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JAMAICAS HEALTH SYSTEMS JAMAICAS HEALTH SYSTEMS TREVOR MCCARTNEY C.D., J.P., M.B.,B.S., DM (Surg.) UWI, F.R.C.S. (Ed.), F.A.C.S SENIOR MEDICAL OFFICER.

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Presentation on theme: "JAMAICAS HEALTH SYSTEMS JAMAICAS HEALTH SYSTEMS TREVOR MCCARTNEY C.D., J.P., M.B.,B.S., DM (Surg.) UWI, F.R.C.S. (Ed.), F.A.C.S SENIOR MEDICAL OFFICER."— Presentation transcript:

1 JAMAICAS HEALTH SYSTEMS JAMAICAS HEALTH SYSTEMS TREVOR MCCARTNEY C.D., J.P., M.B.,B.S., DM (Surg.) UWI, F.R.C.S. (Ed.), F.A.C.S SENIOR MEDICAL OFFICER KINGSTON PUBLIC HOSPITAL

2 Jamaica, the largest English speaking island in the Northern Caribbean is 4,441 square miles in size and has a population of over 2.6 million persons. Jamaica, the largest English speaking island in the Northern Caribbean is 4,441 square miles in size and has a population of over 2.6 million persons.

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4 –Health Care System 18 General Hospitals 6 Specialists Hospitals 6 Specialists Primary Care System (Clinics) 331 Clinics Primary Care System (Clinics) 331 Clinics (+ 23 satellites) (+ 23 satellites) Public Health System Public Health System

5 Hospitals N=18 N=18 Type A: 3 multidisciplinary Final referral centres Type A: 3 multidisciplinary Final referral centres Type B: 5 Large urban centres (O&G, Paed med, gen surgery, int medicine, anesthesiology A&E Type B: 5 Large urban centres (O&G, Paed med, gen surgery, int medicine, anesthesiology A&E Type C: 10 District hospitals ( gen medicine, surgery, child health and maternity care. Type C: 10 District hospitals ( gen medicine, surgery, child health and maternity care. Community hospitals/ deliveries Community hospitals/ deliveries

6 Hospitals 6 specialists 6 specialists –Psychiatric and rehabilitative services for the mentally ill –O & G nationally –Paediatric care –Oncology and hospice –Chest diseases –Physical rehabilitation

7 Other National institutions National public Health lab National public Health lab Blood bank Blood bank

8 Primary care Health districts on a demographic basis Health districts on a demographic basis Pop 20-30,000 served by health centres Pop 20-30,000 served by health centres Type 1. pop 4000 Type 1. pop 4000 Type 2: 12,000 Type 2: 12,000 Type 3- 5: 20,000 Type 3- 5: 20,000

9 Primary care Services offered: Family Health Services offered: Family Health –Antenatal and postnatal care –Child health E.P.I. –Dental health –Mental health –Environmental health –Family planning –STI –Nutrition –Health promotion

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11 Team approach including community participation. Team approach including community participation. Integration of preventative and curative services Integration of preventative and curative services Government of Jamaica (GOJ) major provider Government of Jamaica (GOJ) major provider Non Government Organizations (N.G.Os) private practitioners, private clinics and private hospitals complement the government services. Non Government Organizations (N.G.Os) private practitioners, private clinics and private hospitals complement the government services.

12 Public Sector predominates in the community health and inpatient areas Public Sector predominates in the community health and inpatient areas Private sector dominates in terms of primary care, pharmaceuticals and diagnostic services. Private sector dominates in terms of primary care, pharmaceuticals and diagnostic services.

13 Health sector reform programme Health sector reform programme H.S.R.P H.S.R.P –1. Prevention –2. T reatment –3. Severe Resource Restraints

14 To accomplish these objectives To accomplish these objectives Policy Reform required 1. Decentralization 1. Decentralization 2. Alternate financing 2. Alternate financing 3. Spending efficiency 3. Spending efficiency 4. Restructuring of Head Office 4. Restructuring of Head Office 5. N ew Laws and Regulations 5. N ew Laws and Regulations 6. Revision of Information and reporting systems 6. Revision of Information and reporting systems

15 DECENTRALISATION In 1999, Jamaica decentralized the Administration of its Health Services. Four Regional Health Authorities were established. South East South East Southern Southern North East North East Western Western

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17 Decentralization Administrative Administrative Fiscal Fiscal Political Process Political Process Designed to Improve Health Services through increasing allocation and technical efficiency Designed to Improve Health Services through increasing allocation and technical efficiency

18 Financial Management Financial plans and strategies have determined the pace of decentralization Financial plans and strategies have determined the pace of decentralization A National Health Insurance Scheme proposed not yet implemented A National Health Insurance Scheme proposed not yet implemented National Health Fund National Health Fund Drugs Drugs Institutional Support Institutional Support

19 Spending efficiency Energy Conservation Energy Conservation Solar Heating Solar Heating – Energy Monitors Reorganization of Transportation Reorganization of Transportation

20 Restructuring of Head Office Reduction in personnel ( ) Reduction in personnel ( ) Functions Redefined to reflect Functions Redefined to reflect –Policy Formulation –Quality Assurance and Standards Monitoring

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22 New Laws and Regulations Revision of the Health Services Act Revision of the Health Services Act Public Health Act Public Health Act National Health Services Act National Health Services Act

23 Health Interventions Policy and Procedures Manuals Policy and Procedures Manuals –Streamline Activities for efficiency and effectiveness. –Development of specialized Services in Rural Institutions Increased Training of health Professionals Increased Training of health Professionals Equipping of Institutions Equipping of Institutions Increased Access to Specialist Services and Reduced waiting lists. Increased Access to Specialist Services and Reduced waiting lists.

24 Health Interventions TRIAGE Programme in Accident and Emergency Department TRIAGE Programme in Accident and Emergency Department Improved flow to Primary care Clinics Improved flow to Primary care Clinics Reduced waiting time in Accident and Emergency Department Reduced waiting time in Accident and Emergency Department Improved and efficient Service Improved and efficient Service

25 Ambulatory Care Chronic Disease clinics e.g Diabetes, Hypertension, Arthritis Chronic Disease clinics e.g Diabetes, Hypertension, Arthritis Specialist Medical Outpatient Service e.g Asthma Specialist Medical Outpatient Service e.g Asthma High Risk Ante-Natal Clinics High Risk Ante-Natal Clinics –Admissions and Maternal mortality decreased Community Mental Health Clinics Community Mental Health Clinics Decreased inpatients at mental hospitals

26 SUMMARY Introduction of Primary Care Services has seen an improvement in the control of infections Diseases through a programme of Immunization Introduction of Primary Care Services has seen an improvement in the control of infections Diseases through a programme of Immunization Decentralization has sought to improve Health Services through increased allocation and technical efficiency Decentralization has sought to improve Health Services through increased allocation and technical efficiency Innovative Financing has helped to defray the cost of the decentralization programme and provided increased access to drugs and services Innovative Financing has helped to defray the cost of the decentralization programme and provided increased access to drugs and services

27 Summary contd Health Interventions have improved the quality and quantity of care to the wider population. Health Interventions have improved the quality and quantity of care to the wider population. Emphasis on ambulatory care and the reduction of inpatient services is producing a more efficient and effective service. Emphasis on ambulatory care and the reduction of inpatient services is producing a more efficient and effective service.

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29 Thank you

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