Transcript Quality Health Care for All - Home

Country Presentation
Saint Lucia
Caribbean Map
Macro-economic and Socio –
Economic Profile - Summary
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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
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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
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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 ?
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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
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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
10 Leading causes of death by rank for 2004
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
Trends in Mortality
Indicators
Total deaths
Crude death rate
Live expectancy at birth ( male)
Live expectancy at birth ( female)
Infant Mortality rate
Child (1-4 years ) mortality rate
1994
950
6.6
68
72
12
5
2004
1072
6.5
71
77
16.2
4.1
The top ten causes of death in terms of
years of potential life lost (YPLL) p.a.
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1. Accidents and adverse effects
2. Perinatal conditions
3. Malignant neoplasm
4. Heart disease
5. Homicide
6. Congenital anomalies
7. Diabetes Mellitus
8. Cerebrovascular disease
9. Suicide
10. Chronic liver disease
2,540 years
1,764
1,421
1,110
1,102
797
520
369
369
195
General Conclusions
Morbidity & Mortality
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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)
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Diabetes is the principal cause of death and suffering among
persons 45+ years;
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Malignant neoplasms is a major cause of death among adults
and older persons (prostate, breast and cervix)
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HIV/AIDS - Increasing incidence, particularly among youth
and adult females
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Improve environmental health through monitoring of food,
water and environmental determinants of chronic and
communicable diseases
Present Health Sector Response
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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
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Caribbean Cooperation in Health II
MDG’s
Primary- Based Health Care Model
Caribbean Charter for Health Promotion
Main Objectives
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Improve the health care delivery system
Reduce incidence of communicable and
non-communicable diseases
Enhance productivity
Improve quality of life
Main Deliverables
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Increased access to quality health care
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Value for money
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Equity in health care
PRIORITY AREAS FOR ACTION AND CHANGE
National Health Strategic Plan
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System Development
Sustainable Financing
Quality Improvement
Networking
SYSTEM DEVELOPMENT
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Organisation of the Health Service
Institutional Strengthening
Physical Infrastructure and Outfitting
Health Service Organisation
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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
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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 Relationships
MOH
NIC/UHC
Service Agreement
Quality standards
Service quantities
Financing
Financial Audit
Hospitals
Patient Services
Support to Regional
PHC Services
Proposed Structures
CMO
Central MOH Programme
Heads e.g. Gros Islet Polyclinic, Dennery
PNO
Hospital, Soufriere Hospital, Nutrition, Env.
Health, Dental, CDC N-CDC, Reproductive
Health, etc.
Policy,
Standards,
Monitoring
9 Regional Health
Teams
Health Centres
Hospitals
Improvements to Physical
Infrastructure
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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
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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
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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
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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
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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
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Community Psychiatric Nursing
Continuous Quality ImprovementManagement and Administrationfinancial management and public health
leadership
Health Services Research
Family Nurse Practitioners
Public Health Nursing
Thank You
SAINT LUCIA