1. GRENADA PRESENTATION Presenter: Tessa Stroude

2. GEOGRAPHICAL LOCATION

3. Political Context  Tri-island state-Grenada, Carriacou &Petit Martinique  Extension: 133 sq.miles  Seven Parishes  Westminster style parliamentary democracy – bicameral legislature  -Elected House of representatives  -Senate appointed  Executive powers: P.M. and Cabinet  Governor General represents H.M. Queen Elizabeth 11  No formal local government institutions  Multi-partite consultative committee

4. DEVELOPMENT INDICATORS  Growth Rate (2003-2005) 5.8, -3.0, 1.9%  GDP at 2000 constant prices- US$401mn  Inflation (based on consumer index)5.8%  Population106,027 Male 52,028 Female 54,000  Unemployment 18%  -Male12.4  -Female 26.3  Adult Literacy rate97.0  Human Development Index (2005) 66th

5. Social Development  Household composition  - Female headed 47.0  Access to water 98.8  Safe Water source 87.0  Safe Sanitary (human waste) 61.5  Collected Waste Disposal 97.5  Has Electricity80.9

6. Investment in Health  GDP per Capita (2001)US$3,881  National Health Expenditure as a % of GDP 2006 est. 4.8%  Per Capita Health Expenditure US$ 223.00 (2004)  % Government Expenditure 2006 16.1%  Private Expenditure (2002) est. 1.7%  70% of Health Budget Wages & Salaries

7. HEALTH INDICATORS  Life Expectancy70.9years  Infant Mortality13.6(2004)  Maternal Mortality0  Fertility Rate3.09  Crude Birth Rate17.8 (2004)  Crude Death Rate 8.5(2004)  Immunization (across the board) 100% (2005 )

8. Health Indicators cont’ Top 5 cause of death 2003  Malignant Neoplasm  Endocrine & Metabolic Disease  Disease of Pulmonary Circulatory  Disease of Respiratory system  Hypertensive Disease

9. MAJOR HEALTH PROBLEMS  Chronic Diseases Heart Disease Hypertension Diabetics Cancers HIV/AIDS Traffic Accidents

10. Health Services-Organization  One Main Acute care hospital  Two Subsidiary hospitals –  - Off shore island-Carriacou  - Rural community  One Psychiatric Facility  Community Health Services  - 6 Health Centres, 3 Maternity Units  - 30 Medical Stations

11. Productivity – Health Services- Hospital - 2005  Discharges 7554  Average Length of Stay6.8days  Surgeries/Orthopedic1785  Deliveries1380  Outpatients 9730  Hospital Occupancy75%  Overall Death rate @ Hospital3.6%

12. Health Services - Community Level  Child Health  Ante Natal - 92.8%  Delivery by health professionals100%  Post Natal -  Chronic Diseases  District Medical Officer Clinic  Pharmacy  Dental Services  Mental Health  Infectious Diseases

13. Health Services - Special Response Programs  Drug for the Needy: free access to drugs for chronic diseases  HIV/AIDS Free VCT clinics Free access to Anti-retrovirals  Free access to health services for persons under 16 years of age and over 60 years.  Miracle Program: free ophthalmologic care  Oncology program introduced

14.  Statorization of Solid Waste Management  Development of Executive Agency to manage Hospital Services Process under review – still part of the policy agenda Devolution of Good & Services New positions established (Top Management) Human Resources still under the PSC Recommendations to strengthen Planning and Epidemiology Department Computerization of Medical and Registrar- General Department. Response : Health Sector Reform

15. Health System Response- Steering Role  Leadership  Functional review of Ministry of Health conducted Administration Hospital & Community Services Development of National Strategic Plan Health Disaster Plan near completion  Regulatory Reviewing & revising Legislation  Development of protocols and regulations Public Health  Review of EPHF’s

16. Health System Response: Steering Role Cont..  Harmonization of Health Services Delivery  Training Assessment completed & Human Resource Plan to be developed  Strengthened Human Resource Management New Chief Nurse Officer recruited New Chief Medical Officer recruited Director of Community Health Services introduced Additional Epidemiologist employed Training program to begin by July for Management teams

17. Health Sector Response- Financing/Assurance  General Taxation  User fees reviewed at hospital  Plans to upgrade the Billing and Admissions Department  National Health Insurance (under discussions)

18.  Thank You !