"Going Further in Preventive Healthcare": Speech By President Tharman Shanmugaratnam At KK Women’s and Children’s Hospital Centenary Celebration Dinner on 5 October 2024 At The Ritz Carlton Millenia Singapore

Mr Ong Ye Kung, Minister for Health,                  

Mr Cheng Wai Keung, Chairman, SingHealth,

Professor Ng Wai Hoe, Group CEO, SingHealth,

Professor Alex Sia, CEO, KK Women’s and Children’s Hospital (KKH), 

Distinguished Guests,

1. It is truly a pleasure to be with all of you tonight to celebrate KKH’s extraordinary achievements over its 100 years in maternity care, and its continuing journey of innovation and improvements in quality of care. 

2. KKH’s contributions to Singapore have been immense, in maternity care and beyond – beyond delivering babies safely, to shaping a healthy future for mother and child especially in the early years of the child’s life, and enabling a virtuous cycle of well-being within the family. KK, as it has long been referred to by Singaporeans, has shaped the lives of generations.  

3. Those of us who were around at the time took much pride in the only Singapore entry in the Guinness Book of Records in 1966 – KK delivering close to 40,000 babies in one year, the largest number by any hospital in the world. 

4. But delivering babies is not KKH’s only achievement. Over the years, KKH has built leading capabilities in clinical research and services:

   1. From pioneering pregnancy-related uterine tumour studies in 1960s, led by Dr Tow Siang Hwa, which led to the development of an internationally-recognised treatment protocol for pregnancy-related uterine cancer; 

   2. To delivering Asia’s first in-vitro fertilisation (IVF) or “test-tube” baby in 1983, led by Prof SS Ratnam;

   3. To establishing Singapore’s first human milk bank in 2017, which has benefited more than 5,000 premature and sick babies to date;

   4. To developing the world’s first AI-powered ultrasound guided, automated spinal landmark identification system, uSINE® – which has been implemented in clinical care in KKH since May 2023. It enables women to achieve successful spinal anaesthesia at the first attempt during childbirth, thereby reducing complications associated with the procedure. I understand that it has had success rates of up to 92 per cent in women of healthy weight who have used it and will be introduced to other hospitals. 

Giving Every Mother and Child the Best Start to Life 

5. While Singapore is known for its high medical standards and world-class healthcare, we face our own challenges. Maternal depression and gestational diabetes are two important challenges.

6. Local research has found that approximately one in 10 pregnant women exhibits clinical symptoms of depression. 

7. To address the rising incidence of maternal depression and its impact on maternal-child health, KKH launched the Psychological Resilience in Antenatal Management (PRAM), an antenatal depression screening initiative.  To date, more than 3,000 KKH patients have undergone the screening, and the initiative has since been expanded to polyclinics in Tampines, Punggol, and Yishun.

8. To help women achieve a safe and healthy pregnancy, KKH has also implemented screening and support for gestational diabetes – given that one in five expectant mothers in Singapore has gestational diabetes – and launched the Singapore Perinatal Mental Health Guidelines. Together, these enable healthcare professionals to identify and monitor women with maternal depression and gestational diabetes early. 

9. We know from the studies done under Gusto – the Growing Up in Singapore towards Healthy Outcomes programme – how critical a mother’s health is for her child’s development, and how a child’s early years, especially the golden window of the first 1000 days, have a lasting impact on their well-being throughout life.  

10. This is why it is crucial to ensure every mother and child gets the best start. KKH is playing an active role in making this happen. 

Pushing Further in Preventive Healthcare 

11. KKH is launching three new programmes to provide targeted and early support for maternal-child health, as the basis for long term well-being of both mother and child. They were each made possible through the generosity of donors and partners.

12. First, the Pre-term Pregnancy Prevention Programme. 

    1. Pre-term birth is a global concern and the leading cause of death for children under five. Premature birth survivors face an increased risk of disability and developmental delays, and can suffer long-term health consequences. Of concern also is the significant mental and emotional impact on their family and caregivers.

    2. Supported by The Far East Organization, the Pre-term Pregnancy Prevention Programme aims to undertake research into the factors that contribute to preterm pregnancy, provide training for healthcare professionals, develop personalised prediction and screening tools, and enhance clinical management strategies to prevent preterm pregnancies, and focus on proactive interventions and care, nationally.

13. The second initiative being launched addresses metabolic health, a very important issue. Here too, the approach is preventive. The Paediatrics and Endocrinology Life-Course Action Network or PELiCAN, is a preventive metabolic health initiative. It will focus especially on metabolic disorders linked to diabetes, obesity and hormone-related issues.

    1. PELiCAN will be a network that engages parents and healthcare providers, to act early to identify children with metabolic disorders. It will have a dual focus: 

       1. maintaining metabolic wellness in healthy children and their families; and

       2. preventing new metabolic health risks in children with existing genetic metabolic disorders. 

    2. The early and effective management of existing metabolic disorders is crucial in preventing heart attacks and strokes later in life.

       1. For instance, for children with metabolic disorders such as familial hypercholesterolemia (a genetic disorder that causes very high levels of cholesterol in the blood), it is vital to effectively manage high cholesterol and prevent the development of new risk factors such as obesity, high fats in blood and high blood pressure. 

       2. This requires personalised and early intervention to reduce the risks, and even prevent problems before a baby is conceived.

    3. The PELiCAN initiative is an example of our broader national approach in healthcare, of moving upstream and focusing on preventive health.

14. The third initiative has to do with midwives. KKH has a proud history of midwives delivering care to mothers and their newborns – from labour to delivery to the immediate postnatal recovery period. The midwives were the backbone in maternity care.

15. The new Community Midwifery Programme or EMPOWER², will extend their care beyond the hospital into the home, supporting mothers’ well-being and newborns’ healthy development in the first six weeks after birth.

16. As we all know, it can be the most challenging time for mothers, as they can experience significant physical, emotional and psychological changes in the weeks and months following birth.  Most especially for first-time mothers and those without strong support.

17. No mother should feel isolated or overwhelmed. The Community Midwifery Programme will be a real boon. It goes together with all that fathers must do to be actively engaged at home and playing their roles to look after the baby.  

    1. The programme will provide midwife-led care and guidance for issues such as infant feeding, expressing breast milk, postpartum activity and nutrition.

    2. But the midwives will also be there to provide emotional and psychological support for the mother.

    3. It will include teleconsultations to provide easy access to professional advice, besides regular home visits. 

    4. For a start, it aims to benefit 400 mother-baby pairs living in the North-East, particularly in Ang Mo Kio, Hougang, Serangoon, Sengkang, and Punggol. 

18. Taken together, these are three important initiatives by KKH, focused on intervening early – during and even before pregnancy, and then after the child is born – to provide a strong foundation for long term health of mother and child.

Conclusion

19. In closing, let me once again congratulate KKH on a century of pioneering work in maternity care and beyond. KKH has been more than just a hospital – it is a place where hope is born, and where the future is nurtured with unstinting care.

20. I thank the staff of KKH, from your pioneers till today, and your generous donors and partners who have contributed their money, time, and expertise to make this a reality. I join you in looking forward to the next chapter of your story.