Post on 11-Jan-2016
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Country Presentation
Saint Lucia
Caribbean Map
Macro-economic and Socio –Economic Profile - Summary
MIDDLE INCOME OECS TERRITORY of 238 sq. miles
GDP US$ 625.9 MILLION per capita GDP US$ 3928 5 % ON HEALTH - US$ 196 per capita (8%) 68% public and 32% private Steadily growing and aging population Rising unemployment (18%) Low incomes (25% below poverty Line) Large and growing informal sector
Overview of the Health and Social System Central Ministry of Health Professional bodies that structure and
regulate the sector ( MDA, NA, PC. PHB)
Health Providers and Health Professionals (Public, NGOs, Private)
Financing Agents ( CF, PI, NIC, UHC) Community/local organisations Clients
Structure of the Health System Central Ministry of Health Eight Health regions 32 health centres 1 polyclinic 2 district Hospitals 2 general Hospitals and 1 Private hospital 1 Psychiatric Health facility 1 Drug rehabilitation facility Support services – located hospitals ( private) Universal Health Care – (NHI)
What is Affecting our Health ? Personal Behaviors, attitudes and
Lifestyles Level of Education Environment in which we live and work Access to and availability of Health
Services Attitude of Health care professionals Health conditions affecting the Global
Economy
What are the Issues Affecting the Health System The ability of the economy to sustain the
health system due to change in disease profile and increase health care cost
Supply of Health Professionals and appropriate skill mix
Technological changes Interaction of the health system with other
sectors in the economy Fragmentation of Health System Inadequate Investment in Health Inefficient health information system
PRINCIPAL CAUSE Rank No. Rate
Diabetes Mellitus 1 133 81.9
Cerebrovascular Diseases 2 116 71.4
Ischemic heart diseases 3 61 37.8
Pulmonary heart Diseases, disease of pulmonary circulation
4 51 31.4
Acute respiratory infections 5 42 25.9
Assault (homicide) 6 38 23.4
Malignant neoplasm of the digestive organs 7 37 22.8
Malignant neoplasm of prostate 8 36 22.2
Chronic Lower respiratory disease 9 32 19.7
Land Transport Accidents 10 30 18.5
10 Leading causes of death by rank for 2004
Trends in MortalityIndicators 1994
2004Total deaths 950
1072Crude death rate 6.6 6.5Live expectancy at birth ( male) 68
71Live expectancy at birth ( female) 72
77Infant Mortality rate 12
16.2Child (1-4 years ) mortality rate 5
4.1
• 1. Accidents and adverse effects1. Accidents and adverse effects 2,540 years2,540 years• 2. Perinatal conditions2. Perinatal conditions 1,7641,764• 3. Malignant neoplasm3. Malignant neoplasm 1,4211,421• 4. Heart disease4. Heart disease 1,1101,110• 5. Homicide5. Homicide 1,1021,102• 6. Congenital anomalies6. Congenital anomalies 797 797• 7. Diabetes Mellitus7. Diabetes Mellitus 520 520• 8. Cerebrovascular disease8. Cerebrovascular disease 369 369• 9. Suicide9. Suicide 369 369• 10. Chronic liver disease10. Chronic liver disease 195 195
The top ten causes of death in The top ten causes of death in terms of years of potential life lost terms of years of potential life lost (YPLL) p.a.(YPLL) p.a.
General ConclusionsMorbidity & Mortality Neonatal deaths is a major contributor to infant
mortality
Injuries and accidents principal cause of deaths for children 1-4 years, adolescents and adults especially males
Teenage pregnancies and low birth weight persistently high in spite of reduced fertility
General Conclusions (Cont)
Diabetes is the principal cause of death and suffering among persons 45+ years;
Malignant neoplasms is a major cause of death among adults and older persons (prostate, breast and cervix)
HIV/AIDS - Increasing incidence, particularly among youth and adult females
Improve environmental health through monitoring of food, water and environmental determinants of chronic and communicable diseases
Present Health Sector Response The Health System focuses on Disease
Prevention and Management. Heavy emphasis on Disease Surveillance The system is reactive rather than proactive. Decisions made are not always evidenced
based Limited Service integration Insufficient emphasis on client focused care HSR – NHSP, UHC, HMIS, HR and Training Plan
What do we want to achieve
The Overall Goal :
Producing a nation of productive people capable of Contributing to
national wealth and development
Policy Guidelines
Caribbean Cooperation in Health II MDG’s Primary- Based Health Care Model Caribbean Charter for Health
Promotion
Main Objectives
Improve the health care delivery system
Reduce incidence of communicable and non-communicable diseases
Enhance productivity Improve quality of life
Main Deliverables
Increased access to quality health care
Value for money
Equity in health care
PRIORITY AREAS FOR ACTION AND CHANGE
National Health Strategic Plan
System Development Sustainable Financing Quality Improvement Networking
SYSTEM DEVELOPMENT
Organisation of the Health Service Institutional Strengthening Physical Infrastructure and
Outfitting
Health Service Organisation Convert health centers into health
development units Establish Community Improvement
committees ( PAHO healthy community initiative)
Rationalisation of primary health care services
Integrate levels of care and programmes ( mental health)
Regional Health Team Approach
Institutional Strengthening Refocus and restructure MoH
(leadership: policy development and planning, regulation, monitoring and evaluation)
Development of National Health Information Systems
Development of Human Resource Plan Improve management structures –
central ministry, region and community
Proposed RelationshipsMOH NIC/UHC
Hospitals
Service AgreementQuality standards FinancingService quantities Financial Audit
Patient Services Support to Regional PHC Services
Proposed StructuresCMO
Central MOH Programme Heads e.g. Gros Islet Polyclinic, Dennery Hospital, Soufriere Hospital, Nutrition, Env. Health, Dental, CDC N-CDC, Reproductive Health, etc.
9 Regional Health Teams
Health CentresHospitals
PNO
Policy,Standards,Monitoring
Improvements to Physical Infrastructure
Refurbishment, rehabilitation and expansion of health centres ( CDB, BNTF, World Bank)
Construction of New General Hospital (EU)
Construction of Mental Health Facility (PRC)
SUSTAINABLE FINANCING
Financial accountability of unit managers
Develop National Health Insurance system – Universal Health System
- Ensure access to an essential package
of health care services
QUALITY IMPROVEMENTS
Implement a quality improvement system
Establish regulatory frameworks Develop appropriate legislation and
update medical by-laws Adopt an evidenced-based
approach to health care service delivery.
NETWORKING
Strengthening community, regional, inter-ministerial and inter-sectoral collaboration
Develop clear, objectives and policies
Advocate for a healthy nation Regional Health Institutions International linkages
How will we facilitate change - Tools Integrated planning Intersectoral collaboration Health communication and marketing Community involvement/participation Quality Improvement System Lobbying and advocacy Health management and information
system-monitor and measure health sector performance, health outcomes
Training Community Psychiatric Nursing Continuous Quality Improvement- Management and Administration-
financial management and public health leadership
Health Services Research Family Nurse Practitioners Public Health Nursing
Thank You
SAINT LUCIA