A multidisciplinary approach to scaling up HIV/AIDS treatment and care: the experience of the Bahamas

The Bahamas has a total population of 314,000. It is estimated that there are now 5,600 to 8,700 adults and children living with HIV/AIDS in the country. Approximately 2,500 women in the age range of 15 to 49 years are infected with HIV. To address the HIV/AIDS epidemic, the Bahamas has developed effective HIV/AIDS prevention, care, and treatment policies that have been applied since 1985. The Bahamas National AIDS Program has developed strategies and interventions in the areas of prevention and education, comprehensive care (clinical and social interventions), support services, and surveillance and researc (clinical and behavioral) (AU)

The health of women in Latin America and the Caribbean

This report seeks to contribute to the debate about health policy and program design in Latin America and the Caribbean by focusing on the special topic of women's health. It aims to provide governments and program designers with information about priority needs in the region, and on how policies can yield optimal results. The report, which summarizes more than a dozen original background studies, represents the collaborative effort of three partners - the World Bank, the Inter-American Development Bank (IDB), and the Pan American Health Organization (PAHO). In addition, three regional consultations, sponsored by the IDB, were conducted in collaboration with the Population Council, Latin America and the Caribbean Office, to gain a deeper understanding of the issues related to reproductive health policy in the region. The study has two main objectives: (1) To analyze trends and differentials in women's health; examples of good practices in delivery and financing of women's health programs; and the key dimensions of women's health that are relevant for the health reforms currently underway in Latin America. (2) To provide guidance for governments and progam designers in addressing the most pressing causes of women's ill health, within the context of broader sectoral and national policies (AU)

Here's to your health, Bahamas: a national health promotion programme initiative

OBJECTIVE: To design and implement a national health promotion programme in the Bahamas. DESIGN AND METHODS: A ten-week programme was designed for Bahamas to incorporate healthy lifestyle behaviour practices. A nurse-physician health team evaluated participants for 10 designated parameters of good health, initially, and then at the end of the ten-week period of health promotion and education. Private and government businesses were invited to enrol their employees as a group and compete for the Healthy Company Awards. RESULTS: From 12 Bahamian Island communities, 6,217 residents participated in the programme, 35 companies registered for the Healthy Company Awards competition. The 10 designated health indices were analyzed in a subset of 23 private companies on the Island of New Providence. In the Healthy Company Awards competition 1,636 persons were enrolled of whom 599 (67.4 percent females, 32.6 percent males) completed the 10-week programme. The mean overall score improved from 5.9 to 7.5 (SE +or- 0>1, p>0001). In the mass media campaign, 3 newspaper articles were published, 7 radio programmes were aired, one TV programme was produced and aired, and weekly health features were spotted at news times on the television and radio. Billboards were strategically placed at the roadside. Government health agencies and health allied Non-Government Organisations (NGOs) coordinated and conducted weekly lectures, four community fora, one health fair, health walks, and a no smoking programme. The national programme was self-funded: $75,331 US was generated from corporate sponsorship and company registration fees, thus balancing the projected budget. CONCLUSION: Bahamians are willing to undertake healthier lifestyles if so informed and educated. The programme's success formalized a health promotion Unit within the Ministry of Health.(Au)

Annual comprehensive health report year 2000

The report is an effort by the Ministry of Health to document the progress of the health situation and the performance of the health care system in Belize up to the year 1999. The data shows for the past four years Belize is experiencing a transition from communicable to non-communicable diseases. For the third consecutive year, Road Traffic Accidents ranked number one among the ten leading causes of mortality, followed by hypertension, Cerebrovascular Accidents and Diabetes. In 1999, NCD 's contributed to 77.8% of all deaths in the country. The report focuses on general Morbidity and Mortality figures; the response of the Health Systems; National Health Information and Surveillance System; Health Sector Reform; the response to Hurricane Keith; National Achievement of the Ministry of Health; and District Health services. With regards to the communicable diseases and vector control, data is also provided on the programs aimed at reducing malaria and dengue; the duties and activities of the vector control personnel; and the general objectives of the Vector Control program.

Promoting national school feeding programmes in the Caribbean

School feeding programmes are of critical importance in the development of children today. Scientific research in the Caribbean and elsewhere provides evidence of the cognitive and nutritional benefits of adequately fed school children. Foods available to students through the various programmes have a clear role in realizing these positive effects. Based on this evidence, the Caribbean Food and Nutrition Institute advocates an appropriately administered school feeding programme that can contribute significantly to the achievement of adequate nutritional requirements of students. This is also seen as an effective strategy to develop students to achieve maximum academic and developmental capacities. The withdrawal of several external agencies that once supported these programmes has placed greater responsibility on Caribbean Governments to provide guidance and resources in the establishment of school feeding programmes. The effort should encourage schools to be actively and positively involved in creating an environment that supports the attainment and maintenance of optimal nutritional status with specific attention to dietary intake. School feeding programmes should be viewed as one of the strategies for instilling and promoting positive health habits in students (this should include physical activity). The success of these programmes will depend on the will of decision-makers at both the governmental and the school levels to meet the nutritional needs of their students. In addition, the school programme may need supportive public policy (probably including legislation), community participation and promotional activities.(Au)

Annual report of the Chief Medical Officer for the years 1994-1996

The annual report of the Chief Medical Officer gives an overview of the activities of the Ministry of Health for the years 1994-1996. It aims to provide reliable information on the health situation and the health care system in Barbados during this period.

Annual report of the Chief Medical Officer for the year 1993

The Barbados Ministry of Health is the executing agency for the delivery of health care in the public sector and the Chief Medical Officer is responsible for all technical/professional aspects of the health service. The year 1993 saw the Ministry moving away from incremental budgeting and introducing programme budgeting. During the financial year 1993/94, expenditure was $174,984,469 million and was allocated for the following: policy formulation services; primary health care services; hospital services; care of the disabled; and a pharmaceutical programme. The Ministry's priority programmes are in keeping with the goals and targets of the Caribbean Cooperation in Health (CCH) Initiative which focuses on the following areas: strengthening the health services; environmental protection; human resource development; chronic non-communicable diseases; food and nutrition; maternal and child health; and the prevention and control of AIDS.

Review of health financing in Jamaica and a survey of the feasibility of national health insurance

Assesses Jamaica's Health Sector Initiatives Project which has as its objectives the improvement of the quality and efficiency of health services and to find alternatives for reducing the critical financial constraints in the health sector. Reviews current financing arrangements and allocation of health expenditures in Jamaica as well as earlier studies on health financing in Jamaica, particularly those related to insurance options. Finally, attempts to determine the feasibiity of National Health Insurance options following national and regional consultations. (AU)

A Strategy for directing public health action in Trinidad and Tobago, 1995 - 2015 - abstract

Trinidad and Tobago is embarking on a national health reform programme driven by a decline in the value of the dollar and a need to decentralize its management structures. In order to focus the efforts of its five regions and the central policy formulating body, it is proposing to identify key priority areas and measurable goals and targets. This paper reviews the epidemiological information that was used to select those priority areas, presents three possible models for choosing its goals and targets, and recommends a model for use in Trinidad and Tobago. Demographic changes over the next 20 years will produce a doubling of the population of adults (45 - 64 years old). The expected number of deaths in this age group will increase from 1,895 to 4,020. It will therefore be necessary to focus on preventing some of these deaths, most of which will be from circulatory diseases, diabetes and cancer. Other problems which may increase in numbers but at a more moderate rate are injury and the STDs. Mental illness has also been selected as a priority area because of the perception that it is a serious and growing problem, uses a large proportion of resources and is an area which has been neglected in the past. The model chosen for describing our goals and targets comes from Australia because it best fits the current concepts of coordinated public health action on a number of fronts. This model selects 5 or 6 priority areas and then orders detailed objectives under the headings: preventive mortality and morbidity, health literacy and lifeskills, healthy lifestyles and healthy environments (AU)

Final report: pilot study on national health insurance and managed care

This study seeks to determine the feasibility of managed care accompanied by health insurance and a rationalized program of Government's finding of the cost of the service. Outputs generated by the study are as follows: the feasiblity of managed care in St. Ann; the framework for implementing a pilot project in St. Ann; the general policy framework for managed care and rationalizaton of Government's financing of health care costs. (AU)