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GRENADA PRESENTATION Presenter: Tessa Stroude GEOGRAPHICAL LOCATION Political Context Tri-island state-Grenada, Carriacou &Petit Martinique Extension: 133 sq.miles Seven Parishes Westminster style parliamentary democracy – bicameral legislature -Elected House of representatives -Senate appointed Executive powers: P.M. and Cabinet Governor General represents H.M. Queen Elizabeth 11 No formal local government institutions Multi-partite consultative committee DEVELOPMENT INDICATORS Growth Rate (2003-2005) 5.8, -3.0, 1.9% GDP at 2000 constant pricesUS$401mn Inflation (based on consumer index) 5.8% Population 106,027 Male 52,028 Female 54,000 Unemployment 18% - Male 12.4 - Female 26.3 Adult Literacy rate 97.0 Human Development Index (2005) 66th Social Development Household composition - Female headed Access to water Safe Water source Safe Sanitary (human waste) Collected Waste Disposal Has Electricity 47.0 98.8 87.0 61.5 97.5 80.9 Investment in Health GDP per Capita (2001) US$3,881 National Health Expenditure as a % of GDP 2006 est. 4.8% Per Capita Health Expenditure US$ 223.00(2004) % Government Expenditure 2006 16.1% Private Expenditure (2002) est. 1.7% 70% of Health Budget Wages & Salaries HEALTH INDICATORS Life Expectancy Infant Mortality Maternal Mortality Fertility Rate Crude Birth Rate Crude Death Rate Immunization (across the board) 70.9years 13.6 (2004) 0 3.09 17.8 (2004) 8.5 (2004) 100% (2005) Health Indicators cont’ Top 5 cause of death 2003 Malignant Neoplasm Endocrine & Metabolic Disease Disease of Pulmonary Circulatory Disease of Respiratory system Hypertensive Disease MAJOR HEALTH PROBLEMS Chronic Diseases Heart Disease Hypertension Diabetics Cancers HIV/AIDS Traffic Accidents Health Services-Organization One Main Acute care hospital Two Subsidiary hospitals – - Off shore island-Carriacou - Rural community One Psychiatric Facility Community Health Services - 6 Health Centres, 3 Maternity Units - 30 Medical Stations Productivity – Health ServicesHospital - 2005 Discharges Average Length of Stay Surgeries/Orthopedic Deliveries Outpatients Hospital Occupancy Overall Death rate @ Hospital 7554 6.8days 1785 1380 9730 75% 3.6% Health Services Community Level Child Health Ante Natal Delivery by health professionals Post Natal Chronic Diseases District Medical Officer Clinic Pharmacy Dental Services Mental Health Infectious Diseases 92.8% 100% Health Services Special Response Programs Drug for the Needy: free access to drugs for chronic diseases HIV/AIDS Free VCT clinics Free access to Anti-retrovirals Free access to health services for persons under 16 years of age and over 60 years. Miracle Program: free ophthalmologic care Oncology program introduced Response : Health Sector Reform Statorization of Solid Waste Management Development of Executive Agency to manage Hospital Services Process under review – still part of the policy agenda Devolution of Good & Services New positions established (Top Management) Human Resources still under the PSC Recommendations to strengthen Planning and Epidemiology Department Computerization of Medical and RegistrarGeneral Department. Health System ResponseSteering Role Leadership Functional review of Ministry of Health conducted Administration Hospital & Community Services Development of National Strategic Plan Health Disaster Plan near completion Regulatory Reviewing & revising Legislation Development of protocols and regulations Public Health Review of EPHF’s Health System Response: Steering Role Cont.. Harmonization of Health Services Delivery Training Assessment completed & Human Resource Plan to be developed Strengthened Human Resource Management New Chief Nurse Officer recruited New Chief Medical Officer recruited Director of Community Health Services introduced Additional Epidemiologist employed Training program to begin by July for Management teams Health Sector ResponseFinancing/Assurance General Taxation User fees reviewed at hospital Plans to upgrade the Billing and Admissions Department National Health Insurance (under discussions) Thank You !