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Healthcare in St Kitts & Nevis
 
 
 

Within the public health sector, the Minister of Health is responsible to the Cabinet for implementing relevant policy decisions, the Permanent Secretary functions as a Chief Administrative Officer, and the Chief Medical Officer coordinates the delivery of health services throughout the country. These positions are federal in scope, covering both St Kitts and Nevis. Nevis has considerable autonomy, however, and has its own Minister Responsible for Health and a Chief Secretary who directs administration of local health services. In practice, St Kitts & Nevis operate two independent systems.

Health facilities in St Kitts include J.N. France Hospital (150 beds), Pogson Hospital (18 beds), and Mary Charles Hospital (10 beds). In addition, there is the Cardin Home (50 beds) for chronically ill, disabled and geriatric cases. Nevis has Alexandra Hospital (54 beds) and a 22-bed infirmary that caters to psychiatric patients and the aged-poor. There also are 17 health centres spread throughout the two islands.

The district level has both primary and secondary care services. The network of health centres constitutes the bedrock for the delivery of primary care services: health centres are managed by full-time district nurses/midwives who are supported by a cadre of trained health personnel, including a medical officer, a family nurse practitioner, and a public health nursing supervisor. Mary Charles, Pogson, and Alexandra hospitals provide the first line of secondary care and J.N. France Hospital functions as the main referral centre.

The newly established Health Advocacy and Health Promotion program area consolidates the efforts of traditional health education, nutrition and family planning services. Its scope expands beyond public information, education and training to embrace public policy issues, inter-sectoral cooperation, the mobilisation of community support and the development of media contacts, all of which are part of the Caribbean Charter on Health Promotion.

Health and family life education have been incorporated into the curriculum of all primary schools, which should exert a powerful influence on the lifestyles of the school-age population. Health promotion is considered to be a major strategy for addressing diseases closely tied to lifestyle, such as diabetes, hypertension, cancer and sexually transmitted diseases.

J.N. France Hospital provides inpatient and outpatient care in most major specialities. Mostly as a result of the devastation caused by Hurricane Luis, the Hospital’s activity decreased in all areas except emergencies between 1994 and 1995. Total admissions fell by 15%, from 4,004 in 1992 to 3,397 in 1995; surgical operations declined by 10%; radiography examinations dropped by 11%; and the occupancy rate fell by 8%.

The system provides coverage in medical care, emergency care, maternal and child health and family planning, and chronic illness care, but the incompleteness of data makes it difficult to measure activity patterns and output in health services outside of hospitals.

Public health nurses and family nurse practitioners conduct a school health program for primary school students aged 5 to 12 years old. During the 1992-1994 period, there were 443 visits to schools and 8,197 children were seen, for an annual average of 148 school visits and 2,732 children seen per visit. A total of 268 children were referred to the District Medical Officer, for an average of 89 per year. Services included rapid health assessments of children and visual and hearing check-ups.

The health services in St Kitts & Nevis are administered and operated by a team composed of 21 different categories of workers, ranging from highly skilled technicians in the acute care institutions of J.N. France and Alexandra hospitals to the community outreach workers who provide domiciliary care. Human resources available for health in St Kitts & Nevis are difficult to quantify, because of the islands’ separate budgetary proposals. Previous analyses have not considered this fact, resulting in underestimates.

In 1995, public sector health workers for both St Kitts and Nevis, by category, numbered as follows: 47 medical doctors, 8 dentists, 6 dental auxiliaries, 274 trained nurses, 21 pharmacists, 12 laboratory technicians, 6 radiographers and technicians, 19 public health inspectors, 4 nutritionists/dietitians, 2 veterinary officers, 11 veterinary assistants.

The Government’s recurrent expenditure on health for the entire Federation has averaged 10.6% of total recurrent disbursements over the 1992-1995 period. This ranks health as the third largest recipient of government financial resources, behind finance (26.6%) and education (15.4%). Expenditure on health represents 3.5% of the gross domestic product, somewhat less than the WHO’s recommended target of 5%. The per capita expenditure on health was $163 in 1995. Differences in how expenditure items are classified in the budgetary estimates of each island preclude further analysis of financial resources.

 

 
 

 



 


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