Diaspora%20conference

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Diaspora conference

• NY April 30th2011

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• Dr. Barbara Gordon, Ob/gyn
• Dr. Sharon Ogiste-McBain, Pediatrician
• Dr. Wilkins Williams, Internal Medicine
• Dr. Elma Johnson, Emergency medicine
• Rev Wesley Daniel

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(No Transcript)
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Grenada General Hospital
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Grenada General Hospital
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Grenada General Hospital
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• GRENADA
• NATIONAL STRATEGIC PLAN FOR
• HEALTH
• (2007-2011)
• Govt of Grenada

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The Grenada National Strategic Plan for Health

• designed to involve the whole country in
  setting priorities and a direction for improving
  health status of the population

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Steering Committee

• Appointed by cabinet in 2004
• Financial support from Caribbean Dev. Bank
• Technical support from PAHO
• Consultation launched in Sept 2005
• Ministry of Health

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A National Strategic Plan for Health
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Guiding principles
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Strategies outlined by the Caribbean Charter for
Health Promotion
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Grenada

• Grenada, Carriacou, Petit Martinique
• 133 sq miles
• Independent Nation 1974 from the UK
• Westminister- style parliament
• Population 2005 was 106,027
• Growth rate 0.2

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Demographics 2005

• Ages 0-15 . 34.7
• Ages 15-65 54.9
• Ages 65 10.32

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Overview of the populations health status

• Infant Mortality range 1998-2002
• 12.5 19.6 (deaths /1000 births)
• Maternal Mortality rate
• 0 for 4 years
• Death Rate range from 7.0-8.7 /1000 population
• Life Expectancy Age 68 for men and women 72
• Fertility rate 2004, 2.4 children for women of
  childbearing age

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Socio-Economic Situation

• The 2005 UNDP- Human Development Index ranked
  Grenada 66th of the 177 nations. The ranking
  reflect positive changes in infant mortality
  rates and adult literacy. Other indicators
  include an 18.8 unemployment rate and a 31
  poverty rate

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Leading causes of death 1998-2002

• Disease of the circulatory system including
  pulmonary circulation, cerebrovascular disease
  other forms of heart disease
• Malignant neoplasms
• Disease of respiratory system
• Certain infections and parasitic disease
• Accident and injuries increase 4 fold from
  1989-2002

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Leading causes of morbity 2004

• Diabetes Mellitus
• Hypertensive Disease
• Upper respiratory infections
• Arthritis
• Injuries
• Admissions to hospital greatest in persons in age
  45

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Communicable disease review 1980-2004

• Decline in TB from 17 to 6 cases
• No deaths from Dengue 03-04, the number of
  cases bet 02-04 were 310,19,8 respectively,
  cases related to rainfall an mosquitoes
• Decrease in Sexually transmitted Disease
• Syphilis almost 80 decrease bet 96 02
• Gonorrhea remained stable with 112 cases in 96
  and 101 cases in 02

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HIV/Aids

• HIV midyear 05, reported cases 197, male to
  female ratio 2.5 1
• Cumulative of deaths from AIDS, 155
• 113 males , 42 females

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Hospital utilization

• 04 Women 99 delivered in a health facility,75
  at the General hospital, 1 in private
• 01-04 men accounted for higher utilization of
  hospitalization (compared to women)for injuries
  from work place and road traffic accidents
• Men also had a higher admission to the Carlton
  House for drug and alcohol abuse treatment
• 04 men had 33 first visit to the community
  health services

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School age children

• A survey for Anemia in 2004 , ages 1-4, 62.1 had
  hemoglobin levels below normal
• Dental services at health centers ,2,238 children
  seen ages 5-19, 99.3 were identified with
  problems
• 00 Teenage pregnancies, 21 of total births

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Elderly

• 13 homes care for the elderly (govt assisted,
  public, private)
• An NGO also works in the community for the
  elderly
• Chronic disease management is a major challenge
• By 2014 , 20-25 of the population will be over
  50 years of age there will be greater demand for
  chronic disease care at the community level and
  hospital level

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Health Risks

• Main concern and cause of ill health and death is
  related to poor dietary habits, in particular
  before and after pregnancy, poor fetal
  development, early childhood nutrition, poor
  chronic disease management, accident and
  injuries, drug and alcohol use, and (to some
  extent) unsafe practices

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Health Services

• Public facilities- 3 Acute care hospitals
• General Hospital-240 beds
• Princes Alice Hospital- 56 beds
• Princess royal Hospital (Carriacou ) -40 beds
• 1 Mental health Hospital (Mt Gay Hospital)

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Health Services cont

• 1 Rehabilitation center (Carlton House)
• 1 Home for the elderly ( Richmond Home)
• 6 Health centers
• 30 health stations
• There is limited referral system between
  community services and hospitals as a result many
  patients to directly to the Accident and
  Emergency (AE) resulting in long waiting time

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Hospital Utilization 2004

• General Hospital had 8,313 admissions at the
  Average length of stay 6.6 days, bed occupancy
  rate 73
• Princess Alice has limited diagnostic services
  all x-ray and lab services has to go to the
  General Hospital requiring patients to be
  transferred. Occupancy rate 60

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Hospital Utilization contd

• Princess Royal Hospital (Carriacou) serves a
  population of 7000 including Petite Martinique
• A major constraint is the inability to retain
  doctors who cover both hospital and community
  services

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Community health services 2004

• 10 District Medical Officers
• 10 community health nurses
• 40 district nurses
• 5 Family Nurse Practitioners
• 45 community Health Aides
• 12 Pharmacists
• 8 dentists
• 2 social workers
• 7 environmental Health officers

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Private health services

• Dominated by single practioners, many of these
  doctors work for the public health services
• 2 small private clinics with patient beds
• A diagnostic facility
• General hospital Private ward
• No NGO provide inpatient care, however many
  participate in health promotion an protection
  activities

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Financial Resources

• Health sector receives approx 12 of the annual
  budget in 2000-2005
• Wages and salaries account for approx 70 of
  health expenditures

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Personnel 1997/2002

• 8.1 physicians per 10,000 population
• 19.5 nurses per 10,000
• 1.1 Dentist per 10,000
• 6.9 Pharmacist per 10,000
• 0.75 Nutritionist per 10,000
• Key challenges for health personnel in Grenada
  include the ability to retain medical
  practioners, nursing staff and medical
  administrators

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Central non-partisan body

• To coordinate all voluntary health aide efforts
  made to Grenada with representatives from each
  parish
• Develop a website with links
• Create a central registry for physicians and
  allied health workers with the services they can
  provide
• Governed by an advisory Board efforts coordinated
  by a core body e.g.. secretary , treasurer and
  president
• Set up a central office in Grenada and NY

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Education

• Community education health information,
  pamphlets
• Provide a monitoring system to track the
  educational materials
• Have volunteers /paid personnel to ensure reading
  materials are circulated
• Maintain statistics of the education materials
• Quality assurance to ensure materials are
  distributed to the appropriate parties

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Education contd

• Provider educationphysicians, nurses, aids and
  all allied workers those in direct and indirect
  patient care
• Mandatory continuing medical education (CME)
• Incorporate Health education in high school and
  elementary schoole.g. STD, proper nutrition,
  dental care etc.

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Health Protocols and compliance

• Review health protocols of hospital and satellite
  clinics
• Create a committee of 3-4 physicians/administrativ
  e staff to review protocols are they practical
  ? are they enforced ? The central board should
  be involved in the process

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NGO and Volunteer services

• Central Committee . responsible to coordinate
  the volunteer services for continuity of care
• Have a central registry to coordinate the
  volunteer services e.g. dentists going on
  different months for continuity of care rather
  than having all at the same time
• Have paid staff to coordinate efforts for
  accountability

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Drug Bank

• Drug assistant bank program to assist patient
  with unaffordable medication
• Make arrangement with drug companies and other
  parties

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Weekly Radio and TV health topics

• Have a calendar , get volunteers to provide
  health information for different topics

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Grenada General Hospital
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VOLUNTEERS

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Grenada General Hospital