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Geographical Locations - St Christopher-Nevis
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- (Statistical) Number of Inhabitants per Doctor: 1,498
- CIA - World Factbook: Saint Kitts & Nevis
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- A Knowledge, Attitude and Practices Study of the Issues of Climate Change/Variability Impacts and Public Health in Trinidad and Tobago, and St Kitts and Nevis
Objective: To determine the level of understanding of the issues of climate change (CC)/variability (CV) and public health by populations of St Kitts and Nevis (SKN) and Trinidad and Tobago (T&T) and to find whether respondents would be willing to incorporate these values into strategies for dengue fever (DF) prevention. Design and Methods: Using a cluster sampling system, representative samples of the communities of SKN (227) and T&T (650) were surveyed for responses to a questionnaire document with questions on the impact of climate variability on health, the physical environment, respondents’ willingness to utilize climate issues to predict and adapt to climate variability for DF prevention. Data were analyzed by Epi Info. Results: Sixty-two per cent SKN and 55% T&T of respondents showed some understanding of the concept of climate change (CC) and distinguished this from climate variability (CV). With regard to causes of CC, 48% SKN and 50% T&T attributed CC to all of: green houses gases, holes in the ozone layer, burning of vegetation and vehicular exhaust gases. However, some 39.3% SKN and 31% (T&T) did not answer this question. In response to ranking issues of life affected by CC/CV in both countries, respondents ranked them: health > water resources > agriculture > biodiversity > coastal degradation. The major health issues identified for SKN and T&T respondents were: food-borne diseases > water-borne diseases > heat stresses; vector-borne diseases were only ranked 4th and 5th for SKN and T&T respondents respectively. There was in both countries a significant proportion of respondents (p < 0.001) who reported wet season-related increase of DF cases as a CC/CV link. Respondents identified use of environmental sanitation (ES) at appropriate times as a method of choice of using CC/CV to prevent DF outbreaks. More than 82% in both countries saw the use of the CC/CV information for DF prevention by prediction and control as strategic but only 50–51% were inclined to become personally involved. Currently, only 50% SKN and 45% T&T respondents claimed current involvement in DF vector surveillance and control in the last two days. Conclusion: Despite the fact that knowledge and attitudes did not always coincide with practices of using ES for DF prevention, in both countries, even with CC/CV tools of prediction being available, it seems that respondents could be persuaded to use such strategies. There is a need for demonstration of the efficacy of CC/CV information and promotion of its usefulness for community involvement in DF and possibly other disease prevention. [author abstract] [West Indian Medical Journal. Vol. 56, No.2, pp 115-121]
- Health in the Americas 2007: Saint Kitts and Nevis
As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Saint Kitts and Nevis addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Saint Kitts and Nevis, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
- Health Systems Profile: St. Kitts and Nevis – Monitoring and Analizing [sic] Health Systems Change/Reform, 2008
"St. Christopher and Nevis is an independent, small island developing state. Similar to its neighbors, it has experienced a demographic transition characterized by increased life expectancy and aging of the population. Concomitantly, there was a shift in the epidemiological profile from diseases of nutritional deficiency and poor sanitation to preponderance of chronic non communicable diseases fuelled by an aging population and modifiable lifestyle factors… The Ministry of Health is the national entity responsible for the organization and management of health services. This is accomplished through its tripartite structure comprising of a lead programme, Office of Policy Development and Information Management that makes health policy and two subsidiary divisions – Community Based Health Services and Institution Based Health Services that deliver personal and population based health services. The ministry’s work is governed by the principles of equity, universal access, high quality, sustainability, and attention to vulnerable groups. Programme implementation is guided by its National Strategic Health Plan (2008 – 2012) that identifies seven key priorities for intervention. While there is no discrete health hector reform initiative, public sector reform has been driving both administrative and financial reform of the health sector. There was renewed emphasis on efficiency of processes and accountability for health outcomes. A key area of focus was improving the quality of the workforce as well as the health services. The Ministry experimented with alternative means of financing health services through the limited application of user fees and outsourcing of services through public-private partnerships (e.g. CT scan services). Major challenges include ensuring universal access while sustaining health care financing; adequate supply and distribution of human resources; and reorienting service delivery to emphasize health promotion and prevention of diseases." [Pan American Health Organization/World Health Organization, 2010]
- Strengthening Social Inclusion through Social Guarantees: A Case Study of St. Kitts and Nevis
"This study seeks to examine social services delivery in St. Kitts and Nevis in the areas of health and education using social protection as a crosscutting issue in an attempt to determine the extent to which the country has integrated a rights-based perspective into the planning and delivery of social policy. Within the parameters of the study rights based social policy is defined as an approach comprising of the following features: (i) The definition and widespread communication of rights, entitlements and standards which allows a citizen to hold policy makers and providers accountable for the delivery of social policy; (ii) The availability of mechanisms of redress where citizens can go if they were unable to enjoy specified entitlements or social minimums; (iii) A commitment to the equitable delivery of the specified rights, entitlements and standards to all on a universal basis. The study was conducted based on a review of secondary sources as well as primary sources. A number of individuals representing a cross-section of relevant government, civil society and community organizations were interviewed and tapped for information about the two sections under examination." [World Bank, April 2008]
- UNGASS Country Progress Report 2010: St Christopher and Nevis
"St Kitts and Nevis is a member state of the OECS with a population of approximately 50,000 and a GDP of 0.54 billion. Unlike the HIV epidemic in the majority of the other Caribbean islands where the epidemic is characterized as generalized with an estimated prevalence rate of 0.9-1.1; the HIV epidemic in St Kitts, in the absence of sero-prevalence studies, is believed to be concentrated. It has been postulated that the HIV positive cases are being underreported due to a high level of stigma and discrimination and potential breach of confidentiality. The present prevalence rate is calculated at 0.4% with 314 reported cases from 1984. The incidence of HIV-positive reports peaked in 1996 with 34 new diagnosed cases. This appears to mimic the latest epidemiological data which indicates that the global spread of HIV appears to have peaked in 1996. The annual prevalence of HIV-related deaths have remained at 5 or less for the last ten years although there are fears of underreporting as some doctors may not explicitly record AIDS as the cause of death due to fear of stigma and discrimination to the family…" [National Advisory Council on HIV/AIDS – Ministry of Health, Social Services, Community Development, Culture & Gender Affairs, 31 March 2010]
- WHO-AIMS Report on Mental Health System in Saint Kitts and Nevis
"The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was used to collect information and format the report on the mental health system in the Federation of Saint Kitts and Nevis. The overall goal of collecting this information is to provide an objective baseline for mental health reform and a benchmark for monitoring change. The assessment will give momentum to the government’s initiative to prepare a coherent and rational mental health policy, mental health plan, and legislative Act. The Mental Health and Substance Abuse plan was drafted in 2007. The last enacted mental health Act is dated 1956; a draft Act is dated 2007. No human rights policy exists and no pertinent training conducted for mental health workers. The proposed Mental Health Act includes two human-rights oriented sections that deal specifically with ill-treatment of patients and sexual offences against patients; the proposed enforceable sanctions are included. In 2007, approximately 1% of the Federation’s current and non-recurrent expenditure was allocated to mental health services. There is no national insurance scheme that covers mental health problems of clinical concern. The entire population has free access to Community Mental Health Clinics. Also free access to any psychotropic drug, provided in the Government pharmacy, in the categories of anti-psychotic, antidepressant mood stabilizer, anxiolytic, and antiepileptic medicines. Inconsistent availability of medications at the government pharmacies results in a compliance issue. Primary health care physicians can prescribe and continue prescriptions for psychotropic drugs without restrictions." [WHO and Ministry of Health, Saint Kitts and Nevis, 2009]
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