Health Sector Revitalization Turks & Caicos

Islands

Latin America and the Caribbean Health Sector Reform Workshop

Belize City, Belize

Dr. Rufus W. EwingDirector of Health Services

Source: Vital Statistics Report 2004

CHART 1: TCI TOTAL POPULATION & POPULATION DENSITY 1970, 1980, 1990 - 2003

0

5,000

10,000

15,000

20,000

25,000

1970 1980 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

YEARS

NUM

BER

OF

PERS

ONS

0.0

20.0

40.0

60.0

80.0

100.0

120.0

POP.

DEN

SITY

(SQ

. M

ILE)

TOTAL POPULATION POPULATION DENSITY (PER SQ. MILE)

Vital Statistics –Socioeconomic • Population – 32,200 (2006 estimate)• CBR –10.4• CDR – 1.7• Growth rate 4.6%• GDP per capita – 11,160• Revenue per capita - $2,370• Public Sector Health Expenditure - $27

million (2005-06)• Per capita expenditure - $906• Public Health Expenditure as percentage

of GDP – 8.1%

TCI Health Sector Organization

• Owned and managed by TCIG• Primary /Public Health Care (7

Island Clinics / HC, Dental, Envir. Health, AIDS)

• Secondary Health Care – 2 hospitals

• Tertiary Care – Very Limited on Island – majority receive MTA

Primary Health Care Services

• 9 Public Clinics, 1 located within the hospital

• 5 private clinics on Providenciales – 1 specialist clinic offering secondary

& primary care services– 4 general practice offering some

secondary care services

Secondary Health Care Services• 2 Secondary care Health facilities

• Grand Turk Hospital –21 acute care beds • Myrtle Rigby complex – 10 acute care beds

• 2 operating theatres with full surgical capability – handling all emergencies but elective procedures limited by lack of ICU

• 2 maternity units – types of cases limited by need for advanced Neonatal Care which is not available

Secondary Health Care Services

• Specialty Services – Internal Medicine– Pediatrics– General Surgery– Obstetrics & Gynaecology– Anaesthesiology– Urology (via private sector

collaboration)

Visiting Medical Consultants

• Orthopaedics• ENT• Neurology• Dermatology• Nephrology (voluntary – NGO)• Ophthalmology (Partially funded)

Supportive Health Services

• Full service Blood Banks at two hospital sites

• 2 Dialysis Unit with total of 11 machines

• Physical Rehabilitation (1 private, 2 public)

Health Care Staff -Physicians

General Physician

Specialist Physician

Total

Public 8 14 22

Private 6 3 9

Total 14 17 311999: Physicians per 10,000 inhabitants ratio = 7.3

2006: Physicians per 10,000 inhabitants ratio = 10.3 (31 physicians)

Public Health Sector Per Capita Expenditure

$0

$100

$200

$300

$400

$500

$600

$700

$800

1997 1998 1999 2000 2001 2002 2003

Per CapitaExpenditure

Medical Treatment Abroad Expenditure

$0

$1

$2

$3

$4

$5

$6

$7

US$ Millions

1997

1998

1999

2000

2001

2002

2003

2004

MTA Cost

Health Sector Financing • Improved quality of Health Service

• Strengthen the Planning, policy, and regulatory role of Ministry of Health

• Development of New Hospital facilities • Increase private sector participation• Strengthening Primary Health Care programmes

• The cost of achieving the objectives above cannot be met and sustained if

• MTA continue to escalate uncontrollably• Percentage Public HS expenditure remains high

with no cost recovery mechanism• Private insurance contribution to NHE remains low

(20.9 % in 1998)

MOH STRUCTURE 2000

MOH STRUCTURE 2007