Countries in the Caribbean share a similar history in the development of their health systems. They have often cooperated to deal with many of the challenges to health which they have had to confront. However, there is need for even greater collaboration and cooperation among the countries of the Region, given the increasing threats to the economies of these countries and the presence of newly emerging and re-emerging problems in the health sector. Efforts, therefore, have to be focused not only on the fight against disease, but on promoting healthy lifestyles, protecting the environment and increasing the capacity of the health sector to provide quality services and value for money.
The concept of the Caribbean Cooperation in Health (CCH) Initiative was introduced in 1984 at a meeting of the former CARICOM Conference of Ministers responsible for Health (CMH). The CMH saw this as a mechanism for health development through increasing collaboration and promoting technical cooperation among the countries in the Caribbean. The Initiative, in which seven (7) priority health areas were identified, was adopted by the CMH and approved by the Heads of Government in 1986. An evaluation of the initiative (1992-94), found that the priorities identified ensured that activities were focused in areas critical to improving health status in the region. Overall it was established that the initiative was beneficial to Caribbean countries.In 1996, the CMH mandated a re-definition and re-formulation of the CCH initiative for the period 1997-2001. A wide cross section of national and regional professionals in health and planning from 19 member countries met in Port-of-Spain in July 1997 to re-program the initiative. The meeting selected eight (8) health priority areas, recommended strategies for implementation and identified some areas of common concern which required joint action. The recommendations of that meeting, which were approved by CMH in 1997, form the basis of this current phase of the initiative.
The Caribbean Sea touches the shores of North, Central and South America. Its waters lap at islands inhabited by English, Spanish, French and Dutch-speaking people. Among our continental populations some pre-Colombian languages survive.
The English-speaking Caribbean has a history of co-operation for economic benefit through the Caribbean Community (CARICOM). Approximately 10 years ago these countries began to address health priorities through the Caribbean Cooperation inHealth (CCH) and Phase II of the CCH was initiated in 1998.
Through CARICOM and PAHO several Caribbean institutions have been established to provide resources for health. These include the University of the West Indies (UWI), the Caribbean Food and Nutrition Institute (CFNI) and the Caribbean Epidemiology Centre (CAREC). Caribbean Ministries of Health and Education and other institutions, including Non-Governmental Organisations (NGOs), have long been involved in health education. However, there is recognition of the need to emphasise new approaches to deal effectively with health challenges that currently face the Caribbean sub-region.
Health communication is one of these approaches. Health communication is a relatively new concept and discipline. The decision to produce this manual, based on scientific principles, for the English-speaking sub-region is motivated by a need for Caribbean health communicators to address old and new community health problems more effectively. However, planned systematic communication campaigns are a well-established feature of health promotion.
This booklet, written primarily for the Caribbean, is based on the “Guide to Making Your Home Hurricane Resistant” published by the United Insurance Company Limited of Barbados, although its scope is wider than hurricanes in recognition of the threat of other natural hazards that exist in the Caribbean. It is fortunate that the technical author of the United Insurance Guide, Mr. Tony Gibbs, made available to PAHO his special expertise in this field and is responsible for the technical aspects of this guide.
The underlying principle of both the Insurance Guide and this one is that we all have a responsibility to protect our homes and our families and in the case of those who work in the health field our patients, visitors and staff from the dangers of natural hazards. This Guide seeks to help to do that not in the expectation that its use will create a group of technical experts, but rather, by making the technical expertise available in a form that can be used by the non-technical person.
The checklists reproduced in the Annex were first used in health facilities as part of a Workshop held in the British Virgin Islands in July 1998. The comments and suggestions of those participants have been incorporated in this final version and have undoubtedly contributed to its value.The Guide is being published at the end of the decade that was designated by the United Nations as the “International Decade for Natural Disaster Reduction”. This timing therefore recognizes the need to persevere with the initiatives begun in the years up to 1999, in order to continue to ensure the safety of members of the community and the staff themselves in the event of natural hazards.
The countries and territories of the Caribbean area have a long tradition of collective action. This tradition was embodied in the formation of the Caribbean Community (CARICOM) in the early 1970s, and later was strengthened by the initiative known as Caribbean Cooperation in Health (CCH). In Health Conditions in the Caribbean, the Pan American Health Organization presents an overview of the challenges and conditions faced by health systems in the CARICOM member countries (the English-speaking Caribbean and Suriname).
The book consists of two major sections and an appendix of statistical tables. Section I, which comprises seven chapters, highlights the general health status of the Caribbean people and its social context, as well as policies and legislation that impact health programs. The first two chapters cover the socioeconomic and political situation and include morbidity and mortality statistics. The following chapter deals with two of the priorities of the CCH initiative: health infrastructure and human resources development. Other chapters cover the history and development of health legislation in the sub-region; health promotion; and women, health and development.
Section II describes those health program areas which correspond to the major causes of morbidity and mortality in the Caribbean. Five of the eight chapters concern priorities identified by the CCH: maternal and child health, food and nutrition, control of non-communicable diseases, AIDS prevention and control, and environmental protection, including disaster management. The remaining chapters focus on the elderly - a growing segment of the populations of these countries - mental health, and oral health.
The result of painstaking data collection and investigations by public health experts from across the sub-region, Health Conditions in the Caribbean meets the needs of decision-makers who require accurate information about health trends for the purpose of policy development, health planning, and investment in health projects. Practitioners and students of health disciplines, researchers, and members of the media will also find this publication a useful and accurate resource.Order Code: SP 561 (Available only in English)
Barbados is an independent democratic country in the Caribbean with a mid-year population estimated at 275,000 in 2007 occupying 166 square miles; it is one of the most densely populated countries in the world. Bridgetown and its environs, is the most populated area. In 2008 total life expectancy at birth was 77.5 years, with female life expectancy reaching 80.0 and male life expectancy reaching 74.9. Infant mortality rate declined steadily from 14 per 1,000 live births in the period 1990 to 1995 to 11 per 1,000 in the period 2000 to 2005. In the latter period, total fertility rate was 1.5 births per woman.
A significant epidemiological trend in Barbados is the increasing prevalence of overweight, obesity, and chronic non-communicable diseases in the general population. The incidence rate of HIV remained stable, ranging between 0.14% in 2002 to 0.12% in 2007. There was a 65% decline in the number of HIV-related deaths between 2001 and 2006 but this trend was reversed in 2007, with a 53% increase in the number of reported deaths. Comprehensive health care is provided through a network of polyclinics, a secondary care institution, a mental hospital, and long-term facilities for the elderly and persons with disabilities. Health care services are provided free at the point of service in the public sector. The Barbados Drug Service provides drugs and other pharmaceutics listed in the Barbados Drug Formulary free of charge to persons in the public sector and to pre-defined benefi ciaries in the private sector.
The Health Services Act Cap. 44 of the Laws of Barbados confer on the Minister of Health the responsibility for protecting the health of the population. The Ministry of Health is the singular executing agency for the delivery of health care, policy-making, and regulation of the health sector. The government’s vision for a healthy people is to empower individuals, communities, and organizations to pursue health and wellness within a system that guarantees the equitable provision of quality health care. The Barbados Strategic Plan for Health 2002-2012, which was prepared with wide stakeholder participation, articulates the policy for health sector reform in Barbados.
The Millennium Development Goals and the Essential Public Health Functions provide the timeframe to measure achievements, acknowledge challenges, and plan forward-looking strategies to achieve an equitable efficient, effective and sustainable health care system in Barbados.
Dayrells Rd & Navy Garden, Christ Church, Barbados