ANTIGUA AND BARBUDA HEALTH SYSTEMS PROFILE FOR MONITORING HEALTH SYSTEMS CHANGE/HEALTH REFORMS IN THE ENGLISH SPEAKING CARIBBEAN BELIZE CITY May 30—June 1, 2006 Presented by: Mrs. Cicely Dorsett Principal Nursing Officer

Introduction The Ministry of Health, Sports and Youth Affairs is: mandated with formulating health programmes based on Government Policy. committed to the universal provision of health services as a right to all residents and citizens

Introduction In support of the concepts of equity, effectiveness and quality efficiency, sustainability and social participation.

Mission To facilitate the attainment and maintenance of the highest quality of health by all people of Antigua and Barbuda.

Goals and Objectives Provide efficient and effective delivery of health care services. Formulate health programmes based on health policy. Reduce the incidence of Chronic Non-Communicable Diseases (NCDs) and their complications.

Goals and Objectives Collaborate with local, regional and international agencies. Strengthen capacity of laboratory services. To re-orient the Health Services with increased emphasis on health promotion and disease prevention.

General Organization Provide leadership through regulation and financing to the institutions responsible for the delivery of public health care. Ministry headed by a Minister of Health who is a member of the governing Cabinet.

General Organization Permanent Secretary – Administrative Head. Chief Medical Officer - Chief Technician responsible for coordination of Health Services. Other Technical Officers:- Principal Nursing Officer, Director of Pharmaceutical Services, Chief Nutrition Officer etc. etc.

General Organization Heads of Departments/Institutions Administrative Staff

Functions of the Health System Steering Role Regulation and Control of the practice of Health Professionals Financing of the Public Health Sector Collection and processing of data and dissemination of health information.

Country Profile: The State of Antigua and Barbuda comprises two islands. These islands form part of a chain of islands in the Eastern Caribbean known as the Leeward Island and are part of an “economic block” referred to as the Organization of the Eastern Caribbean States.

Country Profile: In the wider Caribbean, Antigua and Barbuda is a member of CARICOM.

Health System Profile The Ministry of Health, Sports and Youth Affairs is the Ministry responsible for the Health Care Delivery System.

Health System Profile Health Care in Antigua and Barbuda is delivered at the Primary, Secondary and Tertiary levels.

Primary Health Care Services Nursing Medical Environmental Health Care Services (Medical and Nursing) are delivered at eight (8) Main Health Centres and seventeen (17) sub centres.

Primary Health Care Services The Health Centres at St. John’s, Clare Hall, Browne’s Avenue, All Saints and Johnson’s Point have a resident doctor working five days per week along with a district doctor who gives care one day per week. All the other Health Centres and Sub-Centres are assigned district doctors.

Types of Services Given Chronic Diseases Clinics Antenatal and Post Natal Care Immunizations Child Health Clinics

Types of Services Given Oral and Dental Health Care Screening for Chronic Non- Communicable Diseases e.g. Obesity, Hypertension,

Types of Services Given Diabetes, Cervical Cancer, Prostate Cancer Community Psychiatric Care Voluntary Testing and Counseling sites for HIV

Environmental Health Liquid and Solid Waste Management Port Health Food Safety Water Quality Vector Control

Environmental Health The creation of a Sanitary Landfill for the proper disposal of Solid Waste Management. Planned cleaning-up campaign “Cutting back” of sides of roads.

Environmental Health “ Adopt a mile” “Scale up” programme for eradication of rats. Training for management of sewage plants.

Secondary Health Care: Acute Care General – Holberton Hospital Mental Hospital Fiennes Institute (Care for the Elderly)

Holberton Hospital Services: General Surgical General Medical Obstetrics and Gynaecology Accident and Emergency Orthopaedics

Holberton Hospital Services: Paediatrics and Neonatology Ear, Nose and Throat Intensive Care Haemodialysis Referral Services for Neurology Ophthalmology

Mental Hospital (Psychiatry) In patient services provided at the Mental Hospital Development of Mental Health Policies Review of Mental Health Act

Mental Hospital (Psychiatry) Appointed a new Medical Superintendent and Superintendent (Administration) Increased training for nursing staff in Mental Health.

Fiennes Institute (Care for the Elderly) Continued care of elderly and indigent Increase level of education programmes for staff Increased collaboration with Social Agencies

TEN LEADING CAUSES OF DEATH ANTIGUA AND BARBUDA 2004 Total number of death recorded – 516 M – 269 F – 247

BIRTH, DEATH & INFANT MORTALITY RATE 2005 (Source: Health Information Division) Date: May 16th 2006

MID YEAR POPULATION BY AGE-GROUP 2004 ( Source of Data: Statistics Division) Date: May 16, 2006

Relevant Trends in Health Systems Change Marked increase in incidence of Chronic Non-Communicable diseases and their complications. Increase in number of persons needing haemodialysis HIV/AIDS still cause for concern

Specific Health Interventions leading to Strengthening of the Health Systems Cuban Government agreement with the Ministry of Health leading to provision of staff in areas of health care. e.g. Oncology Nurses Laboratory Technicians

Specific Health Interventions leading to Strengthening of the Health Systems Pharmacists Radiographers Proposed Diagnostics Centre Specific Eye Care Programme: Team of Ophthalmologist providing screening for eye problems and full management of identified problem locally and in Cuba.

HIV/AIDS Availability of Anti-retroviral Drugs (free of cost) Continued programme of Prevention of mother to child transmission Voluntary testing and counseling sites Development of work place policies Continuing education of stake holders.

Health Interventions for Strengthening of Health Systems Pilot Projects to identify and reduce NCD’s Screening for obesity and other life style practices Pilot study in the management of diabetics who are non compliant Anaemia project in the 0 -5 years Cervical Cancer Prevention and Management Project.

Health Interventions for Strengthening of Health Systems Oral Health Awareness Programme Increase in dental services in Community Assessment of status of dental health in person attending for Dental Health Care.

Health Interventions for Strengthening of Health Systems Proposed Project to reduce incidence of cavities due to “bottle feeding”. Formation of broad based Strategic Planning Health Committee Revitalizing of Maternal and Child Health/Family and Reproductive Health Committee Development of linkages with the media through Health Communication Workshops.