In light of a recent report which shows that there is no significant decline in maternal mortality, shadow Public Health Minister, Dr Frank Anthony said the high incidence of maternal deaths is an indication that the system is broken.According to Dr Anthony, it is evident that the whole system is not working as it should since many of the deaths occur from preventable situations.“Many of the maternal deaths would somehow relate to hypertension and bleeding but they are preventable,” he said, adding that if Guyana had a strong system of surveillance where pregnant women visit the clinic regularly, they would be able to monitor those pregnancies considered as high risk.He explained, “We need to isolate those high risk people and pay special attention to them; I don’t think we are aggressive enough in curbing maternal mortality.”Dr Anthony further opined that there is a weakness in the mother to child healthcare system and there is room for improvement.According to a recently released report, Maternal Mortality Estimates, which presently stands at 229/100,000 live births, has not shown any significant decline since the year 2000. There are two factors which cause maternal mortality; first, those that are directly related to obstetric complications during pregnancy and the second are related to indirect obstetric deaths.It has been reported that 73 per cent of the maternal deaths in 2012 were direct deaths, ie, those resulting from obstetric difficulties of the pregnant state (pregnancy, delivery and postpartum), interventions, omissions, incorrect treatment, or a chain of events resulting from any of these.On the other hand, indirect obstetric deaths occurs due to either previously existing conditions or from complications arising in pregnancy, which are not related to direct obstetric causes but may be aggravated by the physiological effects of pregnancy, which accounted for 27 per cent of the deaths in 2012.Dr Anthony stated that many deaths could be avoided if the quality of healthcare services for pregnant women were available.He maintained that antenatal care is crucial to preventing complications during pregnancy and at births, and thus advocated for a primary healthcare system.“There is a need for a better primary healthcare system, with more trained personnel so that they can identify the high risks cases quickly before they go into labour… what we need is aggressive monitoring,” he emphasised.Antenatal care is available in Guyana at different levels of the healthcare system. Although differences still exist between the coastal and hinterland regions in Guyana, the national antenatal coverage rate has been above 90 per cent since the year 2000.However, Dr Anthony indicated that in order for healthcare services to be improved, health centres need to be adequately equipped. “How else can they have accurate analysis if ultrasound machines are not available and the mothers have to search elsewhere,” he said.The Shadow Public Health Minister said the capacity of district hospitals, regional hospitals and clinics needs to be improved. Notably, some of the causes of maternal mortality are directly and/or indirectly associated to personal characteristics of the mother – their nutritional status; their health situation; to the quality of the environment of where they live (including access to proper water and sanitation); and to the access to government supplies, among others, a UNICEF report said.