Transcript St Christopher and Nevis

St Christopher and Nevis
Health Systems Strengthening Seminar
Belize City
May 30 –June 1, 2006
Background
 St Christopher and Nevis is an independent twin
island federation that is located in the north
eastern Caribbean.
 St Kitts spans 168km2 and Nevis 93km2
 The combined population is 47,313 (2003 est.)
 The main stay of the economy is tourism with
contributions from agricultural sector and export
oriented manufacturing.
 Per capita GDP $8600 (2004 est.)
 Life expectancy at birth 69 years in males and 75
in females
Public Health System
 There are 2 General
Hospitals (urban) that
offer secondary care.
 Two rural district
hospitals in St Kitts.
 17 Health centers (11
in St Kitts and 6 in
Nevis).
Organizational Structure
Ministry of Health
Office of Policy Development
and information Management
Community Based Health Services
Administration
Family Health
Services
Environmental Health
Services
Health Promotion
Institution Based Health Services
Administration and
auxiliary services
Clinical and
patient care
Health Sector Reform
 Since the late 1990’s, the health sector
has undergone a series of reforms in an
effort to improve efficiency, quality and
sustainability.
 Discrete examples are illustrated in the
following slides.
Establishment of Health Promotion Unit
 With the increasing prevalence of lifestyle related
disorders, there was recognition of the
importance of health promotion strategies and the
need to emphasize prevention as part of the
holistic approach to care.
 A Health Promotion Unit was established in 2000
to coordinate health promotion approaches across
government departments and other sectors.
 It is staffed by a NCD Coordinator, Nutrition
Surveillance Coordinator, Nutrition Officer,
National AIDS Programme Coordinator and 2
health educators.
Upgrading of health facilities
 The main hospitals on both islands were
upgraded.
 Several of the primary care facilities were
also upgraded to accommodate the
operationalisation of the primary health
care approach to promote accessibility,
community involvement and self reliance.
Human resource strategies
 Increased commitment to provide
training opportunities for staff through:
– Scholarships
– In-service Education Department located at
Joseph N France General Hospital
• Training of VCT counselors
• Training of Emergency Medical Technicians
• Continuous education for nurses and assistants
Restructuring of the Nursing
Services
 Training programme for nurses and auxiliaries
is now delivered through the Clarence Fitzroy
Bryant College.
 Restructuring of nursing posts and
responsibilities in an attempt to increase the
autonomy of managers (the role of the Chief
Nursing Officer has been de-emphasized as it
relates to the general management of nursing).
Quality Initiatives
 There has been an effort to incorporate quality
in all care processes.
 National Focal Point has been appointed to
coordinate these efforts.
 Introduction of user satisfaction surveys.
 There has been some movement towards
achieving accreditation of hospital (preliminary
evaluation conducted in 2005)
Health Financing
 After almost thirty years, there was an
evaluation of user charges in an effort to
augment revenue collection (no follow up
research to assess the impact on access).
 There is keen interest in implementation
of a national health insurance scheme to
ensure universal access to services.
Privatization
 There has been an increased willingness
to engage the private sector entities to
ensure provision of health services.
 CT scan available at Joseph N France
through public private partnership.
 Plans to establish a haemodialysis unit at
the same facility with collaboration from
private sector.
Conclusion
 We have achieved some successes in our
attempts to improve the performance of the
health care system through health sector
reform.
 We must build on these efforts and continue
to sustain the momentum that has been
created.
The End
Thanks for your attention!