Division of Health and Social Services, Tobago House of Assembly Customer-driven human enterprise

Transcription

1 Financial Assistance Programme: Assemblyman Claudia Groome-Duke (left) and Administrator of the Division, Ms Ethlyn John (right) present this happy student with a desktop computer Division of Health and Social Services, Tobago House of Assembly Customer-driven human enterprise The Division of Health and Social Services, over the years, has focused on excellence and this has resulted in impressive improvements in the areas of patient care, financial accountability, quality improvement, and employee and public satisfaction. In many categories, we are now leaders in health and social services in the Caribbean. We have remained true to our mission of being a customer-driven human enterprise committed to providing quality services delivered by a competent staff to improve the quality of life of all its clients. The Division is proud of its achievements to date and we continue to strive for even better results through ongoing improvements in service delivery and the creation of systems to safeguard the trust placed in us by the public. We have positioned our internal activities to be the first choice for motivated, talented people who are inspired to deliver and support excellent care to our stakeholders. We are proud of the accomplishments of our staff, physicians and volunteers and are pleased to continue to provide the mechanisms for them to improve their delivery to the community. Our diverse activities at community level have come in for high praise and the Division of Health and Social Services continues to work with stakeholders to improve our understanding of the community we serve. Therefore, we persistently explore unique opportunities for partnerships. We recognise that these relationships foster greater social and economical rewards for the residents of Tobago and Trinidad. In this light, we always seek positive outcomes through our programmes and monitor any negative fallout with the intent to continually improve and offer solutions to blockages in our delivery of service. It is our philosophy that by focusing on services we will see our clients receiving the right care, the right attention, at the right time, in the right place. Contact Who can access our services? Every member of the public. Our services can be accessed by calling the 211 service and explaining your needs. OR , /1433/ Fax: communications@dhsstha.gov.tt Website contact: dhsstha@gov.tt Visit our office at: Lot #2 Glen Road, Scarborough, Tobago far left: DHSS takes its Immunisation Education Programme to the community left: Two of many high-quality services offered at Scarborough Hospital above right: Assemblyman Claudia Groome-Duke, Secretary of Health and Social Services

2 Trinidad and Tobago General information The country, the most southerly of the West Indian island states, situated 11.2 km off the Venezuelan coast, consists of two islands: Trinidad and Tobago. Climate: Tropical, tempered by north-east trade winds, with a temperature range of C and an average annual rainfall of 1,631 mm. The dry season is January to May and the wet season June to December, with a short dry sunny season called the Petit Careme during September and October. Environment: The most significant environmental issues are water pollution from agricultural chemicals, industrial wastes and raw sewage; oil pollution of beaches; deforestation; and soil erosion. Population: 1,346,000 (2011); some 54,000 on Tobago; 14% of the whole population lives in urban areas; growth 0.5% p.a ; birth rate 15 per 1,000 people (27 in 1970); life expectancy 70 years (66 in 1970). The population is made up of about 40% Indian, 38% African and 21% mixed descent, with smaller numbers of people of European, Latin American and Chinese descent (2000 census). Economy: Trinidad and Tobago is classified as a high-income economy by the World Bank. KEY FACTS Joined Commonwealth: 1962 Population: 1,346,000 (2011) GDP per capita growth: 4.8% p.a GNI per capita: US$16,699 (2011) UN HDI 2011 ranking: 62 out of 187 countries Life expectancy: 70 years (2011) Under-five mortality rate (per 1,000 live births): 28 (2011) Maternal mortality ratio adjusted (per 100,000 live births): 46 (2010) Largest contribution to mortality: Non-communicable diseases HIV prevalence rate for people aged years: 1.5% (2011) Government health expenditure: 3% of GDP (2010) Mental health Morbidity: The most commonly diagnosed mental health illnesses in Trinidad and Tobago are schizophrenia and mood disorders. Neuropsychiatric disorders contributed an estimated 17.1% of the global burden of disease in The suicide rate for males is 20.4 per 100,000 people, and for females, four per 100,000 people (2011). Health systems: The most recent legislative action relating to mental health in Trinidad and Tobago is the Mental Health Bill, which was redrafted in 2010 and was submitted to the Legal Review Committee. The review of the Bill is currently on going (2013). A mental health policy exists and was approved in Mental health is also specifically mentioned in the general health policy. St Anne s Hospital is the principal mental health facility in the country and both inpatient and outpatient services are available. Mental health services are centred round St Anne s Hospital, and as a result access is a problem for a significant proportion of the population. Inpatient services are provided at general hospitals and county hospitals, while community psychiatric services are provided free of charge on an outpatient basis at designated health centres. Stigma continues to surround the issue of mental health in Trinidad and Tobago. NGOs have been working to raise awareness in the country, with mental illness in children and young people in particular being highlighted. Commonwealth Health Partnerships

3

4 Tr i n i d a d a n d To b a g o There are 0.1 psychiatric hospitals and 74.4 beds in psychiatric hospitals per 100,000 people. There are 0.2 day treatment facilities, 2.6 psychiatric beds and 14.5 beds in community facilities per 100,000 people (2011). In addition, there are 2.3 mental health outpatient facilities, of which around one in 30 are reserved for children and adolescents, per 100,000 people (2011). Health Child and maternal health: Infant mortality in Trinidad and Tobago was 25 deaths per 1,000 live births in 2011, with an underfive mortality rate of 28 deaths per 1,000 live births. As shown in Graph 1, there has been a consistent decline in the under-five mortality rate since Although this decline is encouraging, it is very gradual and the under-five mortality rate is not yet in line with the country s target of 12 deaths per 1,000 live births, as defined by Millennium Development Goal 4 (MDG 4). In 2010 the three most prominent causes of death for children below the age of five years were congenital anomalies (24%), prematurity (16%) and birth asphyxia (12%). Other contributory causes were pneumonia (7%), injuries (6%) and neonatal sepsis and HIV/AIDS (both 3%). In 2010 Trinidad and Tobago had a maternal mortality ratio of 46 deaths per 100,000 live births (an estimate from UN agencies/world Bank). Burden of disease: Non-communicable diseases (NCDs) in Trinidad and Tobago accounted for an estimated 78% of all mortality in The most prevalent NCDs in Trinidad and Tobago are cardiovascular diseases, which accounted for 34% of total deaths across all age groups in Diabetes, cancers and noncommunicable variants of respiratory diseases contributed 14%, 13% and 3% to total mortality respectively (2008). Communicable diseases along with maternal, perinatal and nutritional conditions in Trinidad and Tobago accounted for an estimated 12% of all mortality in The prevalence of HIV in Trinidad and Tobago, as a percentage of population aged years, stood at just under 2% in HIV prevalence in Trinidad and Tobago has been on the rise since 1990, although the rate of its growth decreased in the period Trinidad and Tobago is non-endemic for malaria. The estimated incidence of tuberculosis (TB) doubled in the period , during which time the estimated mortality rate (when mortality data excludes cases comorbid with HIV) of the disease saw a slight overall decrease. There were 17 reported cases of leprosy in Health systems: Trinidad and Tobago s public spending on health was 3% of GDP in 2010, equivalent to US$861 per capita. In the most recent survey conducted between 1997 and 2010 there were 118 doctors and 356 nurses and midwives per 100,000 people. Additionally, 98% of births are attended by qualified health staff ( ) and 92% of one-year-olds are immunised with one dose of measles (2011). In % of the country s population was using an improved drinking water source and 92% had access to adequate sanitation facilities. The most recent survey, conducted in the period , reports that Trinidad and Tobago has 49 pharmaceutical personnel per 100,000 people. Trinidad and Tobago has four general hospitals, two district hospitals, four specialist hospitals and more than a hundred health Under-five mortality Under-five mortality per 1,000 live births 2015 MDG 4 target Life expectancy and HIV/AIDS Life expectancy in years GRAPH 1 GRAPH GRAPH 3 Prevalence of HIV/AIDS among those aged Life expectancy Mortality by cause of death (% of all deaths), 2008 Diabetes 14% Respiratory diseases 3% Cancers 13% Other NCDs 14% Communicable, maternal, perinatal and nutritional 12% Injuries 10% Cardiovascular diseases 34% Prevalence of HIV, total (% of population aged 15-49) Commonwealth Health Partnerships

5 GRAPH 4 ACI and ACIST Bringing Quality Healthcare to Life ACI and ACI Surgical Therapies operate a full service hospital-based cardiovascular care facility in Port-of- Spain, Trinidad. We utilise the most sophisticated, cutting-edge technology for diagnosing and treating cardiovascular disease. We provide 24/7 access for EMERGENCY PROCEDURES via our life-saving Heart Attack Centre which performs primary angioplasty procedures. We offer Complete Cardiovascular Solutions for Heart Care and Blood Circulation Problems through state- of-the-art catheterisation labs and an ultra-modern open heart surgical programme. Our patients are cared for by the most experienced team in the region: Medical Director - Dr Ronald Henry, the pioneer and foremost expert in interventional cardiology in the region Chief Surgical Officer Mr Roberto Casula, an internationally renowned European Cardiothoracic Surgeon provides oversight for the surgical programme Locally-based lead Cardiothoracic Surgeon Mr Randolph Rawlins A full team of leading internationally credentialed interventional cardiologists and cardiothoracic surgeons are on call to provide regionally unparalleled cardiac care Internationally trained specialist cardiac nurses Conveniently located at: Westshore Medical Private Hospital 239 Western Main Road, Cocorite Trinidad, West Indies Tel: Fax: aci@acicares.com Health professionals working in the mental health sector per 100,000 of the population Psychiatrists Medical doctors not specialised in psychiatry Nurses Psychologists Social workers Occupational therapists Other health workers centres. The private health sector is smaller and includes a variety of private healthcare providers, such as physicians, dentists, pharmacists and opticians. All private hospitals are required to apply for a licence to operate. There are various distribution and retail pharmaceutical operations in the country. Progress towards the 2015 health MDGs: Trinidad and Tobago is currently working towards achieving the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms MDG 4, Trinidad and Tobago should reduce under-five deaths per 1,000 live births to 12, and increase measles immunisation to 100% by In 2011, under-five mortality stood at 28 deaths per 1,000 live births, and measles immunisation at 92%. This suggests that Trinidad and Tobago may be able to achieve MDG 4 by 2015 if some changes are made. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and When applying this target to Trinidad and Tobago, the maternal mortality should fall to 22 cases per 100,000 live births. In 2010 Trinidad and Tobago had 46 maternal deaths per 100,000 live births (an estimate from UN agencies/world Bank), indicating that this target has not yet been achieved. Part of the goal also stipulates that 100% of births must be attended by a skilled health professional. In the period this figure stood at 98%, and so this target is close to achievement. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Prevalence of HIV in Trinidad and Tobago has seen no decrease since 1990, plateauing at 1.5% in the period for the age group. Additionally, there has been an increase in the estimated incidence of TB and only a slight decrease in the estimated mortality (when mortality data excludes cases co-morbid with HIV) from TB since Accordingly, significant progress in these areas is required if the country is to achieve MDG 6, and it is unlikely to do so by For definitions, sources and explanations on the Millennium Development Goals see page Further information Ministry of Health: Commonwealth Health Online: org/health/americas/trinidad_and_tobago