Health Care Delivery Services
St. Maarten’s health care delivery services system
is structured like the traditional health care system into
three areas: primary health care, secondary health care,
and tertiary health care.
Primary Health Care
Primary health care consists of all preventive measures,
which collectively serve to stimulate health and healthy
lifestyles among the population. The concept is that participation
of the population in identifying and taking up their responsibility
of health problems can result in positive behavioral changes
leading to the improvement of the quality of life and well-being.
Primary health care is provided by private health care professionals,
non-governmental and governmental health care organizations
such as: general practitioners; district nursing; dental
care; paramedical care and other healthcare professionals
e.g. psychologists; Turning Point Foundation (Drug Rehab
Center); Sector Health Care Affairs; and voluntarily health
care delivery services.
Secondary Health Care
The secondary health care or specialized care consists of
clinical care and outpatient care, which is provided by
nurses and medical specialists within a health care facility.
The provided care by medical specialists is mainly accessible
through referral by a general practitioner or another medical
specialist (within the framework of intercollegiate consultations).
The following health care providers within this area are:
Medical Specialists, the St. Maarten Medical Center (SMMC),
the St. Martin’s Home (Nursing Home) and the Sister
Basilia Center (physically and mentally handicapped).
Tertiary Health Care
For more specialized care, St. Maarten refers its patients
to health care providers in Curacao and the region. For
specialized diagnostic facilities, specific operations and
treatments (such as kidney transplants, cancer treatments,
burn wound centers) the majority of patients are referred`
to Holland, U.S.A., Puerto Rico, Martinique or Guadeloupe.
There are special arrangements with these tertiary health
care providers. The number of patients referred for tertiary
care from 1990 till 2002 has been increasing within a community
that has high expectations on quality of life
.
Strengths of the health care system on St. Maarten
Commitment of personnel & professionals
Within the Steering Committee, a strong commitment from
health care professionals can be observed. In general, health
care personnel / professionals have a strong commitment
to their professions and work environment.
Organizational developments
Various health care organizations are developing and implementing
a policy plan to determine their respective strategies and
policies. The SHCA has taken the initiative to formalize
its policy plan, the BAHI, which will benefit all health
care organizations. Other examples are the SMMC, White and
Yellow Cross foundation, the ADC laboratory, which have
committed themselves to invest in the renewal and improvement
of their services provided to the community.
Development of curative medicine
A lot has been invested in curative care on St. Maarten,
e.g. an increase in specializations, an increase in specialists,
specialized nurses and equipment such as a CT-scan. The
construction of the SMMC in the early 1990s served as an
impulse towards the development of curative care.
Fair accessibility of health care services
St. Maarten differs in comparison to other islands in the
Caribbean region, because of the insurance systems, which
provide fairly equal and sufficient access to health care
services. The majority of the population is insured through
a social insurance system.
Even though the results of the health survey show the existence
of approximately 30 per cent uninsured inhabitants, health
insurance is being supplied by both government and private
insurers namely, FZOG, BZV, AVBZ, SVB and private insurers.
Their is a need to assess the reasons why so many persons
are uninsured. Intervention is required to bring about a
change in the large number of uninsured persons on the island.
A study needs to be done to compare St. Maarten with other
islands when it comes to uninsured persons.
Opportunities to improve the Health Care System
St. Maarten in general and several health care institutes
in particular have several ‘opportunities’ to
improve the health care system. The main but not limited
opportunities can be distinguished as follows:
Expansion of health care services
Because of its unique location, St. Maarten has a large
tourism industry and therefore has the opportunity to cooperate
with the other Islands in the region. Especially the SMMC
can take advantage of this position by focusing on providing
medical services to tourists and neighboring islands –
health care tourism.
Small scale
St. Maarten is a small island. Communication and consensus
can easily be stimulated due to the number and close distance
of health care providers on the island.
Medical technology
Within the SMMC, specialists and paramedical specialists
can take advantage of new developments / innovations in
medical technology and partly overcome the problem of isolation
from super technology or care, by the use of modern communication
techniques.
Cooperation / communication with French St. Martin/regional
The established (governmental) relation with French St.
Martin and other institutions in the region can benefit
in the use of resources and the coordination to secure the
accessibility to health care for the whole island.
Partnerships
SHCA works with local and regional organizations in the
form of partnerships. On a regional level, SHCA has a very
good relationship with the Caribbean Epidemiology Center
(CAREC) and the Pan American Health Organization (PAHO).
On a local level, SHCA works with a number of non-governmental
organizations within civil society such as the Rotary Club
(Diabetes Fair), Red Cross, Lion’s Club, SIFMA, the
Positive Foundation, St. Maarten AIDS Foundation and many
others. For a complete listing oforganizations, you can
contact SHCA.
List of Policy Priority Areas
These priorities are answering to the vision and include
the empowerment of the community, the increase of public
awareness and own personal responsibility for health in
general, as well as the development of policies, legislation
and / or infrastructure where needed.
Stakeholders and experts will have to keep participating
in the translation of these priorities into specific policy
actions / interventions, through the development and assignment
of programs and projects within the various areas of public
health. This will contribute to the availability and access
to health care services for all inhabitants and eventually
leads to an efficient and effectively operating public health
and health care system on St. Maarten.
Priority Area A:
To make recommendations for legislation and develop standards,
guidelines and policies to maintain and improve quality
care. This may result in a necessity to increase investments
within health care.
Priority Area B:
To increase public awareness of one’s own responsibility
for personal and environmental health, including the reviewing
and developing of infrastructure to address health and environmental
hygiene problems.
Priority Area C:
To develop prevention activities aimed at health promotion
and education pertaining to lifestyle, eating habits, overweight
and exercise.
Priority Area D:
To promote and further develop a collaborated multi-disciplinary
approach in respect to treatments, preventive activities
and the management of health Problems. All stakeholders
need to participate in this approach, through the development
of guidelines and standards at all levels of health care.
Priority Area E:
To develop policies, protocols and educational programs,
ensuring the availability and access to health care services
and health insurance for all inhabitants.
Priority Area F:
To promote primary health care and healthy practices, specifically
emphasizing the monitoring of women’s health, with
the physicians and the insurers playing an active role in
this process.
Strategic Partnerships & Relations
Based on their responsibilities and tasks, Sector Health
Care Affairs focuses on: policy development and advising;
implementation and execution of policies, guidelines and
protocols; quality control in the field of public health;
disease prevention; health education and promotion; and
public health research.
Policy development is also linked to the Pan American Health
Organizations Essential Public Health Functions. These Essential
Public Health Functions are used as a critical framework
for the improvement of Sector Health Care Affairs, as the
governmental public health agency, for the constitutional
developments. Some of the activities currently in execution
or under development are: HIV/AIDS Strategic Plan; establishment
a disaster management protocol regarding water in the case
of a disaster; food safety clinics; surveillance system;
and a vaccination program.
With reference to strategic partnerships, Sector Health
Care Affairs would be very interested in discussing these
with interested partners. Some of the areas that require
a strategic partner are health information system, Expanded
Program on Immunization, HIV/AIDS Strategic Plan, expansion
of healthcare services, monitoring & evaluation of intervention
programs, disaster management. Data and research does not
exist in certain areas of health care and research activities
would be necessary to determine needs.
Contact:
If you are interested in receiving further information about
St. Maarten’s public health / health care policy plans
or may be interested in investing in health care sector
in the form of a strategic partnership, please contact Sector
Health Care Affairs at, P.O.Box 1018, Philipsburg, St. Maarten;
Tel. 00 599 542-2078, 542-2079, 542-3553, Fax 543-7824,
542-2936 or email us at healthaf@sintmaarten.net
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