.

OBJECTIVE

Our objective was to address both challenges in Guyana with the development of an in-country Obstetrics and Gynecology (OBGYN) residency training program.

STUDY

DESIGN

A four-year OBGYN residency program began in Guyana in 2012 using curriculum formalized at US academic institutions and modified to suit local needs and capabilities. Partnerships between multiple academic institutions have allowed for participation of faculty across North America in educating the first in-country specialty trained OBGYN physicians in Guyana.

RESULTS

A total of 32 physicians have completed the OBGYN training program in Guyana and 30 of these graduates are currently practicing in-country. There are 18 residents currently enrolled. Full time staff are present in Guyana with support from visiting faculty members from collaborating academic institutions. Evidence-based clinical guidelines specific to this setting were developed and institutionalized to improve quality of care and patient safety. The maternal mortality ratio at program inception was 135 in 2012 and the most recent measurement has fallen to 75 in 2023. Program success was due in large part to the shared vision of local institutions, establishment of partner organizations, investment in resident leadership development, and concomitant infrastructure change and systems-based improvement.

CONCLUSION

Guyana's first OBGYN residency program can be used as a model for future academic partnerships in low- and middle-income countries. Creation of sustainable training programs in Obstetrics and Gynecology is key to decreasing global maternal mortality.