Group no. 9

ANTIGUA & BARBUDA, BAHAMAS, BARBADOS, BELIZE, GUYANA, HAITI, JAMAICA, ST. LUCIA, TRINIDAD AND

TOBAGO, ST. KITTS AND NEVIS, WASHINGTON

Facilitator: SURINAME

Challenges in Social Protection in Health

• SPH on political agenda

• Integrated and “client oriented” Health services

• Accessible and equitable Quality care health services at all levels, EOC, EmOC

• Adequate No. of Human Resources

• Primary health care with sufficient budget

Challenges

• Early attendance to antenatal care

• Reduced abortion practices

• Delay initiation of sexual activity

• Adequate support services available

• Increased male involvement and access to SRH services

• Youth friendly services available

• Reduced no. of pregnancy in teens

• Strong partnerships “public & private”

Barriers to face the challenge

• Unhealthy behaviors –late antenatal care, home deliveries, low breastfeeding rate, low contraceptive prevalence use, unsafe sex, early sexual initiation-

• Gender inequities

• Gender Based Violence

• Direct payment for services and/or incomplete services

• Poor partner and family support during pregnancy, childbirth and puerperium

• Age specific Sexual and reproductive health not included in Education curricula

Barriers

• Negative attitude of staff

• Poor information on the services available

• Cultural and religious beliefs

• Geographical inaccessibility

• Unemployment

• Technical and first line staff politically appointed

Opportunities to face the challenges

• Political will towards MDGs -Existence of MDGs task force-

• Poverty alleviation programs –housing, school feeding program, “PATH”, others-

• Health sector reform process taking into consideration the integration of the health services

• Technical assistance from UNCT

Opportunities to face the challenges

• Community empowerment

• Maternal and mortality review Committee –includes verbal autopsy and clinical audits-

• Existence of Regional Initiative to eradicate child malnutrition

• Networking with NGOs and Community Based Organizations

• Access to and management of Funds e.g. Global Fund, Clinton Foundation-

• Access to PAHO Revolving Fund –Vaccine procurement-

Recommendations SPH to improve health outcomes

• SPH on Regional & National Agenda –Summit of the Americas, CARICOM, RESSCAD; time frame for universal SPH-

• SRH a primary health care strategy

• Increase the regulatory capacity of the Ministries of Health –planning, monitoring, evaluation, policies for accountability, fiscalization –

• Enable supportive environment for women and children –family and community-

• Increase capacity of health system to provide Essential Obstetric Care –Basic and Emergency- and Home Based Life Saving Skills.

Recommendations SPH to improve health outcomes

• Update health policies related to MNI and work towards integrated health services

• Update health information systems

• Research and evidence based on SPH

• Reorient services to focus on Primary Health Care and implement COMBI strategies

• Design and implement retention strategies for health professionals

• Strengthen Public Health in Medical and allied schools

• Work force projection for the CARICOM countries

Next steps

• Review and update SPH in countries

• Focus and align organizations working in the field of MNI health

• Sensitize health authorities to place SPH on national and regional agenda

• Reorient services to focus on Primary Health Care and adopt COMBI strategies

• Empower Communities to demand their right to health

• Implement Sexual and Reproductive health policies

• Enable supportive environment for MNI –family and community level-

• Technical assistance e.g. work force projection, SPH, M&E,

Next steps

Thank you