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Healthcare in Anguilla
 
 
 

The Ministry of Social Services is responsible for the management of health services. The Director of Health Services bears responsibility for the effective functioning of all departments, and delegates responsibility through the Senior Medical Officer of the Hospital, the Primary Health Care Manager, Health Services Administrator, and Principal Nursing Officer. The post of Primary Health Care Coordinator was recently created.

The healthcare delivery system consists of a public and private sector. The private sector services include primary and secondary care. The public sector delivers primary care services from five district health centres. Secondary care is delivered at the Princess Alexandra Hospital. A nurse or doctor makes referrals to services at the hospital from the primary care level.

For primary healthcare delivery, the island has been divided into five health districts each with a health centre and defined boundaries. Two levels of care – Level III and Level II. Level III comprises the smallest four health clinics, which are staffed by a public health nurse, clinic aide, and environmental health officer. These clinics provide basic core services. Level II care is provided from the Valley Health Clinic, which serves as a referral centre for Level III, and offers daily medical clinics as well as basic primary care services to its defined catchment population. Referrals are made from Level II to the hospital. Except for puerperal mothers, there is no systematic mechanism for referral of patients from the hospital back to the primary level of care.

Public dental services are located at the central unit in The Valley, and supported by a mobile unit that provides care to the primary schools.

A 10-bed geriatric care unit provides institutional care for the elderly.

A psychiatric nurse provides community mental health services, and is responsible for maintenance care of all mentally ill patients. Emergencies can be referred to a district medical officer. There is no mental health facility. Violent cases are detained at Her Majesty’s Prison, and patients requiring specialised hospital care can be referred to neighbouring Caribbean islands, at the Government’s expense.

The island has no facilities for tertiary care, which is sought from the United Kingdom, St Maarten, Puerto Rico, and other Caribbean islands.

There are no training institutions for health personnel in Anguilla. Depending on health staffing needs, personnel are sent to various Caribbean islands. Increasingly, local training workshops, particularly in primary health care issues, are organised. It is the Government’s policy to support training for health personnel in the public and private sectors, and to open all locally organised training to participation by the private sector.

In 1995, there were nine doctors, 37 trained nurses, two dentists, four pharmacists, two dental auxiliaries, three laboratory technicians, two radiographers, four environmental health officers, one nutritionist, and three health educators. New categories of workers have been trained to enhance delivery of services at the primary health care level in the fields of nutrition and dietetics, health information, epidemiology, environmental health and public health nursing. Nursing personnel were redistributed in the primary care sector for improved island coverage.

The Government is the major provider of health services in Anguilla. Recurrent expenditure on health in 1995 was 18% of total Government expenditure, which ranks second after education, and represents 4.5% of the gross domestic product. Approximately 12% of the total recurrent expenditure for health is collected in users’ fees for dental, hospital and pharmacy services. Some 90% of the cost of health services is subsidised through exemption of persons from charges and unrealistic user fees.

The level of private expenditure is not known. However, it was estimated that in 1993, nationals spent at least $1.48 million for private doctor fees and for accessing treatment outside of Anguilla.

 

 
 

 



 


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