Highlights of key initiatives 2017-2018

This document highlights the major achievement of the Ministry of Health for the period 2017-2018. Contains information about compassionate care, the strengthening of the health system , treatment of non-communicable, combating communicable diseases, protecting the health of mothers and children and rehabilitation and new investment in critical health infrastructure.

Policy planning and project management newsletter

Publishing of this online newsletter is supported by the Policy Analysis and Planning Unit of the Ministry of Health, Belmopan, Belize. In this issue, "Special points of interest" are listed as, Salud Mesoamerica Initiative and Zika. Its next issue is October 3, 2016.

CAREC annual report 2009: excellence in public health surveillance

In 2009, the Caribbean Epidemiology Centre (CAREC) entered its 35th year of operation with its main focus on achieving the set objectives and striving to fulfill its mission: To improve the health status of Caribbean people by advancing the capability of member countries in epidemiology, laboratory technology and related public health disciplines through technical cooperation, service training , research and a well trained motivated staff. This report summarizes the achievements and challenges of the Centre, the health situation as provided by the surveillance reports and the management of the Centre.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

More need for the "old" in new public health research in the Americas

Research on the health of older adults in Latin America and the Caribbean has been neglected in epidemiology and public health. This is of grave concern since dramatic changes in fertility and mortality rates in recent decades ensure a rapid aging of the population in the Western Hemisphere. Persons 60 and older in Latin America and the Caribbean now make up 8 percent of the total population; by the middle of this century that figure will grow to 22 percent. In absolute numbers, the population of older persons will total over 180 million by 2050. In the coming decades we expect to find poorer health status and grater disability in the cohorts of persons who survived childhood and adult diseases. That higher survival rate is due to more public health interventions and less to an improvement in their socioeconomic status. Therefore, policy-makers in Latin America and the Caribbean need to understand the correlation among different gradients of poverty, access to health care, social networks, and health in old age (AU)

An inquiry into the equity orientation of health systems and the implications for the individual

This thesis argues that equity is a health system characteristic with potential to influence individuals' welfare. It is assumed that the influence works through access barriers that exist on both the demand and supply side (including income, quantity of services, locality of services). It is also argued that health system that are designed to minimise these barriers are more likely to be equitable. The study focuses on equity in the delivery of health care and started with the assumption that a healthy state is a desirable state and is therefore something that individuals view positively. Health care is identified as a major input into the production of health thereby resulting in a derived demand for health care. Given the possibility of random illness shocks to the health stock, the individual's main interest resides in the ability to retain access to care. This makes it possible to include access as an explicit argument in the individual's utility function and to gauge equity outcomes in the health sector by gauging the probability of access. The study makes use of a logistic regression to measure horizontal equity in the delivery of health care in Jamaica. The results indicate that inequities exist in the Jamaican health sector. Individuals with similar health needs access different levels of health care. This is strongly suggested in the case of the elderly and the more rural dwellers. However, we also observe that low-income individuals are more likely to exhibit a willlingness to access health care that their middle and upper income counterparts all else being equal, and that the health system plays an important role in the lives of the chronically ill (AU)

Repensar la proteccion social en salud en America Latina y el Caribe / Rethinking social protection in health in Latin America and the Caribbean

Despite what is written in the constitutions and other basic document mandates of the countries of the Region, exclusion from societal protection in health (SPH) affects an important proportion of the population (at least 20 percent, which represents, in absolute figures, between 80 and 200 million people). These estimates are obtained through a series of theoretical (social security coverage) and practical indicators that encompass structural indicators (poverty, ethnicity, and geographical barriers) as well as process indicators (non-institutional births, compliance with vaccination schedules, and access to basic sanitation). Exclusion levels in a society are affected by the degree of segmentation of the health system. Traditionally, most countries of the Region have had a public, a social security and a private subsystem in health. Lack of attention to the problem has resulted in the formation of a community-based subsystem. The coexistence of many subsystems, along with poor regulation on the part of health authorities, has resulted in high levels of exclusion and inefficient resource allocation within the sector. The organization of social dialogue processes focusing on SPH within the context of health sector reform initiatives in each country is recommended. The process, which should be participatory, should include a full diagnosis of the situation (how many are excluded, who are they, and why, and what mechanisms are the most appropriate for tackling the issue in each country). It should also provide a political and technical feasibility analysis of the most suitable options for each society, and a determination of whether or not conventional subsystems have exhausted their potential. The process should culminate in a program for implementing the specific proposals made in each society, in an effort to maximize SPH (AU)

Las funciones esenciales de la salud publica: un tema emergente en las reformas del sector de la salud / The essential functions of public health: an emerging theme in health sector reforms

In the Americas, health sector reforms are facing the challenge of strengthening the steering and leadership role of health authorities. An important part of that role consists of fulfilling the essential public health functions (EPHFs) that are incumbent on all levels of government. For that, it's crucial to improve public health practice, as well as the instruments used to assess the current state of public health practice and the areas where it needs to be strengthened. For that purpose, the Pan American Health Organization has started an initiative called "Public Health in the Americas", with the objective of defining and measuring EPHFs, as a way of improving public health practice and strengthening the leadership provided by health authorities at all levels of government. This article summarizes conceptual and methodological aspects of defining and measuring EPHFs. The article also analyzes the implications that measuring performance on these public health roles, responsibilities, and activities would have for improving public health practice in the Americas (AU)

Science for health: notes on the organization of scientific activity for the development of health in Latin America and the Caribbean

During the 1990s the countries of Latin America and the Caribbean went through profound transformations in their economic, political, and social structures-including in the way that those nations produced, disseminated, and used scientific knowledge that could enhance their citizen's health. Nevertheless, still more changes are needed to fully develop the potential of scientific activity to promote health in Latin America and the Caribbean (LAC). In this task the LAC countries face two major challenges: building their capacity to develop, interpret, and adapt new knowledge and technologies, and creating opportunities for democratic consensus-building so that this capacity serves to improve the health of the peoples of the LAC countries. And while those nations confront many weaknesses in generating and mastering the needed scientific and technological knowledge, the situation in the 1990s was greatly improved over that in the 1980s (AU)

Pre-hospital Emergency Medical Services, Phase I: Role of the Department of Community Health and Psychiatry

The Department of Community Health and Psychiatry was contracted by the Ministry of Health to assist with the implementation of a pilot programme in the Western Health Region to train fire fighters as basic level Emergency Medical Technicians (EMTs), and was responsible for its design, implementation and monitoring for first 18 months. The course was covered in 440 hours over a 10 week period, and included training in emergency medical response, driving an emergency medical vehicle, emergency medical despatching and inventory control. Of 76 fire fighters selected for training, 62 graduated, receiving Certificate of Merit from the Ministry of Health, Jamaica and were deployed into service on 17th April 1996. During the period 17 April to 31 December, 1996, the newly trained EMT's responded to 1,299 calls. Medical and surgical cases represented approximately 55 percent of all calls, followed by trauma (19 percent), motor vehicle accident (9 percent) and obstetric emergencies (8 percent). Between 15 percent and 20 percent of calls in Montego Bay and Negril involved tourists. This first group of EMT's has performed well and was well received by the communities and the persons who used the service.(AU)

Montserrat. Managing health care in a volcanic crisis

The volcano on Montserrat, after being dormant for over 400 years, has been active for the past two years, last erupting on 27 June, 1997. With the capital, Plymouth, in the unsafe zone, major dislocation of people, facilities and services has occurred. The Health Department is splintered over five sites across an eight mile span and the temporary 30 bed hospital, sited at a primary school, is separated from its Casualty and Out-patient Department and Operating Theatre by 0.25 mile. In order to maintain continuity of care for communities, efforts have been made to keep evacuated clients and their community health workers as close together as possible. The mass emigration has depleted the health services, creating severe stress for those remaining. Elderly relatives have frequently been left behind, necessitating the establishment of special geriatric care facilities to cater to their needs. Increased and continuous health surveillance and mass media education have been integral to the prevention of major disease outbreak - particularly with added challenges to food safety, and management of liquid and solid waste disposal. Cooperation from neighbouring states, particularly Antigua, Barbados and Guadeloupe, as well as from the United Kingdom, has been critical in the management of the continuing crisis.(Au)

Health and health care in the English-speaking Caribbean: a British public health physician's view of the Caribbean

People of Caribbean origin form one of the United Kingdom's most important ethnic minority groups but health conditions in the West Indies are not well understood in the UK. This review outlines past and present health conditions in the West Indies and describes the system of health care and some of the problems it faces at present. The last 30 years have seen a transition from a pattern of high childhood mortality from chronic non-comminicable diseases in adult life. Over the last ten years the severity of economic conditions undermined this progress, with the threatened re-emergence of malnutrition and infectious diseases as important health problems. Although most people in the region have access to health care, the quality and outcomes of care may be compromised by financial constraints and an unresponsive management system. Adopting modern approaches to planning and managing health system might be one path to improvement, one to which public health professionals could make a significant contribution (AU)

Caribbean cooperation in health: project profiles

The project profiles presented here have been developed by the Caribbean Government in collaboration with PAHO and CARICOM within the context of the joint initiative for Caribbean Cooperation in Health (CCH). For easy reference the profiles have been grouped according to the six priority health areas of the initiative: Environmental protection, human resources development, chronic diseases, strengthening of health systems, food and nutrition and mother and child health. A further subgrouping based on the geographic scope of the projects lists them as: Caribbean, for the entire subregion; Eastern Caribbean; and specific national projects. Budget totals are presented by project subgrouping and by priority area

The public nursing system in Jamaica: a management perspective

This dissertation examines the principles on which the public administrative system in Jamaica has been structured, and the impact which application of these principles has on the management process of planning, organizing and controlling in the nursing service which is administered by the Ministry of Health. The view taken in the analysis is that the structures and processes which have been influenced by the classical theories of management are inadequate for the purpose of management of human resources in underdeveloped countries such as Jamaica: that the assumptions on which the classical models of "authority structure: decision-making, leadership styles, communication patterns"; "the system of reward", and "the management conflict" are premised do not have generalized applicability in underdeveloped societies nor among all categories of employees in a public administrative/management system. The study critically examines the effects of these structural variables on the motivation and morale of nurses and develops a paradigm for a public administrative structure which is more relevant to management needs in a developing country (AU)