1. Health Sector Revitalization Turks & Caicos Islands Latin America and the Caribbean Health Sector Reform Workshop Belize City, Belize Dr. Rufus W. Ewing Director of Health Services

3. Source: Vital Statistics Report 2004

4. Vital Statistics –Socioeconomic Population – 32,200 (2006 estimate) CBR –10.4 CDR – 1.7 Growth rate 4.6% GDP per capita – 11,160 Revenue per capita - $2,370 Public Sector Health Expenditure - $27 million (2005-06) Per capita expenditure - $906 Public Health Expenditure as percentage of GDP – 8.1%

5. TCI Health Sector Organization Owned and managed by TCIG Primary /Public Health Care (7 Island Clinics / HC, Dental, Envir. Health, AIDS) Secondary Health Care – 2 hospitals Tertiary Care – Very Limited on Island – majority receive MTA

6. Primary Health Care Services 9 Public Clinics, 1 located within the hospital 5 private clinics on Providenciales –1 specialist clinic offering secondary & primary care services –4 general practice offering some secondary care services

7. Secondary Health Care Services 2 Secondary care Health facilities Grand Turk Hospital –21 acute care beds Myrtle Rigby complex – 10 acute care beds 2 operating theatres with full surgical capability – handling all emergencies but elective procedures limited by lack of ICU 2 maternity units – types of cases limited by need for advanced Neonatal Care which is not available

8. Secondary Health Care Services Specialty Services –Internal Medicine –Pediatrics –General Surgery –Obstetrics & Gynaecology –Anaesthesiology –Urology (via private sector collaboration)

9. Visiting Medical Consultants Orthopaedics ENT Neurology Dermatology Nephrology (voluntary – NGO) Ophthalmology (Partially funded)

10. Supportive Health Services Full service Blood Banks at two hospital sites 2 Dialysis Unit with total of 11 machines Physical Rehabilitation (1 private, 2 public)

11. Health Care Staff -Physicians General Physician Specialist Physician Total Public81422 Private639 Total141731 1999: Physicians per 10,000 inhabitants ratio = 7.3 2006: Physicians per 10,000 inhabitants ratio = 10.3 (31 physicians)

12. Public Health Sector Per Capita Expenditure

13. Medical Treatment Abroad Expenditure

14. Health Sector Financing Improved quality of Health Service Strengthen the Planning, policy, and regulatory role of Ministry of Health Development of New Hospital facilities Increase private sector participation Strengthening Primary Health Care programmes The cost of achieving the objectives above cannot be met and sustained if MTA continue to escalate uncontrollably Percentage Public HS expenditure remains high with no cost recovery mechanism Private insurance contribution to NHE remains low (20.9 % in 1998)

15. MOH STRUCTURE 2000

16. MOH STRUCTURE 2007