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