Group no. 9

1. Group no. 9 ANTIGUA & BARBUDA, BAHAMAS, BARBADOS, BELIZE, GUYANA, HAITI, JAMAICA, ST. LUCIA, TRINIDAD AND TOBAGO, ST. KITTS AND NEVIS, WASHINGTON Facilitator: SURINAME

2. Challenges in Social Protection in Health • SPH on political agenda • Integrated and “client oriented” Health services • Accessible and equitable Quality care health services at all levels, EOC, EmOC • Adequate No. of Human Resources • Primary health care with sufficient budget

3. Challenges • Early attendance to antenatal care • Reduced abortion practices • Delay initiation of sexual activity • Adequate support services available • Increased male involvement and access to SRH services • Youth friendly services available • Reduced no. of pregnancy in teens • Strong partnerships “public & private”

4. Barriers to face the challenge • Unhealthy behaviors –late antenatal care, home deliveries, low breastfeeding rate, low contraceptive prevalence use, unsafe sex, early sexual initiation- • Gender inequities • Gender Based Violence • Direct payment for services and/or incomplete services • Poor partner and family support during pregnancy, childbirth and puerperium • Age specific Sexual and reproductive health not included in Education curricula

5. Barriers • Negative attitude of staff • Poor information on the services available • Cultural and religious beliefs • Geographical inaccessibility • Unemployment • Technical and first line staff politically appointed

6. Opportunities to face the challenges • Political will towards MDGs -Existence of MDGs task force- • Poverty alleviation programs –housing, school feeding program, “PATH”, others- • Health sector reform process taking into consideration the integration of the health services • Technical assistance from UNCT

7. Opportunities to face the challenges • Community empowerment • Maternal and mortality review Committee –includes verbal autopsy and clinical audits- • Existence of Regional Initiative to eradicate child malnutrition • Networking with NGOs and Community Based Organizations • Access to and management of Funds e.g. Global Fund, Clinton Foundation- • Access to PAHO Revolving Fund –Vaccine procurement-

8. Recommendations SPH to improve health outcomes • SPH on Regional & National Agenda –Summit of the Americas, CARICOM, RESSCAD; time frame for universal SPH- • SRH a primary health care strategy • Increase the regulatory capacity of the Ministries of Health –planning, monitoring, evaluation, policies for accountability, fiscalization – • Enable supportive environment for women and children –family and community- • Increase capacity of health system to provide Essential Obstetric Care –Basic and Emergency- and Home Based Life Saving Skills.

9. Recommendations SPH to improve health outcomes • Update health policies related to MNI and work towards integrated health services • Update health information systems • Research and evidence based on SPH • Reorient services to focus on Primary Health Care and implement COMBI strategies • Design and implement retention strategies for health professionals • Strengthen Public Health in Medical and allied schools • Work force projection for the CARICOM countries

10. Next steps • Review and update SPH in countries • Focus and align organizations working in the field of MNI health • Sensitize health authorities to place SPH on national and regional agenda • Reorient services to focus on Primary Health Care and adopt COMBI strategies • Empower Communities to demand their right to health • Implement Sexual and Reproductive health policies • Enable supportive environment for MNI –family and community level- • Technical assistance e.g. work force projection, SPH, M&E,

11. Next steps Thank you