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PREFACE

The Caribbean Public Health Agency (CARPHA) has proudly adopted the mandate of one of its predecessor regional health institutions, the Caribbean Health Research Council (CHRC) to facilitate evidenced-based practice through the development and promotion of clinical care guidelines. Maternal Care in Pregnancy: Guidelines for the Caribbean outlines standards for care that are expected to result in the reduction in pregnancy related morbidity and mortality in the Region. Its main objective is to provide an easy to read reference especially designed for the primary care practitioner. It is intended to specifically serve as a guide to facilitate effective first line actions and appropriate referrals.

CHRC had produced Clinical Guidelines for prevalent chronic diseases in the Caribbean since 1995. These addressed conditions such as Diabetes, Hypertension, Asthma and Depression. The Guidelines were also regularly revised to ensure that practitioners in the Caribbean remained up-to-date with current research findings and best practices.

It should be noted that CHRC was one of the five CARICOM Regional Health Institutions that were merged to form the Caribbean Public Health Agency. CARPHA became operational in January 2013 and, critically, all the CHRC core functions were subsumed including the development of clinical guidelines.

As was the case with the previous CHRC Clinical Guidelines, Maternal Care in Pregnancy: Guidelines for the Caribbean was developed taking into account the culture, economic situation and health care systems of the Caribbean while still ensuring that international best practices are applied to patient care.

CARPHA (CHRC) is pleased to have collaborated with the Faculty of Medical Sciences, The University of West Indies, St. Augustine in the development of these guidelines. Indeed, a similar partnership successfully developed the (2009) edition of Managing Asthma in the Caribbean.

The process for the development of the Guidelines was as follows:

  • Professor Samuel Ramsewak volunteered to be the project team leader with overall responsibility for the development of the Guidelines. He convened and chaired an Expert Working Group, which prepared a draft.
  • Before the document was finalized, an iterative process was implemented in which (multiple) successive drafts were disseminated to a wide cross-section of stakeholders for feedback and inputs. Stakeholders included the Chief Medical Officers from 19 Caribbean countries, regional health institutions, professional associations, senior and influential Caribbean health professionals, inter alia. After receiving feedback at each stage, the document was updated incorporating the suggested edits.
  • The Guidelines were finalized when all stakeholders were satisfied with the eventual product.

We expect that the utilization of these clinical guidelines in the management of Maternal Care in Pregnancy by practitioners in the Caribbean would result in a significant decrease in adverse outcomes of pregnancies. The inclusive approach to its development would also facilitate widespread acceptance in both the public and private sectors.


Caribbean Public Health Agency
Port of Spain
Trinidad and Tobago

January 2014

Faculty of Medical Sciences
The University of the West Indies
St. Augustine, Trinidad and Tobago

Caribbean Public Health Agency © 2014