1. JAMAICA’S HEALTH SYSTEMS
TREVOR MCCARTNEY
C.D., J.P., M.B.,B.S., DM (Surg.) UWI, F.R.C.S. (Ed.), F.A.C.S
SENIOR MEDICAL OFFICER
KINGSTON PUBLIC HOSPITAL

2. Jamaica, the largest English speaking island in the Northern Caribbean is 4,441 square miles in size and has a population of over 2.6 million persons.

4. Health Care System 18 General Hospitals 6 Specialists
 Primary Care System (Clinics) Clinics
   (+ 23 satellites)
Public Health System

5. Hospitals N=18 Type A: 3 multidisciplinary Final referral centres
Type B: 5 Large urban centres (O&G, Paed med, gen surgery, int medicine, anesthesiology A&E
Type C: 10 District hospitals ( gen medicine, surgery , child health and maternity care.
Community hospitals/ deliveries

6. Hospitals 6 specialists
Psychiatric and rehabilitative services for the mentally ill
O & G nationally
Paediatric care
Oncology and hospice
Chest diseases
Physical rehabilitation

7. Other National institutions
National public Health lab
Blood bank

8. Primary care Health districts on a demographic basis
Pop 20-30,000 served by health centres
Type 1. pop 4000
Type 2: 12,000
Type 3- 5: 20,000

9. Primary care Services offered: Family Health
Antenatal and postnatal care
Child health E.P.I.
Dental health
Mental health
Environmental health
Family planning
STI
Nutrition
Health promotion

11. Team approach including community participation.
Integration of preventative and curative services
Government of Jamaica (GOJ) major provider
Non Government Organizations (N.G.O’s) private practitioners, private clinics and private hospitals complement the government services.

12. Public Sector predominates in the community health and inpatient areas
Private sector dominates in terms of primary care, pharmaceuticals and diagnostic services.

13. Health sector reform programme
 H.S.R.P
1.     Prevention
2.     Treatment
3.      Severe Resource Restraints

14. To accomplish these objectives
Policy Reform required
1.    Decentralization
2.    Alternate financing
3.    Spending efficiency
4.    Restructuring of Head Office
5.    New Laws and Regulations
6.    Revision of Information and reporting systems

15. DECENTRALISATION
In 1999, Jamaica decentralized the Administration of its Health Services.
Four Regional Health Authorities were established.
South East
Southern
North East
Western

17. Decentralization Administrative Fiscal Political Process
Designed to Improve Health Services through increasing allocation and technical efficiency

18. Financial Management
Financial plans and strategies have determined the pace of decentralization
A National Health Insurance Scheme proposed not yet implemented
National Health Fund
Drugs
Institutional Support

19. Spending efficiency Solar Heating Energy Conservation Energy Monitors
Reorganization of Transportation

20. Restructuring of Head Office
Reduction in personnel ( )
Functions Redefined to reflect
Policy Formulation
Quality Assurance and Standards Monitoring

22. New Laws and Regulations
Revision of the Health Services Act
Public Health Act
National Health Services Act

23. Health Interventions Policy and Procedures Manuals
Streamline Activities for efficiency and effectiveness.
Development of specialized Services in Rural Institutions
Increased Training of health Professionals
Equipping of Institutions
Increased Access to Specialist Services and Reduced waiting lists.

24. Health Interventions
TRIAGE Programme in Accident and Emergency Department
Improved flow to Primary care Clinics
Reduced waiting time in Accident and Emergency Department
Improved and efficient Service

25. Ambulatory Care Community Mental Health Clinics
Chronic Disease clinics e.g Diabetes, Hypertension, Arthritis
Specialist Medical Outpatient Service e.g Asthma
High Risk Ante-Natal Clinics
Admissions and Maternal mortality decreased
Community Mental Health Clinics
Decreased inpatients at mental hospitals

26. SUMMARY
Introduction of Primary Care Services has seen an improvement in the control of infections Diseases through a programme of Immunization
Decentralization has sought to improve Health Services through increased allocation and technical efficiency
Innovative Financing has helped to defray the cost of the decentralization programme and provided increased access to drugs and services

27. Summary cont’d
Health Interventions have improved the quality and quantity of care to the wider population.
Emphasis on ambulatory care and the reduction of inpatient services is producing a more efficient and effective service.

29. Thank you