Bi-national Commission on Health Guyana Suriname National Health Care System of Guyana Dr. Shamdeo...

Bi-national Commission on HealthGuyana Suriname

National Health Care System of Guyana

Dr. Shamdeo PersaudChief Medical Officer Ministry of HealthGUYANA

GEORGETOWNJuly 2013

Ministry of Health, GUYANA

Vision

People of Guyana be among the

healthiest people in the Caribbean and

the Americas


Goals and Targets for Health Millennium Developmental Goals

Goal 1- Nutritional Disorders, Hunger and Poverty Goal 4 - Child Health (Morbidity and Mortality) Goal 5 - Maternal Health and Women’s Health Goal 6 - Communicable Diseases Goal 7 - Environment

National Development Strategy Poverty Reduction Strategy Paper y Health Sector Strategy (2008-2012) Health Vision 2020

Health Vision 2020 - Framework

National Health Authority Ministry of Health

Policy/Leadership and Guidance Minister of Health

Administration/Accountability Permanent Secretary

Technical Leadership Chief Medical Officer Skilled Professionals Other technical

Functions Policy Regulations Maintain standards Human Recourses

development

Health/Developmental Partner



Regulatory Functions Legislation

Food and Drugs Act Antibiotics, Immunization Health Professionals (Medical, Nursing, Dental,

Pharmacist, Allied Health Act) Ministry of Health Act Regional Health Authority Act Georgetown Public Hospital Order Health Facilities Act


Minister of Health

Permanent SecretaryFinance

Chief Medical Officer

DirectorDisease Control

DirectorStandards and Technical Services

DirectorRehabilitation Services

DirectorPrimary Health Care

Director Health Sciences Education

HIV/AIDS, STI

Vector Borne Disease

TB/Chest Disease

Chronic Non Communicable Disease

Maternal and Child Health

Adolescent and young adult

Environmental Health

Drug Control Authority

Laboratory

Radiology Unit

Epidemiology and Surveillance

Nutrition Program

DirectorRegional Health Services

CoordinatorHinterland Services

CoordinatorCoastal Services

RHO(Regions 1,7,8,9)

RHO(Regions 2,3.4,5,6,10)

National Blood Bank

Ministerial Secretariat

Deputy Permanent SecretaryAdmin/HR

Mental Health

Oral Health

GA-FAD/CBH/PPB/TOP/MC/AHPC

Decentralized Health Services Five Levels of Care (All services Free to public)

Level V – GPHS and other national Referral Facilities

Level IV – Regional Hospital offering specialized services

Level III – District Hospital Level II – Health Centers Level I – Health Post


Agency Programs – Program 1 Administration

Minister of Health Permanent Secretary

Deputy Permanent Secretary General Administration Accounts/Financing and planning Personnel/HR Materials Management Unit Management Information system Linden Hospital


Program 1 - Administration Chief Medical Officer

Central Board of Health Pharmacy and Poisons Board Intuitional Review Board (Ethics Committee)/Research All Technical Programs

Seven Directors Chief Nursing Officer

General Nursing Council

Food and Drug Analysis Department National Psychiatric Hospital – Administered by RHA


Program 2 – Disease Control Administration Vector Control TB/Chest Diseases Hansens Disease NAPS-HIV/AIDS/STI CNCD Mental Health VPH Surveillance/Epidemiology National Public Health Laboratory


Program 3 – Primary Health Care Family Health (Maternal & Child Health,

Adolescent and Adult Health) Oral Health Environmental Health Food Policy Division Health Education Division


Program 4 – Regional Health Services Implement in collaboration with RDC/MOLG Curative services

Regional /District Hospitals/HC and HP Diagnostic Centers Medical outreach

Special programs Eye Care/Miracle Vision Indigenous programs Medical Evacuation


Program 5 – Health Sciences Education Core Training Programs

Nursing MEDEX Pharmacy Assistant Environmental Health Assistant Lab and X-ray Technicians CHW

In-service and continuous training Ministry of Health, GUYANA

Program 6 – Standards and Technical Services Quality health care system

Health Facility Licenses Pharmacy Services Laboratory Services Radiology and Imaging services National Blood Transfusion Services


Program 7 – Rehabilitation Services Disability Commission

Ptolemy Reid Centre Cheshire Home Audiology services Physiotherapy Services


Expanded Clinical Services GPHC

Curative and specialized services Medical Training

Berbice Regional Health Authority Regional Health Departments Para-stateal – NIS, GUYSUCO Private

Private Hospital (7), Private Practitioners

Other - Laboratories, Pharmacies, Dialysis, Cancer treatment



Health Manpower/Bed CapacityIndicato

r

03 04 05 06 07 08 09 10 11 12

Number of Physicians per Ten Thousand Population

4.2 4.2 4.9 4.9 5.1 6.1 6.6 6.8Cb

59.1

7.9Cb61

9Cb61

Number of Nurses per Ten Thousand Population

11.5 12.7 11.6 10.8 9.9 10.6 11.2 11.5Cb86

12.8Cb85

13.3Cb78

Number of Hospital Beds per Ten Thousand Population

25.0 24.9 24.9 24.1 24.9 24.9 25.1 25.1Cb49

28Cb50

28Cb50


Health SituationLife expectancy

1950’s – Just above 50 years at birth 1990 - 2002 – 64 years at birth 2005 - 2006 – increased to 66 for all at birth 2011

Women – 71.1 years at birth Men – 66.5 years at birth

Population 2002 – 751,000 2012 Mid year estimate – 768,200


Life Expectancy

0

10

20

30

40

50

60

70

80

1970 1990 2005* 2007 2011

All

Females

Males


Health SituationVital Statistics Crude Birth Rate (per 1,000 persons)

2003 – 22.8 2009 – 18 2011 – 17.7

Crude Death Rate (per 1,000 persons) 2003 – 6.6 2009 – 6.1 2011 – 6.1


Health SituationInfant Mortality Rate – The number of deaths of infants

from among all live births of current year 2003 – 17 per 1,000 LB 2009 – 14.1 per 1,000 LB 2011 – 15.1 per 1,000 LB

Most causes are preventable Premature babies Respiratory distress Some unavoidable – congenital deformity, birth defects


Infant Mortality

0

5

10

15

20

25

30

35

40

45

2000 2002 2004 2006 2008 2010

IMR/1000 Live Births

Under 5MR


Health Situation Under 5 mortality Rate – deaths of children

under five for all births of current years 2003 - 21.2 per 1,000 live births 200 8– 17.2 per 1,000 live births

Most preventable cause Diarrheal disease and dehydration ARI and Pneumonias Other infections


Health SituationMaternal Mortality Ratio Direct causes Critical indicator Most preventable cause

2003 – 168/10,000 2006 – 115/10,00

Main causes include post partum hemorrhage, sepsis and anemia


Maternal Mortality

0

20

40

60

80

100

120

140

160

180

200

2000 2002 2004 2006 2009 2011

MMR/10,000 Livebirths


Nutritional Status

0

1

2

3

4

5

6

7

8

9

2004 2005 2006 2007 2008 2009 2010

Moderate

severe

Overweight


Nutritional Status Low birth-weight babies (<2500g.) as a % of live births

2003 – 11.9 2006 - 10.8 2010 – 9.1

Severely malnourished 2003 – 0.6 % of all under 5 2007 - 0.3 % of all under 5 2010 – 0.3 % of all under 5

Moderately malnourished 2003 – 8.8% of all under 5 2010 – 4.1 % of all under 5

Overweight – 2.8% (2003) - 6.9%(2007) – 8.1% (2010)


Communicable Disease Morbidity

Major causes of Illness ARI – 84,000 Gastroenteritis/ADD – 38,421 cases Unspecific fevers – 62,321 cases

Other specific Causes Malaria – 31,876 cases (185,000 smears in 2012) TB – 93/100,000 (725 cases 2012) HIV – 1.1 % (8,263 cases, 106,492 tested )


Non Communicable Disease Diabetes Cardiovascular diseases, heart diseases,

hypertension Cancers Chronic Lung Diseases, GI and Liver Disease Accidents, violence and injuries (MVA etc) Mental Illnesses


CancersRanking of top cancers Prostate (male) Breast (female) Cervical (female) Stomach, Colon and other bowel (both sex) Liver Lung


Diabetes Diabetes –

Estimated Prevalence – 6.2% of population Average of 4.8 % of population over 30 years Incidence – 4,000 new cases annually Types of Diabetes

Type 1 (Insulin Dependant) – 8% Type 2 (non-Insulin Dependant) - 92 %


Hypertensive Diseases Prevalence – 9% of the Population over 30

years Incidence – 16,000 new cases reported

annually Major contributing cause of

Strokes in persons over 40 Heart Attacks Disability and under productivity


Cardiovascular and heart disease Strokes

Hemorrhagic – 1,901 cases annually Thrombo-embolism (Clots) – 896 cases annually

Heart Attacks – 2,012 cases Blood vessel disease

Atherosclerosis – 3,129 reported Aneurysms


MorbidityMain Causes 1999 2000 2001 2002 2003 2004 2005 Total

Heart Diseases

796 1001 936 963 1056 1176 1128 7056 (21.4%

)

Infectious* HIVTB

565302

45

753312

47

683405

61

753475

97

661374

84

644358118

670359

96

4729(14.3%)2585(54.7%)548(11.6%)

Cerebro Vascular

Diseases

392 545 494 574 633 558 585 3781(11.5%)

Cancers 348 394 431 396 423 426 452 2870(8.7%)

Endocrine(Diabetes)

367 377 345 395 370 385 411 2650 (8.0%)

All Causes 3749 4227 4629 5003 4986 5141 5232 32,983

New Priority Areas Health in the life cycle (Family health - child,

adolescence, women, men, elderly) Non communicable disease (CNCD and Mental

Health) and their risk factors Communicable Disease (Priority, neglected, emerging

and remerging disease) Violence, accidents and injuries Health Environments or settings (health communities,

city, hospital, workplace and homes) Nutrition and food security Frontier, migrant, remote and vulnerable population


Thank You!

Bi-national Commission on Health Guyana Suriname National Health Care System of Guyana Dr. Shamdeo...

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