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BARBADOS

BARBADOS. Trends in Health System Change and Health Sector Reform. Social and Political Context. estimated mid- year population of 273,018 in 2005 sustained GDP growth averaging 3% p.a. fiscal deficit of 2.5% of GDP Per capita GDP of US $7,950 ( 2002).

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BARBADOS

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  1. BARBADOS Trends in Health System Change and Health Sector Reform

  2. Social and Political Context • estimated mid- year population of 273,018 in 2005 • sustained GDP growth averaging 3% p.a. • fiscal deficit of 2.5% of GDP • Per capita GDP of US $7,950 ( 2002)

  3. Social and Political Context cont’d • Tourism remains one of the main foreign exchange earners and employers of labour • International and Financial Business Services sector is a growing source of foreign exchange • Construction is buoyant with increasing output • Agriculture contribution to GDP is declining although non-sugar agriculture and fishing increased during the period.

  4. Social and Political Context Cont’d • Unemployment rate fell to single digits from 2001. Female participation rate in the labour force has been increasing • Adult literacy rate of 99% in 2004. Approx. 66.7% of persons enrolled in tertiary institutions are females • Infant mortality declined from 13.3 per thousand births in 2002 to 10.1 in 2004, rose to 12.3 in 2005 • Maternal Mortality ratio – one and two maternal deaths in 2002 and 2003 respectively. Nil in 2004 and 2005.

  5. Social and Political Context Cont’d • Perinatal mortality is a challenge – fluctuating between 18.6 in 2003 to 15.8 per thousand births in 2005. • Life expectancy at birth – 72.6 years for men and 78.3 years for women • 1997 Poverty Study found 15% of the population lived below the poverty line of BDS $5,503 p.a.

  6. Leading Causes of Death • Disease of pulmonary circulation and other forms of heart disease • Cerebrovascular diseases • Diabetes mellitus • Ischaemic Heart Disease • Malignant neoplasms of digestive organs except stomach • HIV/AIDS

  7. Leading Causes of Death • Pneumonia • Hypertension • Malignant neoplasm of prostate • Septicaemia • Acute respiratory infection • Malignant neoplasm of the female breast

  8. Priorities for Change • Management systems – linking planning and budgeting cycles; - policy formulation process that is responsive to globalization • Financing Systems - provider – payment mechanisms; cost and management accounting systems in institutions • Improving healthcare quality and efficiency • Improving equity of access

  9. Priorities for Change Cont’d • Health Promotion policy • Human resource management • Management information systems

  10. Public Sector Reforms That Impact on Health Sector Reform • Multi-year budget cycle (three years) • Accrual accounting to replace cash accounting • Information systems policy • Human resources - performance management system

  11. Barbados Strategic Plan for Health 2002-2012 • Provides the Health Reform Agenda for the country • Identifies the Priorities for Action – these are in keeping with the Caribbean Cooperation in Health initiative • Has become the blueprint in negotiations and collaboration with donors and other stakeholders

  12. Health System Changes Already Being Implemented • Contractual arrangements with non-state providers with respect to the following services: 1. Care of the elderly 2. Provision of treatment for drug abuse • Autonomy of the Management of the Queen Elizabeth Hospital

  13. Health System Changes Being Implemented • Mental Health Reform – the policy approved by the Cabinet of Barbados places emphasis on prevention and community-based treatment.

  14. Health System Change Through Technical Cooperation • PAHO - BPB • EU – Sector budget support along with technical assistance

  15. Technical Assistance to the MOH includes: • Reorganising and strengthening the steering role of the MOH • Strengthening family health services, specifically initiating interventions in home and community-based care for the elderly and the disabled • Reorganising and strengthening health promotion – policy; management framework which includes health promotion support unit and implementation plan.

  16. Technical Assistance to the MOH includes Cont’d: • Development of information systems to provide relevant and timely information at all levels for decision making - HIS in all institutions - A central Health Information Unit - Updated surveillance system • Development of cost accounting systems

  17. Technical Assistance to the MOH includes Cont’d: • Development of modern cross-cutting approaches to the management of CNCDs, starting with cardio vascular disease. • Formulation of policies to strengthen human resource management:- recruitment and retention; training; job satisfaction; appraisal.

  18. The End Prepared by Samuel DeanePlanning and Research UnitMinistry of Health Barbados

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