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
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.
–Health Care System
18 General
Hospitals 6 Specialists
Primary Care System (Clinics)
331
Clinics
(+ 23 satellites)
Public Health System
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
Hospitals
6 specialists
– Psychiatric and rehabilitative services for
the mentally ill
– O & G nationally
– Paediatric care
– Oncology and hospice
– Chest diseases
– Physical rehabilitation
Other National
institutions
National public Health lab
Blood bank
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
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
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.
Public Sector predominates in the
community health and inpatient areas
Private sector dominates in terms of
primary care, pharmaceuticals and
diagnostic services.
Healthsector reform
programme
H.S.R.P. - 1995
– 1. Prevention
– 2. Treatment
– 3. Severe Resource Restraints
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
DECENTRALISATION
In 1999, Jamaica decentralized the
Administration of its Health Services.
Four Regional Health Authorities were
established.
South East
Southern
North East
Western
Decentralization
Administrative
Fiscal
Political Process
Designed to Improve Health Services
through increasing allocation and
technical efficiency
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
Spending efficiency
Energy Conservation
Solar Heating
– Energy Monitors
Reorganization of Transportation
Restructuring of Head
Office
Reduction in personnel (600 300)
Functions Redefined to reflect
– Policy Formulation
– Quality Assurance and Standards
Monitoring
New Laws and
Regulations
Revision of the Health Services Act
Public Health Act
National Health Services Act
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.
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
Ambulatory Care
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
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
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.
Thank you
