1 / 41

ST. KITTS & NEVIS HEALTH SITUATION

ST. KITTS & NEVIS HEALTH SITUATION. Health Status Indicators & Socioeconomic Determinants of Health. PATRICK MARTIN CHIEF MEDICAL OFFICER 12/12. WHY HEALTH SITUATION ANALYSIS? A SYSTEM PERFORMANCE EVALUATION (“GUT CHECK ” ) PROMOTES EVIDENCE-BASED PROGRAMMING & DECISION-MAKING.

raja-everett
Download Presentation

ST. KITTS & NEVIS HEALTH SITUATION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ST. KITTS & NEVIS HEALTH SITUATION Health Status Indicators & Socioeconomic Determinants of Health. PATRICK MARTIN CHIEF MEDICAL OFFICER 12/12

  2. WHY HEALTH SITUATION ANALYSIS? • A SYSTEM PERFORMANCE EVALUATION (“GUT CHECK ” ) • PROMOTES EVIDENCE-BASED PROGRAMMING & DECISION-MAKING RATIONALE FOR DATA USE • Planning Starts With Data • Operational Data drive Analysis • Without Data, One Is Opinionated • No Measure, No Manage, No Money

  3. A: OBJECTIVE HEALTH Life Expectancy, Mortality, Morbidity/Disability

  4. POPULATION AND BIRTHS

  5. 2006 - 2008 • Life Expectancy @ Birth • Increased from 70 years in 2003 to 73 years in 2006 • Compared to 2001-2005 • Estimated population increased by 3.9% • Ave. # of live births decreased by 6.7% (724 to 687). • Net increase in population due to inward migration (death rate also dropped)

  6. CHRONIC NON-COMMUNICABLE DISORDERS • Dominated the epidemiologic profile since the early 1980’s. • Risk factor Survey (STEPS - SK, WHO, 2008) – Prevalence Findings • Adult Overweight - 75% • Hypertension - 36%. • Diabetic prevalence (est.) - 15-20% adults • Extrapolating from the public sector diabetic clinic register. • 80% due to obesity (2006 CCHD)

  7. NON-COMMUNICABLE DISORDERS External Injury • Violence-related injuries continue to increase. • JNF Hospital – Cases of assault (non-gunshot) and wounding • [2001-2005] = 3 x [1996 – 2000] • Homicides • 56 in 2006-2008 vs. 42 in 2001-2005 • Most were attributed to drug-trafficking gang activity (RSCNPF; UNODC) • The increase in homicide reflected in the increase in deaths of persons 20-59 years

  8. NON-COMMUNICABLE DISORDERS Mental Illness • Prevalence • ~ 1.2% of the total pop. registered in the public sector’s mental health program. • Major mental illnesses • Schizophrenia, Depression and Substance Abuse Disorders.

  9. MAJOR DISABILITIES • Mental/Neurological • Depression, Paranoia, Substance Abuse, Dementia, Epilepsy • Learning/Behavioral/Developmental • Reading, Mathematics • Conduct Disorders associated with Parental Dysfunction • Brain Disorders e.g. Cerebral Palsy • Diabetes-Related Amputations • External Injury-Related

  10. COMMUNICABLE DISEASES • Account for less than 5% of deaths. • HIV/AIDS • In 2006-2008, HIV incidence 40 cases; AIDS deaths 6; 2009 – 8 cases • in 2001-2005, 73 and 14. • Tuberculosis • 2006-2008 - Average annual incidence of 3 cases • 2005 - 1 case • No cases of the diseases covered by EPI • Endemic Vector-Borne Diseases • Dengue Fever - Outbreaks every 6-7 years. Dec. 2008 - 60 confirmed cases • Malaria and cholera are non-existent.

  11. MORTALITY TREND ANALYSIS

  12. MORTALITY • Average crude death rate decreased to 7 deaths per 1000 population compared to 7.5 in 2001-2005. • Absolute infant mortality decreased from average 12 to 10 deaths per year • Rate fluctuations reflect larger changes in the numerator (infant deaths) compared to the denominator (live births). • Neonatal (<28 days) deaths, especially in the first week of life, account for all infant deaths (80% in 2001 – 2005) • Deaths in this age group are largely due to conditions originating in the perinatal period, chief among them respiratory distress syndrome associated with the immature lungs of premature infants. • 2 maternal deaths; similarly for 2001-2005.

  13. LEADING DEATH CATEGORIES - SKN • 2006-2008 • Circulatory System Disorders (34%) • Heart Disease; Stroke • Other Diseases (27%) • Diabetic Complications • Neoplasms (18%) • External Injuries (12%) • Homicide

  14. LEADING CONDITION / DISEASECAUSES OF DEATH • Adults • Heart Disorders • Stroke-related Disorders • Diabetes Complications • Homicide • Children • Prematurity • Congenital Anomalies

  15. [2006 – 2008] vs. [2002 – 2005] Re Actual Deaths (No data for 2001) • Decreases • Communicable diseases (by 50%) • Circulatory disorders (37%) • Deaths due to heart diseases increased • Stroke syndromes remained unchanged • Perinatal conditions (20%) • Increases • Neoplasms (30%) • External injuries (33%).

  16. B: SOCIAL & ECONOMIC DERTERMINANTS OF HEALTH

  17. COMPARISIONS

  18. HOSPITAL MORTALITY

  19. MAJOR WORK AHEAD • Health Systems & Regulation • Financing – Universal Benefits Plan • Reduce personal bankruptcy • Reduce burden on treasury • Restructure of the National Health Authority • Legislation • Registration • Environmental Health • Pharmacy • Mental Health • Laboratory

  20. MAJOR WORK AHEAD • Other • Community Health Worker (Outreach) • Key to service delivery to homes • Patient Charter • Continuing Education Credits • Time-limited registration • Environmental Health Department • Food Safety; Effects of Climate Change; Port Health • Emergency Medicine Specialist • International best practices

  21. MAJOR WORK AHEAD • Reduction of Risk & Burden of Disease • Dietary Guidelines • Oral Health • Cavities the major infectious disease in children • Cancer Registry • Wellness Revolution esp Men • Active Ageing • Violence & Injury Prevention (VIP) • Youth Anger; Adult Conflict (Relationships; Politics) • Speeding; DUI; DWD • Substance Demand Reduction • Substance Culture

  22. HEALTH RISKS[WHO] • 75% of Coronary Heart Disease caused by • Alcohol Consumption • High Blood Glucose • Tobacco Use • Overweight • High Blood Cholesterol • Low intake of Fruit & Vegetables • Physical Inactivity

  23. HEALTH RISKS[WHO] • 25% of all deaths caused by • Childhood underweight • Unsafe Sex • Alcohol Misuse • Unsafe Drinking Water • Poor Sanitation & Hygiene • High Blood Pressure

  24. HEALTH RISKS[WHO] • 25% of child deaths caused by unsafe and unhealthy environments • 45% of cancer caused by 9 environmental & behavioural risks + 7 infections • 71% of Lung Cancer caused by Tobacco Smoking

  25. MINISTRY OF HEALTH POLICY OUTLOOK • Philosophy: “Nation’s Health Is Its Wealth” • Value Statement: Health Care is a Human Right and a contributor to individual wellbeing and national development • Principles  Quality  Equity Universality  Sustainability • Strategies  Effective Stewardship  Health Promotion Primary Health Care Integrated Service Delivery

  26. NATIONAL STRATEGIC PLAN - HEALTH Priority Areas 2008 – 2012 • Reducing Chronic Non-Communicable Diseases • Improving Mental Health and Reducing Substance Abuse • Prevention and Control of Sexually Transmitted Infections • Safeguarding Health of the Environment • Promoting the Health of the Family • Health Systems Development • Human Resource Development

  27. EXPECTED OUTCOMES: By 2015 • Service Features • High Quality; Impactful; Affordable & Sustainable; Satisfactory

  28. THE FINAL ANALYSIS Pr imary Heal thcare Primary Care EC $$$ GOOD HEALTH Disease/Injury Prevention/Early Intervention Impairment Major Disorder/Disability Dependency Secondary Care EC $$$$ Tertiary Care + US$$$$$

  29. THANK YOU FOR YOUR ATTENTION

More Related