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Grenada Healthcare

Grenada’s health policy aims at ensuring that every Grenadian has access to quality health services. The Government has embraced primary health care as the main strategy for improving the population’s health status. It also has adopted the goals and targets established through the Caribbean Cooperation in Health initiative as the priorities for its health services.

The Government is decentralising the health services and placing them under the management of a board of directors established by law. As part of an effort to introduce a national health insurance program, the financing of the health services also is being reviewed. The insurance program would create an equitable way of injecting new resources into the health sector, contribute to improve the quality of care, and help to reduce the dependence on the central government for health sector financing. The proposal for implementing the health insurance program is being reviewed to ensure that it responds to Grenada’s needs and that both healthcare providers and the public understand it fully.

The health sector’s basic organisation has remained unchanged in recent years. Most program heads are based at Ministry of Health headquarters, as are those for administrative, planning, health promotion, and budget and expenditure. A Medical Board chaired by the Chief Medical Officer is responsible for granting medical licenses to practice medicine in Grenada. Nurses must register with the Nursing Council. A pharmacy council monitors the importation and distribution of pharmaceuticals to the public and private sectors and registers pharmacists and pharmacies on an annual basis.

Grenada is divided into seven medical districts, each headed by a District Medical Officer. The acute care facilities in the public sector include a 240-bed at St George’s General Hospital and two rural hospitals, Princess Alice, with 60 beds and the Princess Royal, with 40. A 20-bed acute psychiatric unit is located on the grounds of the General Hospital, and it serves as the entry point for those seeking psychiatric care and support. There also is an 80-bed psychiatric hospital (Mt Gay), which handles chronic patients, and a geriatric facility with 120 beds; occupancy rates usually exceed 100% at both. Carlton House provides support and assistance to substance abuse patients.

Consultants conduct specialist clinics in paediatrics; ears, nose, and throat; and mental health at the district level. The District Medical Officer refers persons seeking care in other specialities to the General Hospital, but there are long delays before receiving services. Referrals for admission to the General Hospital also are made through the Accident and Emergency Department. No established follow-up system is in place to inform the district medical team when a discharged patient returns to the community, and this is an area that also will be given high priority in the future.

In 1996, there were 50 physicians employed in the public health sector, and most of them also worked in private practice; 10 were District Medical Officers who conduct clinics at the community level. There are 36 doctors who work primarily in a hospital setting, 16 of whom are consultants and the rest, junior doctors. 15 doctors work exclusively in the private sector, most of them as general practitioners. There are 6 physicians per 10,000 population.

Several categories of nurses work in the public health system – 173 nurse/midwives work in the three hospitals; 50 work at the district level, including public health nurses, family nurse practitioners and district nurses; and nine work in the mental and geriatric facilities. There are 24 nurses per 10,000 population.

The public sector employs 26 pharmacists, most of whom are based in the community, the procurement division, and at the hospitals. There are 18 private pharmacies staffed with 21 pharmacists. Grenada has 4.8 pharmacists per 10,000 population. Seven dentists are employed in the public sector, but they all have private practices as well; another seven work exclusively in private practice. The country has 1.4 dentists per 10,000 population. Five dental auxiliaries work with the dentist in the public sector, mainly with the school population.

The health sector has consistently received more than 12% of the annual Government recurrent budget, and public health recurrent expenditure is estimated to have represented about 4.5% of GDP over the 1992-1996 period. The main hospital accounted for 40% of all health expenditures, and district health services – including community health services, environmental health, and dental department programs – accounted for approximately 26%. Wages and salaries in the sector accounted for approximately 70% of health expenditures on human resources.





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