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Healthcare in St Lucia

The Ministry of Health’s main policy mandate is "to maintain and upgrade the present and future stock of human resources". The National Health Policy covers revenue collection, use of appropriate technology, health personnel quality, population growth, vulnerable and at-risk groups, substance abuse, workers’ health and environmental issues.

The Government will continue to improve the health care system through a primary healthcare/preventive approach, while also increasing the availability and quality of secondary and tertiary services.

Financial constraints, the rising cost of healthcare, dwindling external funding, and the public’s demand for more sophisticated and expensive healthcare have led St Lucia to review health services management. At the heart of this reassessment is the question of how to organise the health services so as to promote equity, efficiency, sustainability, accessibility, quality and consumer satisfaction.

The Ministry of Health’s technical directorate and the country’s health professional organisations are responsible for leadership in health.

At the central level, heads of departments manage staff and different health development programs; they are supported by national program managers, who manage specific health programs. At the district level, health teams manage the healthcare administration and services. It should be noted that there are only two teams functioning.

In the public sector, healthcare is broadly grouped into personal healthcare services, human resources, and physical resources. Health promotion and prevention, curative, and rehabilitation services are offered and delivered at the primary, secondary, and tertiary levels.

The private health sector is made up of health professionals, non-governmental organisations and traditional healers. Medical and dental practitioners have always operated in the private sector, and many work in both the public and private sector. Nurses more recently have been employed in the hotel industry and in private home nursing care.

The Ministry of Health is responsible for establishing user fees in the public sector, but it has no jurisdiction over the operations of private health insurance companies. The main types of health insurance are private health insurance for individuals and groups and coverage by National Insurance Scheme (NIS).

The medical and nursing councils are responsible for the registration and monitoring of doctors and nurses; the Medical Board is responsible for the registration of dentists, pharmacists and optometrists. The practice of public health professionals is guided by the Public Health laws. Currently, practitioners need not submit proof of continued medical education or a certificate of physical fitness to practice in order to re-register.

There were two general hospitals, one psychiatric hospital, and two district hospitals on St Lucia in 1998. The main hospital, with over 200 beds, is located in Castries. In addition, there are 34 health centres scattered throughout the island. In 1995, there were an estimated 33 hospital beds per 1,000 people. In 1999, total health care personnel (with number per 1,000 people), included 81 physicians (0.6), 13 dentists (0.1), 312 nurses (2.3), and 36 pharmacists (0.2). As of 1999, total healthcare expenditure was estimated at 4.3% of GDP.

Medical and pharmaceutical services are available at least once a week at the 34 health centres throughout the island. Inpatient, outpatient, and accident and emergency services are available at the two general hospitals. The two district hospitals offer primary healthcare services and limited secondary care and emergency services. Patients move from the public to the private sector and between different levels of care to seek medical attention.

The Sir Arthur Lewis Community College is the only local institution that trains health professionals. The college began training of general nurses and midwives in 1988, and in 1994 conducted a Community Nutrition Diploma Course for Field Nutrition Officers. Community health aides are trained by the Community Nursing Department. Training for other categories of health professionals has to be pursued at regional and international institutions, and it is severely constrained by lack of financial resources.

There is no national drug regulatory authority; CARICOM is working to establish a Regional Advisory Body on Drugs and Therapeutics (RABDAT), which will serve as the regional regulation authority for the registration of drugs. Trade licences are required for the importation of drugs, reagents and other medical supplies.





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