4Health Care System 18 General Hospitals 6 Specialists Primary Care System (Clinics) Clinics (+ 23 satellites)Public Health System
5Hospitals N=18 Type A: 3 multidisciplinary Final referral centres Type B: 5 Large urban centres (O&G, Paed med, gen surgery, int medicine, anesthesiology A&EType C: 10 District hospitals ( gen medicine, surgery , child health and maternity care.Community hospitals/ deliveries
6Hospitals 6 specialists Psychiatric and rehabilitative services for the mentally illO & G nationallyPaediatric careOncology and hospiceChest diseasesPhysical rehabilitation
7Other National institutions National public Health labBlood bank
8Primary care Health districts on a demographic basis Pop 20-30,000 served by health centresType 1. pop 4000Type 2: 12,000Type 3- 5: 20,000
9Primary care Services offered: Family Health Antenatal and postnatal careChild health E.P.I.Dental healthMental healthEnvironmental healthFamily planningSTINutritionHealth promotion
11Team approach including community participation. Integration of preventative and curative servicesGovernment of Jamaica (GOJ) major providerNon Government Organizations (N.G.O’s) private practitioners, private clinics and private hospitals complement the government services.
12Public Sector predominates in the community health and inpatient areas Private sector dominates in terms of primary care, pharmaceuticals and diagnostic services.
13Health sector reform programme H.S.R.P1. Prevention2. Treatment3. Severe Resource Restraints
14To accomplish these objectives Policy Reform required1. Decentralization2. Alternate financing3. Spending efficiency4. Restructuring of Head Office5. New Laws and Regulations6. Revision of Information and reporting systems
15DECENTRALISATIONIn 1999, Jamaica decentralized the Administration of its Health Services.Four Regional Health Authorities were established.South EastSouthernNorth EastWestern
17Decentralization Administrative Fiscal Political Process Designed to Improve Health Services through increasing allocation and technical efficiency
18Financial ManagementFinancial plans and strategies have determined the pace of decentralizationA National Health Insurance Scheme proposed not yet implementedNational Health FundDrugsInstitutional Support
19Spending efficiency Solar Heating Energy Conservation Energy Monitors Reorganization of Transportation
20Restructuring of Head Office Reduction in personnel ( )Functions Redefined to reflectPolicy FormulationQuality Assurance and Standards Monitoring
22New Laws and Regulations Revision of the Health Services ActPublic Health ActNational Health Services Act
23Health Interventions Policy and Procedures Manuals Streamline Activities for efficiency and effectiveness.Development of specialized Services in Rural InstitutionsIncreased Training of health ProfessionalsEquipping of InstitutionsIncreased Access to Specialist Services and Reduced waiting lists.
24Health InterventionsTRIAGE Programme in Accident and Emergency DepartmentImproved flow to Primary care ClinicsReduced waiting time in Accident and Emergency DepartmentImproved and efficient Service
25Ambulatory Care Community Mental Health Clinics Chronic Disease clinics e.g Diabetes, Hypertension, ArthritisSpecialist Medical Outpatient Service e.g AsthmaHigh Risk Ante-Natal ClinicsAdmissions and Maternal mortality decreasedCommunity Mental Health ClinicsDecreased inpatients at mental hospitals
26SUMMARYIntroduction of Primary Care Services has seen an improvement in the control of infections Diseases through a programme of ImmunizationDecentralization has sought to improve Health Services through increased allocation and technical efficiencyInnovative Financing has helped to defray the cost of the decentralization programme and provided increased access to drugs and services
27Summary cont’dHealth 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.