CMCFeature CARIBBEAN-Fostering progress strengthening health sector Reforms for better health in the Caribbean

CMCFeature CARIBBEAN-Fostering progress strengthening health sector Reforms for better health in the Caribbean
CMCFeature CARIBBEAN-Fostering progress strengthening health sector Reforms for better health in the Caribbean

CASTRIES, St. Lucia, CMC – Nurse Gabriel in St. Lucia’s Anse La Raye Wellness Centre looks satisfied as she conducts a nutritional demonstration, where she teaches h

She has demonstrated alternative meal preparation, and her clients seem excited to try them at home.

The Wellness Centre where Nurse Gabriel works is one of the health facilities supported by the World Bank’s Health Systems Strengthening Project. The project aims to improve the accessibility, efficiency, and responsiveness of essential health services in St. Lucia.

When it comes to health issues, non-communicable diseases, such as diabetes, high blood pressure, and heart disease, are a significant concern in St. Lucia. The mortality rate from diabetes is approximately 60 percent higher than the regional average. The majority of deaths on the island – 80 percent – are due to non-communicable diseases.

Yet, St. Lucia’s health facilities must be equipped to cope with the growing burden. In primary care services, patients’ first point of contact is a significant lack of essential technologies and procedures to support patients with non-communicable diseases, forcing them to seek help in other, costlier instances, such as hospitals.

Recognizing the critical need to address the issue, the St. Lucia government has initiated a series of reforms in the health sector. A based financing mechanism is an approach where healthcare providers are rewarded for achieving desired outcomes, such as improving patient health or increasing the number of people accessing services. This approach incentivizes providers to deliver improved quality care and meet specific performance targets.

The Performance-Based Financing pilot for St. Lucia was designed with the support of the Korea World Bank Partnership Facility, which included study tours to South Korea and Colombia, expert advice from Argentina, and several regional knowledge exchanges.

Performance-based financing was initially implemented in eight wellness centers across the island. The second program is underway, expanding the scheme to nine additional wellness centers.

Following the pilot under the Health Systems Strengthening Project, the scheme will be scaled nationwide, covering all thirty-four primary care health facilities in the country. The initiative is expected to improve access to quality health services for hypertension and diabetes at the primary health care level.

The performance-based pilot focuses on reforming how primary health care is financed and delivered to achieve more equitable and sustainable universal health coverage. The project invests in creating the foundations for scalable reform to provide valued essential services to the population.

It is reassuring to see how projects like this and similar initiatives we are implementing in the region yield positive results. However, there is still much more to be done.

As we have recently marked Health Day, I see three key priorities in the health sector for Caribbean countries in the future:

First, continue accelerating progress on universal health coverage, which provides affordable access to quality health care. In St. Lucia, those with non-communicable diseases spend an average of 36 percent of their household budget on health care every year.

However, the numbers vary significantly, with some data suggesting that the poor spend almost 50 percent of their budget while the rich spend less than 20 percent. The picture may be similar to that of other countries in the region. Universal health coverage will enable equal access to critical healthcare services.

Second, strengthen national health information systems. Our research has found that in many countries, medical charts are paper-based, unstructured, and reside with the patient, making it difficult to retrieve health information efficiently and monitor and evaluate whether best practices are followed.

Strengthening national health information systems and data analytical capacity will facilitate data-driven decision-making, improve public health interventions, and enhance healthcare delivery for the region’s diverse populations.

Third, ensure consistent availability of safe and affordable medicines and supplies. Critical medication is unavailable in some countries due to financial and logistical issues. Limitations in human resources in drug policy and pharmaceutical services, procurement, and forecasting are also obstacles.

These issues can be addressed through supply-chain management, international collaboration, capacity strengthening, and regulatory reforms, among other things.

The age-old adage “health is wealth” holds a profound truth in today’s fast-paced world. It underscores the importance of well-being as the foundation of prosperity and economic resilience – extending beyond the individual level: a healthy population is critical for a nation’s overall well-being and financial success.

With concerted efforts from governments, healthcare providers, communities, and international partners, the Caribbean can pave the way toward a healthier future.


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