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Country Presentation

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

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Country Presentation

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  1. Country Presentation Saint Lucia

  2. Caribbean Map

  3. 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

  4. 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

  5. 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)

  6. 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

  7. 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

  8. 10 Leading causes of death by rank for 2004

  9. Trends in Mortality Indicators 1994 2004 Total deaths 950 1072 Crude death rate 6.6 6.5 Live expectancy at birth ( male) 68 71 Live expectancy at birth ( female) 72 77 Infant Mortality rate 12 16.2 Child (1-4 years ) mortality rate 5 4.1

  10. The top ten causes of death in terms of years of potential life lost (YPLL) p.a. • 1. Accidents and adverse effects 2,540 years • 2. Perinatal conditions 1,764 • 3. Malignant neoplasm 1,421 • 4. Heart disease 1,110 • 5. Homicide 1,102 • 6. Congenital anomalies 797 • 7. Diabetes Mellitus 520 • 8. Cerebrovascular disease 369 • 9. Suicide 369 • 10. Chronic liver disease 195

  11. 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

  12. 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

  13. 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

  14. What do we want to achieve The Overall Goal : Producing a nation of productive people capable of Contributing to national wealth and development

  15. Policy Guidelines • Caribbean Cooperation in Health II • MDG’s • Primary- Based Health Care Model • Caribbean Charter for Health Promotion

  16. Main Objectives • Improve the health care delivery system • Reduce incidence of communicable and non-communicable diseases • Enhance productivity • Improve quality of life

  17. Main Deliverables • Increased access to quality health care • Value for money • Equity in health care

  18. PRIORITY AREAS FOR ACTION AND CHANGENational Health Strategic Plan • System Development • Sustainable Financing • Quality Improvement • Networking

  19. SYSTEM DEVELOPMENT • Organisation of the Health Service • Institutional Strengthening • Physical Infrastructure and Outfitting

  20. 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

  21. 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

  22. Proposed Relationships MOH NIC/UHC Service Agreement Quality standards Financing Service quantities Financial Audit Hospitals Patient Services Support to Regional PHC Services

  23. Proposed Structures CMO Policy, Standards, Monitoring Central MOH Programme Heads e.g. Gros Islet Polyclinic, Dennery Hospital, Soufriere Hospital, Nutrition, Env. Health, Dental, CDC N-CDC, Reproductive Health, etc. PNO 9 Regional Health Teams Health Centres Hospitals

  24. 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)

  25. 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

  26. 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.

  27. 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

  28. 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

  29. 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

  30. Thank You SAINT LUCIA

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