BARBADOS Wendy Sealy Chief Nursing Officer, Ministry of Health Barbados

CONTRIBUTION OF NURSING IN THE REGION OF THE
            AMERICAS AND ITS POTENTIAL
towards Universal Access to Health and Universal Health
                      Coverage

                     BARBADOS
                        Wendy Sealy
                        Chief Nursing Officer, Ministry of Health Barbados

CONTRIBUTION OF NURSING IN THE
REGION OF THE AMERICAS AND ITS
POTENTIAL TOWARD UNIVERSAL
ACCESS TO HEALTH AND UNIVERSAL
HEALTH COVERAGE.

CONTRIBUTION OF NURSING AND ITS POTENTIAL IN
BARBADOS
By Dr. Wendy Sealy, Chief Nursing Officer

OBJECTIVES OF THE PRESENTATION

 Present a country overview of Barbados
 Outline the Epidemiological profile and current situational analysis
 Explain the context of Health sector reform
 Describe the Nursing human resources
 Outline the challenges related to nursing human resources
 List the services offered
 Explain the contribution of nurses to Universal Health
 Outline the challenges related to Universal Health
 Outline the Next steps

Barbados: A country review

 Barbados a sovereign island
  country in the Lesser Antilles.
 It is 34 kms (21 mi) in length and up
  to 23 kms (14 mi) in width,
  covering an area of 432 square
  kms (167 sq mi).
 It is situated in the western area of
  the North Atlantic and 100 kms
  (62 mi) east of the Windward
  Islands and the Caribbean Sea.
 It is the most easterly of the
  Caribbean islands.

Epidemiological profile

 Barbados is an independent democratic country in the Caribbean with a
  mid-year population estimated at 275,000 in 2007 occupying 166 square
  miles;
 One of the most densely populated countries in the world.
 In 2008 total life expectancy at birth was 77.5 years, with female life
  expectancy reaching 80.0 and male life expectancy reaching 74.9.
 Infant mortality rate declined steadily from 14 per 1,000 live births in the
  period 1990 to 1995 to 11 per 1,000 in the period 2000 to 2005
 In 2006, total fertility rate was 1.5 births per woman.
 A significant epidemiological trend in Barbados is the increasing
  prevalence of overweight, obesity, and chronic non-communicable
  diseases in the general population.

BARBADOS: CURRENT SITUATIONAL
ANALYSIS
 Universal Health-High priority of the overall national development agenda
 Several policy measures introduced to improve the living conditions of the
  population:
 Health care free at the point of delivery-funded through general taxation
 Health expenditure approximately 4% of GDP
 Comprehensive health services provided through primary, secondary and
  tertiary care systems (public and private).
 Comprehensive Expanded Programme of Immunization (EPI).

CURRENT SITUATIONAL ANALYSIS cont’d

 Access to quality sexual and reproductive health services; reproductive
  rights
 Access to contraceptives and safe termination of pregnancy
 Early detection and prevention of cervical cancer
 Reduction in the number of deaths related to cervical cancer
 Introduction of the Human Papilloma Virus (HPV) vaccine in January, 2014
 Maternal death rate 0.8 per thousand.

CURRENT SITUATIONAL ANALYSIS cont’d

Comprehensive STI/HIV programme- evidence informed, gender-sensitive,
 and human rights-based
Declines in HIV-related morbidity and mortality and in mother-to-child
trans mission
1.   Expansion of HIV prevention and care services through decentralized
     testing and referral
2.   Coverage of ARVs is currently 86% for those who need it
3.   A reduction of AIDS mortality rates to under 2%
4.   A reduction of mother- to- child transmission of HIV to 0.8% 2003-2012

Health care reform (HCR)

 HCR impacted by the following:
1. Multi-year budget cycle
2. Accrual accounting system (replaced cash accounting system)
3. Information systems policy
4. Human resource performance management system

Health sector reform cont’d

 Based on the Barbados Strategic Plan for Health 2000-2012
 Emphasis on the priorities focused on the Caribbean Cooperation for
  Health Initiative
 Strengthened primary, secondary and tertiary care systems
 Mental health reform programmes
 Enhanced surveillance systems
 Phased implementation of a health information system.

Nursing human resources

 Development of a draft Nurses Human Resources Strategy 2013-2018
 Distribution- concentrated in the public health sector
 Training- pre-service training at tertiary level/ post graduate training
  education available
 Labour market-dynamic with a focus on labour market analysis
 Practice- general clinical and specialized services

Challenges related to nursing human
resources
 Human resource management systems
 Finance systems
 Administrative and management systems

Services

 General clinical
 Specialty clinics
 Maternal and Child care
 Health education and health promotion
 Disease surveillance
 Care of the Elderly
 Training
 Community services
 Auxiliary services
 General management and administration

CONTRIBUTION OF NURSES TO Universal
Health
 Policy, Leadership and management
 Collaborative partnerships
 Education and Training
 Clinical practice
 Research

CHALLENGES related to Universal
Health
 Limited fiscal space and constrained financing
 Increased reliance of population on government operated health services
 Dynamic health care needs of population
 Static health care models
 Aging human resource base
 Lack of a comprehensive nursing research agenda

NEXT STEPS

 Assessment of gaps in achieving Universal Health from a nursing perspective utilizing the
  strategic priorities.
 Conduct an evaluation of the nursing structure within the country context.
 Establish national nursing research agenda- priorities of Universal Health.
 Increase nurse participation in policy processes at all levels.
 Increase the involvement of nurses in the health finance debate.
 Build on the achievements and successes of nurses in programmes and activities which
  increase Universal Health.
 Review the findings of the national consultation on Universal Health (2014) with a view of
  operationalizing the recommendations.
 Strengthen partnerships between and among state and non-state actors.
 Strengthened coordination of the Universal Health utilizing tenets of Health Systems
  Strengthening and the WHO Building Blocks.

THANK YOU

Thank you for
       YOUR                            paho.org/nursing

   PARTICIPATION                       observatoriorh.org/enfermeria
                                       facebook.com/EnfAmericas
 The recording will be available at:
http://observatoriorh.org/enfermeria   twitter.com/EnfAmericas