For Paraguay’s public health system, 2021 continued to be a very complicated year marked by the Covid-19 pandemic, despite the gradual improvement of the situation in relation to the previous year. The need to focus on care and mass immunization of the population demanded a lot of effort and resources from the Ministry of Health.
The overall situation has been challenging in terms of the expected growth in the number of patients served, and the expansion of the Foundation’s collaboration with the Ministry. However, despite the limitations imposed by the pandemic, this interview highlights some of the milestones achieved.
We would especially like to highlight the unconditional effort made by health professionals closely linked to the support provided year after year. Patricia Abed, Executive Manager, recounts some of the achievements.
The Foundation presented the milestones for the year 2021 on the evening of Tuesday 14 December. The framework of the event was to celebrate mainly the health professionals, due to them substantial progress was achieved in relation to the two strategic axes that our institution has been carrying out for more than 4 years.
The Rassmuss Foundation has been supporting Paraguay’s public health system since 2017 in two priority areas:
Reducing maternal and perinatal morbidity and mortality rates due to pre-eclampsia and its complications, the leading cause of maternal death in the country, and promoting comprehensive adolescent health, through the establishment of Espacios Ñangareko in public hospitals, under a concept of high quality, differentiated, friendly care, in a physical environment where adolescents feel cared for.
MILESTONES ACHIEVED DURING 2021 DESAFÍO PRE-ECLAMPSIA
Fulfilling one of the objectives of the challenge, that of providing comprehensive care of excellence to each patient admitted to partner hospitals, training was carried out during the months of July, September, October and November to strengthen knowledge on prevention and early detection of pre-eclampsia in all partner hospitals, reaching a total of 173 professionals, including obstetrician-gynecologists, obstetricians and nurses.
At the invitation of the Ministry of Public Health (MSPyBS), a training module on “Management of severe pre-eclampsia” has been incorporated into the NATIONAL CODE RED response system. For this purpose, training dynamics were previously recorded with each medical advisor of the foundation, followed by live questions and answers with them via the zoom platform. The impact so far is of 343 trained professionals at the national level.
For the second consecutive year, the free online course on “Preeclampsia: prevention, diagnosis and management” has been made available through the platform of the National Institute of Health (INS), aimed at obstetrician-gynecologists, family doctors, obstetrics graduates and final year students of these careers. A total of 1,050 professionals participated in this second edition.
EXPANSION TO NEW HEALTH CARE CENTRES
Centro Ciudad Mujer at the Villa Elisa Hospital
In September, the agreement was signed with the General Hospital of Villa Elisa to begin training in the health module of the Ciudad Mujer Centre. The capacities of health personnel have been strengthened and the implementation of the Pre-eclampsia Challenge strategy has begun.
Hospital Materno Infantil San Pablo
On 22 September, a meeting was held to present the Preeclampsia Challenge at the San Pablo Hospital involving all the doctors in service, followed by the signing of the collaboration agreement; and on 3 December, the San Pablo Hospital officially joined the Challenge, together with the remodelling and improvements to the prenatal clinic.
With these two additions, the Preeclampsia Challenge is now present in 7 hospitals, the other 5 being: Hospital de Clínicas, Hospital de Loma Pyta, Hospital de Barrio Obrero, Hospital de Fernando de la Mora and Hospital de Lambaré.
CONTRIBUTION FROM COMPANIES INTERESTED IN JOINING THIS CAUSE
Thanks to the contribution of Banco Sudameris, we were able to purchase and provide all the necessary supplies to carry out 24,000 risk assessments for the prevention of pre-eclampsia in the 7 partner hospitals. In 2021, 14,977 consultations were registered in our partner hospitals.
ADOLESCENCE PROJECT, ÑANGAREKO SPACES CONCEPT
This year, in response to the pandemic situation, we have placed emphasis on ensuring that all Ñangareko spaces offer the best possible range of planning methods, at all times and throughout the year.
We have purchased and distributed 300 units of subdermal implants, as well as intrauterine devices for adolescents, known as mini diu, to the sites. The corresponding training on insertion and removal of both methods has been carried out in the partner hospitals beforehand.
A very important fact to highlight is that despite experiencing difficulties and challenges during the pandemic, the number of pregnancies in the adolescent centres we support has not been higher than in previous years. This is thanks to the commitment and effort made by the professionals who provide services there.
As part of the expansion of the ÑANGAREKO concept, the alliance between the Foundation and the Adolescent Home of the San Lorenzo de Calle’i Hospital was made official: The Adolescent Home will now have the seal of excellence of the Ñangareko Spaces.
For this new collaboration, we optimised the premises and also provided the necessary supplies, equipment and tools for optimal care. As usual in the work system, the staff of the service will be constantly strengthened with support and training in order to provide high quality care.
At the moment, we are initiating the necessary improvements to inaugurate the Ñangareko area of the San Pablo Hospital, a national reference in maternal and infant care, in approximately 30 days.
REASONS FOR CONSULTATIONS IN THE ÑANGAREKO SPACES
We are very pleased that in despite the short period of supporting the Ministry of Health’s efforts to prevent unintended adolescent pregnancy, figures show that progress is being made in the right direction.
In 2018, the main reasons for consultations were adolescent pregnancies. In 2021, more than 70% of patients have been admitted for gynaecology or planning and only 30% for pre-natal care.
The 2021 closing event was attended by health professionals from the partner hospitals, representatives of the Ministry of Public Health, special guests, representatives of the companies that support the Foundation and benefactor partners.
One of the challenges for the new year is to reach vulnerable communities in the Capital and Central departments.
With much enthusiasm and great commitment from the Foundation, we plan to directly reach the most vulnerable communities of Asunción and the Central Department with our work. The goal is to expand the message of the axes we have been working on, reaching groups of families that we do not have access to through conventional media. We want to provide adolescents and women of reproductive age with sufficient and timely information that will allow them to develop knowledge and attitudes to be able to make decisions and prevent risks that compromise their health and integral development. In the month of November 2021, this new work axis has been incorporated and is currently in the methodological design stage, in order to adequately reach the communities, an action planned for February 2022.