Netherlands Antilles


The Caribbean islands of Bonaire, Sint Eustatius, and Saba have been special municipalities of the Netherlands since 2010, when public administration responsibilities were transferred from the Government of the Netherlands Antilles to the Netherlands. As a result, all residents have access to new social and health benefits, which are similar for the three islands. The Ministry of Health, Welfare and Sport makes health care policy for Bonaire, Sint Eustatius, and Saba. In 2012, total health costs for the three islands came to around US$ 102 million. This summary explores each municipality’s particular social and health determinants. It also describes the health system shared by the three municipalities, which have similar achievements, challenges, and outlooks.


Bonaire is located 70 km off the coast of Venezuela and has a landmass of 288 km2. Between 2011 and 2016, its population grew by 23% as a result of immigration, totaling 19,408 in 2016. Population distribution is concentrated around 50 years of age. In 2016, 37% of residents had been born on the island. The rest came from Curaçao (18%), Aruba (2%), the Dutch mainland (14%), and Latin America (18%). Life expectancy in these municipalities is estimated at 80.2 years. In 2014, economic growth was 1.6%, with national GDP estimated at US$ 403 million. Government, real estate, financial services, and tourism are the main economic sectors.


Sint Eustatius lies in the Leeward Islands in the Caribbean Sea between Saint Kitts and Anguilla, with a landmass of 21 km2. In 2016, the municipality had a population of 3,200 (800 fewer people than in 2014), 79% of whom held Dutch nationality. The population structure is influenced both by in- and out-migration, contributing to a proportionally large working-age population. Some 34% of residents were born on the island, 11% were born in Sint Maarten, 9% in Curaçao or Aruba, and 6% on the Dutch mainland. Most of the population (68%) is multilingual: 85% speaks English as a first language, 6% speaks Dutch, and 7% Spanish. The population of Saint Eustatius declined by 21% between 2014 and January 2016. The gross domestic product per capita was US$ 25,100 in 2014.


Saba is also located in the Leeward Islands, occupying a landmass of 13 km2. In 2016, it had a population of almost 2,000. The population structure is influenced both by in- and out-migration, especially in the working-age population. The population grew by 5% between 2014 and 2016, increasing by 136 people. The population is evenly distributed between males and females. 28% of residents were born in Saba; 14% in Sint Maarten; 5% in Aruba and Curaçao, and 5% on the Dutch mainland; 60% of the population has Dutch nationality. The per capita gross domestic product was US$ 25,100 that year. Tourism, the Saba University School of Medicine, fisheries, and infrastructure investments are the main economic drivers.

(Source: Health in the Americas+, 2017 Edition)