Health Systems andServices Profile for the British Virgin Islands.

Health SystemsHealth Systemsand and

Services Services Profile forProfile for

the the British Virgin British Virgin

IslandsIslands

The BVI, an overseas dependent Territory of The BVI, an overseas dependent Territory of the United Kingdom comprises 50 islands, the United Kingdom comprises 50 islands, cays and rocks, 15 of which are inhabited. cays and rocks, 15 of which are inhabited. The 4 largest islands are Tortola, Anegada, The 4 largest islands are Tortola, Anegada, Virgin Gorda, and Jost Van Dyke.Virgin Gorda, and Jost Van Dyke.

It is self-governed by a democratically It is self-governed by a democratically elective Legislative Council.elective Legislative Council.

The Executive Council consists of the The Executive Council consists of the Governor, a Chief Minister, the Attorney Governor, a Chief Minister, the Attorney General, and four other ministers. The General, and four other ministers. The Governor and Deputy Governor are Governor and Deputy Governor are appointed by His Majesty, the Queen.appointed by His Majesty, the Queen.

Under the constitution, the Governor is Under the constitution, the Governor is responsible for foreign affairs, defense, and responsible for foreign affairs, defense, and internal security.internal security.

BRITISH VIRGIN ISLANDSBRITISH VIRGIN ISLANDSSummarySummary

General elections are held every four General elections are held every four years and are constitutionally due in years and are constitutionally due in mid 2007.mid 2007.

In 2004, the estimated population of In 2004, the estimated population of the BVI was 22,053, and the major the BVI was 22,053, and the major ethnic group is black.ethnic group is black.

The BVI has one 44-bed public The BVI has one 44-bed public hospital (Peebles Hospital) and one 8-hospital (Peebles Hospital) and one 8-bed private hospital (the Bougainvillea bed private hospital (the Bougainvillea Clinic), both located in Road Town.Clinic), both located in Road Town.

BRITISH VIRGIN ISLANDSBRITISH VIRGIN ISLANDSSummary (cont.)Summary (cont.)

HEALTH CONCERNSHEALTH CONCERNS Obesity, particularly among Obesity, particularly among

women.women. Dengue is the most important Dengue is the most important

vector borne disease in the BVI. vector borne disease in the BVI. Since 1985, 50 cases of HIV/AIDS Since 1985, 50 cases of HIV/AIDS

had been reported, with a total of had been reported, with a total of 25 deaths by the end of 2004.25 deaths by the end of 2004.

BRITISH VIRGIN ISLANDSBRITISH VIRGIN ISLANDSSummary (cont.)Summary (cont.)

PUBLIC SECTORPUBLIC SECTOR The Ministry of Health and Social Services is The Ministry of Health and Social Services is

the agency responsible for carrying out the the agency responsible for carrying out the Government’s national health policy. Government’s national health policy.

A 2006 Health policy document is currently A 2006 Health policy document is currently under review and consultation. under review and consultation.

In 2005, the BVI Health Services Act was In 2005, the BVI Health Services Act was passed establishing the BVI Health Service passed establishing the BVI Health Service Authority Board, which manages all public Authority Board, which manages all public health care delivery services.health care delivery services.

The performance of the Authority is to be The performance of the Authority is to be monitored and evaluated based on goals and monitored and evaluated based on goals and targets as set out in a service level agreement targets as set out in a service level agreement which is currently being developedwhich is currently being developed

HEALTH SYSTEMHEALTH SYSTEM

The Ministry of Health focuses on the The Ministry of Health focuses on the performance of the Essential Public performance of the Essential Public Health Functions, standard setting Health Functions, standard setting and regulation of the health sectorand regulation of the health sector

The Government’s health priorities The Government’s health priorities are the enhancement of hospital are the enhancement of hospital services, the strengthening of public services, the strengthening of public primary health care services, and the primary health care services, and the improvement of environment health improvement of environment health including solid waste management.including solid waste management.

HEALTH SYSTEM HEALTH SYSTEM (cont.)(cont.)

Government health services are provided Government health services are provided free at the point of use to certain groups. free at the point of use to certain groups. These include full-time school children, These include full-time school children, nursing mothers, the elderly, the nursing mothers, the elderly, the mentally ill, health workers, firefighters, mentally ill, health workers, firefighters, the police, prisoners, and prison officers.the police, prisoners, and prison officers.

Patients requiring diagnostic and Patients requiring diagnostic and treatment services beyond the scope of treatment services beyond the scope of Peebles Hospital are referred to Puerto Peebles Hospital are referred to Puerto Rico, Jamaica, Barbados, the United Rico, Jamaica, Barbados, the United States, USVI and the United Kingdom.States, USVI and the United Kingdom.


The BVI does not have a formal health The BVI does not have a formal health plan, though incremental health sector plan, though incremental health sector development initiatives are undertaken development initiatives are undertaken as part of the budget development as part of the budget development process.process.


PRIVATE SECTORPRIVATE SECTOR The territory has a growing private health The territory has a growing private health

sector, encompassing both inpatient and sector, encompassing both inpatient and ambulatory care. Private sector provisions ambulatory care. Private sector provisions are concentrated in Tortola the most densely are concentrated in Tortola the most densely populated island. populated island.

There is one private hospital (Bougainvillea There is one private hospital (Bougainvillea Clinic), which specializes in plastic surgery, Clinic), which specializes in plastic surgery, two private dental surgeries, and three two private dental surgeries, and three private medical complexes, all located in the private medical complexes, all located in the capital.capital.

There are 16 physicians practicing in the There are 16 physicians practicing in the private sector.private sector.


Many residents access services Many residents access services through the private sector and care through the private sector and care abroad, mainly in the US Virgin Islands abroad, mainly in the US Virgin Islands or Puerto Rico, either by choice or or Puerto Rico, either by choice or because they require specialized care because they require specialized care unavailable locally.unavailable locally.


SOCIAL SECURITYSOCIAL SECURITY A compulsory social security scheme covers A compulsory social security scheme covers

all paid employees, with employees and all paid employees, with employees and employers contributing equally to the employers contributing equally to the premiums. Self-employed workers are also premiums. Self-employed workers are also required to participate in the plan. required to participate in the plan.

The social security benefits include maternity, The social security benefits include maternity, occupational injury, unemployment, old-age occupational injury, unemployment, old-age pension, sickness, and survivor’s benefits, as pension, sickness, and survivor’s benefits, as well as a funeral grant.well as a funeral grant.

Discussion on the development and Discussion on the development and implementation of a National Health implementation of a National Health Insurance scheme is ongoing.Insurance scheme is ongoing.


REGULATIONSREGULATIONS The new Medical Act, passed in 2000, The new Medical Act, passed in 2000,

provides for the registration of medical provides for the registration of medical dental, and allied health practitioners, and dental, and allied health practitioners, and for pharmacists. It makes provisions for for pharmacists. It makes provisions for enforcement of standards and ethical enforcement of standards and ethical professional practice.professional practice.

The Nursing Act, 1976 provides for the The Nursing Act, 1976 provides for the regulation of the nursing professionals. regulation of the nursing professionals.

The Ministry of Health has the mandate to The Ministry of Health has the mandate to regulate the health sector including regulate the health sector including registration, and licensing of facilities, but registration, and licensing of facilities, but does not have effective mechanisms in does not have effective mechanisms in place to do so.place to do so.


HUMAN RESOURCESHUMAN RESOURCES As of 2004, a total of 45 physicians As of 2004, a total of 45 physicians

registered to practice in the BVI. Out registered to practice in the BVI. Out of these 29 work in the public sector of these 29 work in the public sector and 16 physicians in the private and 16 physicians in the private sector.sector.

There are 6 dentist registered to There are 6 dentist registered to practice in the BVI, 2 work in the practice in the BVI, 2 work in the public sector and 4 in the private public sector and 4 in the private sector.sector.

All non-nationals coming to the All non-nationals coming to the territory to work require a work territory to work require a work permit.permit.

SYSTEM’S RESOURCESSYSTEM’S RESOURCES

There are 121 Registered Nurses There are 121 Registered Nurses employed in the public sector; 24 of employed in the public sector; 24 of these work in Community Health these work in Community Health Services and 97 at Peebles Hospital. Services and 97 at Peebles Hospital.

SYSTEM’S RESOURCES (cont.)SYSTEM’S RESOURCES (cont.)

DRUGS & OTHER HEALTH PRODUCTSDRUGS & OTHER HEALTH PRODUCTS There is no local production of drugs, There is no local production of drugs,

vaccines or medical equipment. The vaccines or medical equipment. The Peebles Hospital Pharmacy is the central Peebles Hospital Pharmacy is the central purchasing agency for the public health purchasing agency for the public health services.services.

Drugs are purchased through the Drugs are purchased through the Organization of Eastern Caribbean states Organization of Eastern Caribbean states pharmaceutical Services (OECS-PPS). Some pharmaceutical Services (OECS-PPS). Some drugs not included in the OECS-PPS drugs not included in the OECS-PPS formulary and are purchased directly from formulary and are purchased directly from private suppliers. The OECS-PPS formulary private suppliers. The OECS-PPS formulary is revised every two years. is revised every two years.


Narcotics are not available at district Narcotics are not available at district clinics.clinics.

A certificate from the Ministry of Health A certificate from the Ministry of Health Services is required for importation of Services is required for importation of narcotics.narcotics.

All other drugs used in the private sector All other drugs used in the private sector are purchased independently and except for are purchased independently and except for antibiotics are not regulated by the antibiotics are not regulated by the government. government.

The Peebles Hospital Pharmacy supplies The Peebles Hospital Pharmacy supplies pharmaceuticals to the district health pharmaceuticals to the district health centers (primary care units). centers (primary care units).


The Medical Act (2000) requires that a The Medical Act (2000) requires that a registered pharmacist be present at both registered pharmacist be present at both private and public pharmacies. There are private and public pharmacies. There are privately owned pharmacies in Tortola and privately owned pharmacies in Tortola and Virgin Gorda.Virgin Gorda.

Vaccines are purchased through PAHO Vaccines are purchased through PAHO Revolving Fund. When urgently needed, Revolving Fund. When urgently needed, some vaccines are purchased through a some vaccines are purchased through a vendor in Barbados. vendor in Barbados.

Some vaccines are provided at no cost to the Some vaccines are provided at no cost to the private sector practitioners as a strategy to private sector practitioners as a strategy to boost vaccination coverage. A limited number boost vaccination coverage. A limited number of vaccines are ordered directly by the private of vaccines are ordered directly by the private sector.sector.


The national blood bank service is The national blood bank service is located at the Peebles Hospital medical located at the Peebles Hospital medical diagnostic laboratory. The laboratory diagnostic laboratory. The laboratory uses the Caribbean Regional Standards uses the Caribbean Regional Standards for blood banking. for blood banking.

All blood for transfusion is screened for All blood for transfusion is screened for HIV, Hepatitis B and syphilis. HIV, Hepatitis B and syphilis.

There is no remuneration offered for There is no remuneration offered for blood donations. All donations are blood donations. All donations are collected on a voluntary basis. collected on a voluntary basis.


EQUIPMENT & TECHNOLOGYEQUIPMENT & TECHNOLOGY Most of the equipment which includes Most of the equipment which includes

laboratory, x-ray, ultrasound and dialysis laboratory, x-ray, ultrasound and dialysis are located at the public hospital. CT Scan are located at the public hospital. CT Scan and mammography are available in the and mammography are available in the private sector. private sector.

The maintenance staff at Peebles Hospital The maintenance staff at Peebles Hospital has had biomedical technology training has had biomedical technology training provided by the suppliers and service provided by the suppliers and service contracts are maintained with some contracts are maintained with some suppliers.suppliers.

There are three private medical diagnostic There are three private medical diagnostic laboratories in the private sector. laboratories in the private sector.


STEERING ROLESTEERING ROLE The Ministry of Health and Welfare is The Ministry of Health and Welfare is

responsible for providing public health and responsible for providing public health and social services, as well as for monitoring social services, as well as for monitoring and regulating health sector providers. and regulating health sector providers.

The Permanent Secretary is responsible for The Permanent Secretary is responsible for the administration of the Ministry the administration of the Ministry headquarters and for supporting the headquarters and for supporting the Minister in his policy role. Minister in his policy role.

The Director of Health Services is the chief The Director of Health Services is the chief technical adviser on health matters. technical adviser on health matters.

FUNCTIONS OF THE HEALTH SYSTEMFUNCTIONS OF THE HEALTH SYSTEM

FINANCING & EXPENDITUREFINANCING & EXPENDITURE The Health Ministry of Health is responsible for The Health Ministry of Health is responsible for

exercising supervision and control of financing exercising supervision and control of financing of the sector.of the sector.

Public health services are almost entirely Public health services are almost entirely financed by the government financed by the government

In 2000, the total Ministry of Health and In 2000, the total Ministry of Health and Welfare expenditure was an estimated Welfare expenditure was an estimated US$20.3 million, or approximately 17% of total US$20.3 million, or approximately 17% of total government expenditure. government expenditure.

Community Services accounted for Community Services accounted for approximately US$3.53 million (17%) of the approximately US$3.53 million (17%) of the Ministry’s expenditure, and hospital services Ministry’s expenditure, and hospital services for some US$7.7 million (38%).for some US$7.7 million (38%).

FUNCTIONS OF THE HEALTH SYSTEMFUNCTIONS OF THE HEALTH SYSTEM(cont.)(cont.)

The public health services’ overseas The public health services’ overseas medical expenditure was estimated at medical expenditure was estimated at US$700,000 in 2003.US$700,000 in 2003.

User fee generally recover only 8% of User fee generally recover only 8% of the operating cost of primary and the operating cost of primary and secondary health care services.secondary health care services.

FUNCTIONS OF THE HEALTH SYSTEMFUNCTIONS OF THE HEALTH SYSTEM(cont.)(cont.)

There is no Health Insurance Scheme at There is no Health Insurance Scheme at present however a feasibility study for the present however a feasibility study for the development of a National Health Insurance development of a National Health Insurance scheme was commissioned in 2006.scheme was commissioned in 2006.

A compulsory social security scheme covers A compulsory social security scheme covers all paid employees, with employees and all paid employees, with employees and employers contributing equally to the employers contributing equally to the premiums; some persons are covered 100% premiums; some persons are covered 100% by the government by the government

The social security benefits include The social security benefits include maternity, occupational injury, maternity, occupational injury, unemployment, old-age pension, sickness, unemployment, old-age pension, sickness, and survivor’s benefits, as well as a funeral and survivor’s benefits, as well as a funeral grant.grant.

HEALTH INSURANCEHEALTH INSURANCE

PRIMARY CARE LEVELPRIMARY CARE LEVEL The territory has been divided into The territory has been divided into

health districts to facilitate efficient and health districts to facilitate efficient and effective deployment of resources to the effective deployment of resources to the various communities of the BVI.various communities of the BVI.

There are 5 Zones: Zone 1 (Eastern There are 5 Zones: Zone 1 (Eastern Tortola); Zone 2 (Central Tortola), Zone Tortola); Zone 2 (Central Tortola), Zone 3 (Western Tortola); Zone 4 (Virgin 3 (Western Tortola); Zone 4 (Virgin Gorda) and Zone 5 (Anegada).Gorda) and Zone 5 (Anegada).

Public sector primary care services are Public sector primary care services are offered at the District Health Clinics. offered at the District Health Clinics.

SERVICE DELIVERYSERVICE DELIVERY

There are a total of 12 health clinics and There are a total of 12 health clinics and health posts in the BVI (10 clinics and 2 health posts in the BVI (10 clinics and 2 health posts) – the Road Town Health health posts) – the Road Town Health Center and 7 other clinics on Tortola, two Center and 7 other clinics on Tortola, two on Virgin Gorda, and one each on Jost Van on Virgin Gorda, and one each on Jost Van Dyke and Anegada Dyke and Anegada

The Road Town Health Center serves as a The Road Town Health Center serves as a referral point for the district clinics. referral point for the district clinics.

The clinic in The Valley, on Virgin Gorda, is The clinic in The Valley, on Virgin Gorda, is staffed by two physicians’ the clinic at staffed by two physicians’ the clinic at North Sound is staffed by a resident nurse North Sound is staffed by a resident nurse who is supported by the Valley clinic who is supported by the Valley clinic physicians.physicians.

SERVICE DELIVERY (cont.)SERVICE DELIVERY (cont.)

District clinics provide a full range of District clinics provide a full range of child health services, including growth child health services, including growth and nutritional monitoring, and nutritional monitoring, development assessment, treatment of development assessment, treatment of common illnesses, counseling, school common illnesses, counseling, school health, and screening for anemia, health, and screening for anemia, including sickle cell anemia.including sickle cell anemia.


The Community Health Pharmacy The Community Health Pharmacy Programme was established in 2002. Programme was established in 2002. The Community Health Pharmacist The Community Health Pharmacist although stationed at Road Town although stationed at Road Town Clinic, also provides services to Virgin Clinic, also provides services to Virgin Gorda and East End and West End on Gorda and East End and West End on Tortola.Tortola.

In January 2003, the post of Health In January 2003, the post of Health Disaster Coordinator was established Disaster Coordinator was established with responsibility for coordinating with responsibility for coordinating Health Disaster Management activities Health Disaster Management activities within the territory. within the territory.


The Health Promotion Unit in the Ministry The Health Promotion Unit in the Ministry of Health focuses on the promotion of of Health focuses on the promotion of health and wellness and emphasized health and wellness and emphasized behaviour modification and life style behaviour modification and life style changes.changes.

Programmes for the prevention and Programmes for the prevention and management of both communicable and management of both communicable and non-communicable diseases are available non-communicable diseases are available through the Community Health Services through the Community Health Services and Peebles Hospital.and Peebles Hospital.

Hypertension and Diabetes clinics are Hypertension and Diabetes clinics are conducted on Tortola at the Road Town, conducted on Tortola at the Road Town, Iris Smith-Penn (East End), Cappoons Bay Iris Smith-Penn (East End), Cappoons Bay and on Virgin Gorda at North Sound and and on Virgin Gorda at North Sound and Iris O’Neal Clinics. Iris O’Neal Clinics.


The BVI’s Expanded Programme for The BVI’s Expanded Programme for Immunization (EPI) is a component of the Immunization (EPI) is a component of the Family Health Programme. Under the EPI, Family Health Programme. Under the EPI, children under the age of one year receive children under the age of one year receive BCG, Hep. B, DPT, Hib, OPV vaccines; at BCG, Hep. B, DPT, Hib, OPV vaccines; at one year of age, children receive MMR one year of age, children receive MMR vaccine, DPT Polio, and MMR booster shots vaccine, DPT Polio, and MMR booster shots are given according to the immunization are given according to the immunization schedule until 11 years of age. schedule until 11 years of age.

The Hepatitis B and Hib vaccines were The Hepatitis B and Hib vaccines were added to the immunization programme in added to the immunization programme in 1999, and the pentavelant vaccine, which 1999, and the pentavelant vaccine, which provides coverage for diphtheria, pertusis, provides coverage for diphtheria, pertusis, tetanus, hepatitis B and Meningitis, was tetanus, hepatitis B and Meningitis, was added in 2000.added in 2000.


No cases or deaths of neonatal tetanus were No cases or deaths of neonatal tetanus were recorded in 2004.recorded in 2004.

Adina Donovan Home for the elderly is a senior Adina Donovan Home for the elderly is a senior citizens home that offers care and protection to citizens home that offers care and protection to the elderly. There is a similar home in Virgin the elderly. There is a similar home in Virgin Gorda.Gorda.

The Environmental Health Division is responsible The Environmental Health Division is responsible for food hygiene, vector control, water quality for food hygiene, vector control, water quality surveillance, institutional hygiene, and surveillance, institutional hygiene, and investigation of complaints such as septic tank investigation of complaints such as septic tank problems, rodents, and abandoned vehicles.problems, rodents, and abandoned vehicles.

The Government Dental Services provide oral The Government Dental Services provide oral health services to the population. There are two health services to the population. There are two Govt. employed Dentists who are based on Govt. employed Dentists who are based on Tortola. These officers also visit Virgin Gorda Tortola. These officers also visit Virgin Gorda and Anegada.and Anegada.


The Dental Service Unit monitors The Dental Service Unit monitors primary school fluoridation and dental primary school fluoridation and dental health programmes. health programmes.

The Community Mental Health Center, The Community Mental Health Center, located in Road Town, provides mental located in Road Town, provides mental health ambulatory care for the health ambulatory care for the Territory through its outreach Territory through its outreach psychiatric services.psychiatric services.


SECONDARY CARE LEVELSECONDARY CARE LEVEL Secondary health care is delivered at Secondary health care is delivered at

Peebles Hospital.Peebles Hospital. There is an organized Accidents and There is an organized Accidents and

Emergency Department which also Emergency Department which also offers walk-in and scheduled offers walk-in and scheduled outpatient services.outpatient services.

A 8 bed unit renal dialysis unit was A 8 bed unit renal dialysis unit was commissioned in May, 2000.commissioned in May, 2000.


Consultant pathology services are now Consultant pathology services are now provided on-island.provided on-island.


TECHNICAL QUALITYTECHNICAL QUALITY Quality improvement programmes for all Quality improvement programmes for all

aspects of health care are in varying aspects of health care are in varying stages of development. stages of development.

There is a Quality Assurance Nurse who There is a Quality Assurance Nurse who has responsibility for quality standards in has responsibility for quality standards in the Community and Hospital Services.the Community and Hospital Services.

There is no research ethics committee in There is no research ethics committee in the territory. the territory.

There is currently no committee on There is currently no committee on Hospital Nosocomial Infections, and there Hospital Nosocomial Infections, and there is no staff assigned to deal with this. is no staff assigned to deal with this.

QUALITY QUALITY

PERCEIVED QUALITYPERCEIVED QUALITY There is no operational programme for There is no operational programme for

improving user relations. No user satisfaction improving user relations. No user satisfaction surveys are undertaken even though users surveys are undertaken even though users are encourage to put their complaints in are encourage to put their complaints in writing to the Director of Health Services, writing to the Director of Health Services, Ministry of Health and the Chief Executive Ministry of Health and the Chief Executive Officer of the BVI Health services authority.Officer of the BVI Health services authority.

An Employee Orientation Manual and a An Employee Orientation Manual and a directory of service was developed in 2003 to directory of service was developed in 2003 to provide information to staff and clients on provide information to staff and clients on the services.the services.

QUALITY (cont.) QUALITY (cont.)

MONITORING THE PROCESSMONITORING THE PROCESS The BVI undertook a United Kingdom The BVI undertook a United Kingdom

Government-funded Health Sector Government-funded Health Sector Adjustment Project from 1993 to 1996.Adjustment Project from 1993 to 1996.

The objectives of the project were to:- The objectives of the project were to:- implement new management structures implement new management structures and processes, to revise planning and processes, to revise planning approaches and systems and to revise approaches and systems and to revise financing strategies and improved financing strategies and improved quality of care and optimized health quality of care and optimized health outcomes.outcomes.

MONITORING & EVALUATION OF THE MONITORING & EVALUATION OF THE HEALTH SECTOR REFORMHEALTH SECTOR REFORM

The results of the project were as The results of the project were as follows:follows: Agreement and partial implementation Agreement and partial implementation

of a new management structureof a new management structure A number of health sector studies A number of health sector studies

(including information, health (including information, health promotion, accident prevention, promotion, accident prevention, mental health, and environmental mental health, and environmental health), which were accepted by local health), which were accepted by local health managers as giving them a health managers as giving them a sound basis for further planning.sound basis for further planning.

MONITORING & EVALUATION OF THE MONITORING & EVALUATION OF THE HEALTH SECTOR REFORM (cont.)HEALTH SECTOR REFORM (cont.)

- This project had very little success in terms - This project had very little success in terms of achievement of its objectives. of achievement of its objectives. Significant progress was only realized in Significant progress was only realized in the redesignation of the post of Chief the redesignation of the post of Chief Medical Officer to Director of Health Medical Officer to Director of Health Services, Chief Nursing Officer to Assistant Services, Chief Nursing Officer to Assistant of Director of Health Services and Hospital of Director of Health Services and Hospital Administrator to Hospital General Manager. Administrator to Hospital General Manager.

There was no strengthening of the There was no strengthening of the management systems and no activities management systems and no activities were developed to build management were developed to build management capacity. capacity.


The National Health Sector Emergency The National Health Sector Emergency and Disaster Management Plan was and Disaster Management Plan was revised with the participation of all revised with the participation of all managers and representatives from all managers and representatives from all levels of the health sector as well as levels of the health sector as well as all the health related sectors in all the health related sectors in collaboration with the Department of collaboration with the Department of Disaster Management. Disaster Management.

Every year simulation exercises are Every year simulation exercises are held to ensure that the plan is tested held to ensure that the plan is tested and revised as necessary. and revised as necessary.


INVESTMENT IN HEALTH SERVICE INVESTMENT IN HEALTH SERVICE INFRASTRUCTUREINFRASTRUCTURE The government of the BVI has committed The government of the BVI has committed

to the building of a new hospital in 2006 to to the building of a new hospital in 2006 to replace the present Peebles Hospital. This replace the present Peebles Hospital. This will result in an increase in the number of will result in an increase in the number of beds available from 44 to 120. beds available from 44 to 120.

In the area of health care financing, there In the area of health care financing, there has been much discussion about the has been much discussion about the formation of a National Health Insurance formation of a National Health Insurance Scheme. Scheme.

A feasibility study was commissioned in A feasibility study was commissioned in 2006.2006.


SAFEGUARDING THE QUALITY OF SAFEGUARDING THE QUALITY OF MEDICAL PRACTICEMEDICAL PRACTICE A new medical act was passed in 2000. A new medical act was passed in 2000.

This act makes provision for the This act makes provision for the formation of a Medical and Dental Council formation of a Medical and Dental Council and on Allied Health Professions Council. and on Allied Health Professions Council.

These bodies which will operate These bodies which will operate independently of the Ministry of independently of the Ministry of Health will seek to ensure quality Health will seek to ensure quality practice of doctors, dentists and practice of doctors, dentists and allied health professionals.allied health professionals.


HUMAN RESOURCE DEVELOPMENTHUMAN RESOURCE DEVELOPMENT In 2000, Sixteen (16) nurses were up-In 2000, Sixteen (16) nurses were up-

graded from the certificate/diploma graded from the certificate/diploma to the bachelorate BSN level through to the bachelorate BSN level through a special initiative of the Ministry of a special initiative of the Ministry of Health and the H.L. Stoutt Health and the H.L. Stoutt Community College in collaboration Community College in collaboration with the University of New York at with the University of New York at Sunny Buffalo. Sunny Buffalo.


In 2005 a strategy was implemented in the In 2005 a strategy was implemented in the Community Health services to strengthen Community Health services to strengthen programme planning and programme programme planning and programme management in the areas of;management in the areas of;

Maternal and Child Health, Family Planning, Maternal and Child Health, Family Planning, Prevention of Chronic Disease (Diabetes), School Prevention of Chronic Disease (Diabetes), School and Adolescent Health, Healthy Elderly and and Adolescent Health, Healthy Elderly and Workplace Health (building on the Food Workplace Health (building on the Food Handlers and Immigration Clinics) have targeted Handlers and Immigration Clinics) have targeted for action. for action.

Through this programme, it is expected that the Through this programme, it is expected that the community and public health programmes, will community and public health programmes, will be better focused with targeted objectives and be better focused with targeted objectives and improved monitoring and evaluation.improved monitoring and evaluation.


The territory is currently preparing to The territory is currently preparing to undertake a national consultation for the undertake a national consultation for the development of a new national strategic development of a new national strategic plan to respond to the HIV/AIDS epidemic.plan to respond to the HIV/AIDS epidemic.

It is expected that this new plan will have It is expected that this new plan will have participation of all relevant sectors and participation of all relevant sectors and would yield a better programme of action would yield a better programme of action and response to HIV/AIDS prevention and and response to HIV/AIDS prevention and control including protection of human control including protection of human rights and access to ant ratio viral therapy.rights and access to ant ratio viral therapy.


The Health System and Services Profile is The Health System and Services Profile is currently updated by the Ministry of currently updated by the Ministry of Health working closely with the Health working closely with the PAHO/WHO Caribbean Program PAHO/WHO Caribbean Program Coordination office in Barbados. Coordination office in Barbados.


Health Systems andServices Profile for the British Virgin Islands.

Documents

health workers

government health services

bvi health services

health system slide

ministry of health focuses

governments health priorities

health policy document

formal health plan