- Overall Context
- Leading Health Challenges
- Health Situation and Trends
- Full Article
Saint Lucia is located northeast of Saint Vincent and the Grenadines, northwest of Barbados, and south of Martinique; it is part of the Windward Islands. The country extends for 620 km2, in very mountainous terrain. Saint Lucia is a parliamentary democracy with elections every five years, with the last election having been held in 2016. Saint Lucia is a member of the Caribbean Community (CARICOM) and home to the Organisation of Eastern Caribbean States (OECS). Saint Lucia is organized into 11 districts.
The population is mainly of African descent (85.3%), followed by mixed (10.8%), East Indian (2.2%), and Amerindian (Carib) (0.6%) population groups. Approximately 70% of the population is Roman Catholic. English is the official language, although a French patois is commonly spoken. The total estimated population in 2010 was 166,526, of which 50.2% were females and 49.8%, males. The 2014 estimated mid-year population was 172,255, representing a 3.4% increase compared to 2010 and a 22.1% increase since 1990. The estimated annual growth rate is expected to be just below 1% in 2013 and to continue gradually and steadily declining to 0.63% per annum through 2017. The population density was 796 persons per mi2; 72.0% of the population lived in rural communities and 26% of the population lived in or near the capital, Castries (). Average life expectancy is estimated as 77.8 years in 2016 (78.0 for males and 80.7 for females), compared with 74 years in 2001 (72.5 for males and 75.5 for females). Figure 1 shows Saint Lucia’s population structure in 1990 and 2015.
Figure 1. Population structure, by age and sex, Saint Lucia, 1990 and 2015
Saint Lucia’s population size increased 33.9% between 1990 and 2015. In 1990, the age structure had an expansive structure, with most of the population falling below the 30-year-old age groups. By 2015, the population structure had become transitional, growth declining in groups under 25 years of age. These changes were the result of ageing and lower fertility and mortality, especially in the last two and a half decades.
Source: Pan American Health Organization, based on the United Nations Department of Economic and Social Affairs, Population Division. Revision 2015, New York, 2015
In 2014, females comprised about 51% of the population, with women of childbearing age (15-44 years) accounting for 24%, children (under 15 years old) for 21%, and the elderly (65 years or older) for 9%; the population under 19 years of age represents 29.7% of the population.
The country’s economy depends primarily on tourism (65% of GDP), banana production, and light manufacturing. The per capita GDP increased slightly, from US$ 6,626 in 2010 to US$ 6,848 in 2014. According to an International Monetary Fund report, Saint Lucia’s economic activity has recovered and the country’s fiscal situation became stronger in 2014, mainly due to strong tourism inflows and lower oil prices. After the 2012 recession and close-to-zero growth in 2013, in 2014 the economy was again showing signs of recovery, with GDP growth reaching 0.5%, mainly driven by the transportation and hotel industries, although the construction, communication, and agriculture sectors remained in decline ().
Social Determinants of Health
The 2005 poverty assessment study showed that approximately 18.7% of households and 25.1% of individuals were poor, and that 5.3% of households and 7.1% of individuals were indigent (). In 2015, the government conducted a multidimensional poverty study using the dimensions of education, employment, living standards, and health. According to this later study, the adjusted headcount ratio for poverty was 23% and higher for males (24%) compared to females (21%). This survey corroborated the findings of the earlier poverty assessment, which indicated that poverty disproportionately affected rural communities.
According to the 2012 Multiple Indicator Cluster Survey funded by UNICEF, literacy levels for young females 15-24 years old was 99.3%, and did not vary by geographic location, education, age, wealth index, or ethnicity of household head (). Between 2003 and 2013, the male-to-female enrollment ratio was 1:1 at the various educational levels, with girls outperforming boys. Females have the highest enrollment at post-secondary institutions ().
In 2010, males accounted for an estimated 55% of the labor force and females for 45%; the unemployment rate was 20.6% (24.2% for males and 28.2% for females) (). By 2014, unemployment had reached 24.4%, as demand was insufficient to fully absorb the growth of the labor force. Youth unemployment, in particular, rose to an alarming 41.8%().
The Health System
The Ministry of Health is responsible for overseeing the health of the population by providing finances, issuing regulations, and developing and enforcing public health policies. Saint Lucia’s health system offers primary, secondary, and some tertiary level of care. Primary health care is delivered through a network of 33 health centers, two district hospitals, and one polyclinic in each of the eight health regions. In addition, there are two acute care general hospitals, Victoria Hospital in the north and St. Jude Hospital in the south, and one private hospital that mainly provides secondary care. A psychiatric hospital provides mostly inpatient care, including rehabilitation.
Leading Health Challenges
Critical Health Problems
Emerging and Neglected Diseases
Between 2010 and 2014, there have been 44 confirmed cases (18 males; 26 females) of influenza A (H1N1), and no confirmed cases in 2015.
A baseline survey aimed at declaring the elimination of schistosomiasis is being conducted with Pan American Health Organization (PAHO)/World Health Organization (WHO) support. Two cases of schistosomiasis were reported in 2011-2015; the disease’s incidence has continued to decline since 2006-2010, when there were 5-10 cases.
During the period 2011–2013, there were 45 cases of tuberculosis recorded between 2011 and 2013 (33 males and 12 females); there were 2 deaths with coinfection with HIV in the same period. In 2015, there were 11 cases (7 males and 4 females), with an incidence rate of 6.3 per 100,000 population.
In the past decade, births to teenagers have declined markedly, reaching their lowest levels in 2012 and 2013, with 14% of total births. In 2014, however, teenage births accounted for 15% of total births, with a rate of 22 per 1,000 females 10-19 years old. Table 1 shows selected adolescent pregnancy indicators for 2006-2014.
Table 1. Selected teenage pregnancy indicators, by year, Saint Lucia, 2006-2014
|Percentage of total births||17||18||16||16||17||15||14||14||15|
|Rate per 1,000 females 10-19 years||24||26||22||22||21||19||19||20||22|
Source: Saint Lucia, Ministry of Health and Wellness, Fertility Database.
In 2012, chronic noncommunicable diseases (NCDs) accounted for 58% of premature deaths and 73% of all preventable deaths excluding infant mortality. The five leading causes of death for persons aged 65 years and older in 2014 were the same for males and females, although the rank order differed. The leading five causes of death accounted for about two-thirds of all deaths in both sexes: malignant neoplasms, 110 deaths per 100,000 population; heart disease, 96; cerebrovascular diseases, 84; and diabetes mellitus, 43. The death rates for cancers, heart diseases, and cerebrovascular disease were higher for males, with cancer and heart rates in males doubling those in females. Among cancer deaths in the group 60 years old and older, prostate cancer–related deaths were higher. Table 2 shows the 10 leading causes of death, by sex, in 2014.
Table 2. Number of deaths, percent of total deaths, and rank of the 10 leading causes of death, by sex, Saint Lucia, 2014
|Causes (ICD-10 code)||Male||%||Rank||Female||%||Rank||Both||%||Rank|
|Malignant neoplasms (C00-C97)||142||19.5||1||97||17||1||239||18.4||1|
|Heart diseases (105-109; 120-152)||108||14.8||2||73||12.8||3||181||13.9||2|
|Cerebrovascular diseases (160-169)||62||8.5||3||62||10.8||4||124||9.5||3|
|Diabetes mellitus (E10-E14)||45||6.2||4||78||13.6||2||123||9.4||4|
|Hypertensive diseases (I10-I150||37||5.1||5||49||8.6||5||86||6.6||5|
|Chronic lower respiratory diseases (J40-J47)||36||4.9||6||10||1.7||6||46||3.5||6|
|Chronic liver disease and cirrhosis (K70-K74)||19||2.6||8||9||1.6||7||28||2.2||8|
|Influenza and pneumonia (J09-J18)||17||2.3||9||10||1.7||6||27||2.1||9|
|Perinatal conditions (P00-P96)||17||2.3||10||9||1.6||7||26||2||10|
Source: Saint Lucia, Ministry of Health and Wellness, Mortality Database.
The Ministry of Health has given priority to mental health: to that end, it has implemented the revised strategic plan, which aims to incorporate mental health into primary health care. Further, families of the mentally ill are provided opportunities to become more involved with their care, to ease the burden on the institution and the government. An estimated 5% of the national health expenditure is allocated each year to mental health. In 2012, the main admitting diagnoses were schizophrenia and delusional disorders, including psychosis (not drug-induced), followed by disorders due to psychoactive substance abuse, including alcohol; and mood disorders, including depression, bipolar disorder, and manic episodes. A greater proportion of admitted mental health patients are males (73%), largely 20-39-year-olds (61%).
The National Strategic Plan for Health 2006-2011 outlines the strategic road map for proposed health reforms and the impetus for action and change in the health system. In the absence of a new plan since 2011, the current plan continued to guide the operations of the Ministry of Health. A new five-year National Strategic Plan for Health is being developed and should be implemented by the end of 2017.
In Saint Lucia, the number of doctors available in the private sector far outnumbers that of the public sector. As of December 2014, the number of doctors in the public health system was 82, servicing an estimated 2,101 persons, compared to 250 doctors in the private sector serving 689 persons. A strategy for human resources in health was developed in 2014 to strengthen staffing functions. In 2012, through a financial agreement with the European Development Fund, a project designed to support the implementation of universal health care in Saint Lucia was launched. Since its implementation in 2013, the project has issued some 250 scholarships in priority areas such as family nursing, environmental health, diabetes, physiotherapy, midwifery, and mental health. The 60 new midwives, 4 family nurse practitioners, and 6 pharmacists boosted existing staff. By December 2014, the Ministry of Health had 275 nurses (including family nurse practitioners and midwives), 113 nursing support staff, 23 pharmacists, 77 allied health professionals, and 7 dentists, among others.
Health Knowledge, Technology, and Information
Two units within the Ministry of Health are primarily responsible for health information systems: the National Epidemiology Unit, charged with collecting and analyzing health data, and the National Health Management Information System (HMIS) Unit, responsible for implementing the electronic national system known as the Saint Lucia Health Information System (SLUHIS). The system, launched in 2011, is responsible for setting up data collection in all 36 primary care facilities throughout 2016-2017. As of this writing, the system had been rolled out at 31 health care facilities, including the Gros Islet Polyclinic and the Dennery Hospital. The electronic system will greatly enhance, and in some cases replace, the current system of collecting and recording written records. It will also make data and patient records easier to retrieve, such as when patients relocate and must receive services at different health facilities.
According to the Office of the Civil Registry, which is legally mandated to collect information on births and deaths, almost all (99.8%) births occur within an established institution. In 2014, the Registry implemented the process of bedside registration at the National Hospital. Deaths must be registered prior to burial.
The Environment and Human Security
Saint Lucia is vulnerable to natural disasters such as hurricanes and the potential floods and disease outbreaks that may occur in their aftermath. With the ongoing effects of climate change, the country is likely to face more and more severe weather events, sea level rise, and altered patterns of precipitation, all of which could interfere with the safety and livelihood of its citizens. In response, Saint Lucia is working on putting in place a broad range of preparedness and adaptation measures.
In 2010, Hurricane Tomas resulted in 7 deaths and 36 injuries. Then, during Christmas 2013, the country experienced torrential rains and strong winds that resulted in six deaths; roughly 1,050 persons were severely affected. Saint Lucia suffered total losses of approximately US$ 99 million as a result of that event, mainly due to serious damage to infrastructure, including nine bridges and several roads. A dengue outbreak in 2011, with 749 confirmed cases, and the first chikungunya outbreak, in 2014, followed natural disasters.
The population has access to piped drinking water of satisfactory quality. Over 80% of homes have private connections to the system, and the rest of the population gets its water through public standpipes, trucks, and private tanks. Most homes (92.5%) have sanitary facilities through sewer connections, septic tanks, or pit latrines. The Ministry of Health’s Food and Water Safety Unit monitors and evaluates sanitary facilities for compliance with public health standards.
The majority (88%) of households are served by two sanitary landfills on the island. The remaining households dispose of waste by composting, dumping, or burning. Residential or institutional and commercial waste account for more than half of the waste produced ().
A food safety policy and an emergency response plan for food-borne diseases were implemented in 2015 to guide food surveillance activities. There was a 31% increase in the number of food handlers certified to handle and sell food to the public in 2015 compared to the figure in 2014.
In 2010, persons 60 years old and older accounted for 12% of the population; by 2014, they represented 21.8% of the population, an increase that highlights the growing importance of the needs of the elderly in all government development planning policies and programs. Males accounted for 44.6% of this age group (9,738). Elderly males died at a higher rate than did elderly females during the period 2006 to 2014. The death rate for females fell progressively to its lowest level for the period in 2010 (about 1 per 10,000) from its highest level (21 per 10,000) in 2007, and was 9 per 10,000 in 2014. Similarly, the death rate for males fell to its lowest level in 2011 (3 per 10,000) from its highest level in 2008 (28 per 10,000), but was 17 per 10,000 in 2014.
Between 2001 and 2010, 8,435 persons migrated out of the country, of which 42.7% were males and 52.3% were females (). In 2010, 8,436 persons migrated to Saint Lucia (3,855 males and 4,581 females).
Monitoring the Health System’s Organization, Provision of Care, and Performance
The National Strategic Plan for Health (2006–2011) is currently being revised. The new plan will focus on universal coverage to improve health equity and service delivery; use of a defined national model of care; adequate standards (clinical governance and physical determinants), integrated service delivery, and an accreditation road map; leadership reforms, through an evaluation and redesign of the health governance model; and public policy reforms, through the development of appropriate policies and related legislation.
Universal health coverage is the overarching framework that guides the Ministry of Health’s efforts to achieve health equity, sustainable health coverage, quality care, and improved health outcomes. To this end, the Ministry pursues a cost-effective approach designed to reduce segmentation and to ensure fair access that upholds human rights. A basket of services has already been identified and efforts towards finalizing this and other related initiatives are currently under way.
Services are free, and will continue be provided at the 36 health facilities and 2 main hospitals, all within easy reach of the population. The Ministry of Health makes it possible to access services that are not available in-country, including CT scans, treatment for severe burns, and some oncology services. Affected persons often receive treatment in Martinique under a government-to-government arrangement. In support of the implementation of universal health coverage, the Ministry of Health launched a “Health Financing Strategy and Policy” with funding from the European Union, which will be fully implemented after the passage of related legislation. A package of health care services was designed based on an analysis of epidemiological and demographic trends, as well as consideration of social determinants of health. The package, which includes specific services within the framework of a comprehensive model of care, is already being offered in many of the health facilities across the island.
The National Health Sector Policy currently in force addresses the following imperatives: investment in health, tackling health challenges, strengthening people-centered health systems, and creating resilient communities. Policies already have been set for chronic NCDs, mental health, and nutrition.
A new health sector governance model has been proposed to come into effect with the commissioning of the new national hospital (the Owen King EU Hospital), whereby the government need not own or directly control any health facility or provider. According to this model, the Ministry of Health’s role as steward and regulator is clearly defined, as is a dedicated health fund. There will be mechanisms to engage all health actors in maintaining acceptable standards of performance in the delivery of care for clinical and nonclinical care and support. The proposed governance model , along with a new integrated health care model , will provide a framework for the delivery of the essential package of health services. The integrated care delivery model emphasizes primary prevention and related services to create a more patient-friendly and effective experience. An operational procedure for the “Integrated Health Services Delivery Network” is currently being developed with assistance of PAHO, and should be in place by the end of 2017.
An assessment of the country’s legislative system has been conducted as a way to strengthen the Ministry of Health’s stewardship role. In light of this review, the following pieces of legislation were updated or enacted: the Public Health Act; the Health Practitioners Act; the Mental Health Act, the Health Records Act, and laws that govern the hospitals. These acilities are managed by an independent board and receive an annual subvention from the government.
Saint Lucia’s health services are funded primarily through a government consolidated fund, donor contributions, out-of-pocket payments, and private health insurance schemes. Under the new governance strategy, all of these financing mechanisms and funds will be consolidated into a single pool, with the funds allocated based on service level agreements.
Health expenditure, as a percentage of total government expenditure, ranged from 6% to 8% between 2004 and 2014 (). Health expenditure accounted for somewhat more than 2.5% of GDP in 2014/2015. The bulk of recurrent expenditure in health goes to secondary and tertiary care, namely to the three main public hospitals. This includes staff remuneration, maintenance, and, over the last three years, a significant increase in capital expenditure for the construction and equipping (EU grant funding) of the Owen King EU Hospital and the reconstruction of the St. Jude Hospital.
Pharmaceuticals are sourced through the Pharmaceutical Procurement Service of the OECS. A formulary committee reviews the essential pharmaceuticals list at regular intervals and updates it accordingly.
Health Situation and Trends
Health of Population Groups
Maternal and Reproductive Health
The crude birth rate remained constant during 2010-2015, at approximately 12 live births per 1,000 population (11.4 in 2010, 11.9 in 2015); the number of births also remained fairly consistent. Maternal and child health services are offered at public health facilities and in the private health sector. Approximately 98% of births occur in hospitals and are attended by trained health personnel. There has been a steady decline in normal vaginal deliveries (from 86% in 2010 to 76% in 2014), with an inverse trend in caesarean sections (from 14% to 24% in the same period). Four maternal deaths were reported in 2012-2014, one in 2012 and 2013 and 2 in 2014. Exclusive breastfeeding at 6 weeks remained below 50% for each year in the reporting period, with the lowest figure seen in 2014 (40%). There were 1,071 mothers attending postnatal clinics in the public, representing the highest attendance to date.
The infant mortality rate declined from 23 deaths per 1,000 live births in 2012 to 17 in 2014, and the number of infant deaths ranged from 29 to 43 annually between 2012 and 2014, with most of the deaths occurring in the neonatal period. From 2005 to 2014, the percentage of low birthweight infants ranged between 9% and 12%, and, on average, low birthweight infants accounted for 11.3% of all births in 2012-2014. In 2014, 86% of all live births were seen at postnatal clinics in 2014, a figure similar for 2012 and 2013.
The mortality rate for children under 5 years old has been increasing since 2010 (18.6 per 1,000 live births), with the highest rate having been recorded in 2012 (24.1). For 2014, perinatal conditions, congenital anomalies, and respiratory infections, particularly asthma, accounted for most of the hospitalization of children 1-4 years old in 2014, with gastroenteritis, injuries, and accidents also being common. In 2015, there were eight confirmed cases of pertussis in children, with six of those infants being younger than 3 months and, therefore, not eligible to be vaccinated. The age of first dose for vaccination was reduced to 8 weeks, in alignment with regional standards.
The diseases being vaccinated against under the Expanded Programme on Immunization (EPI) are: poliomyelitis; diphtheria, whooping cough, tetanus, hepatitis B, and Haemophilus influenza type b (DPT/Hep B/Hib); tuberculosis (BCG); and measles, mumps and rubella (MMR). In 2014, about 98% of infants completed the vaccination series for polio and DPT/Hep B/Hib; 83% received the BCG vaccine and 98% received the first dose of the MMR vaccine (MMR1).
In 2015, a survey was conducted among school-aged children (6-11 years old) in order to determine the coverage and timeliness of the second dose of the MMR vaccine (MMR2). The findings validated the administrative vaccination coverage for MMR2, which was 76%. Vaccination strategies, including closer collaboration between the ministries of health and of education, are being implemented.
Health of Schoolchildren and Adolescents (5–19 Years Old)
In 2014, the age group 5-19 years old accounted for 23% of the population, with males representing 50.6% of the group, having decreased by 10% since 2010. Children aged 5–14 years accounted for 14.4% of the population, with males accounting for 7.3% and females for 7.1%. School and child health programs continue to focus mainly on physical assessments, immunization, and screening for health problems. Problems related to teen pregnancy, drug and alcohol abuse, accidents and violence, homicide, and suicide together accounted for about 51% of all adolescent deaths, 60% of male adolescent deaths, and 34% of female adolescent deaths for 2012 to 2014 combined.
Health of Adults (20–59 Years Old)
There were 99,341 persons between the ages of 20 and 59 years old in 2014, a 12% increase from 2006. Males comprised 49.8% and females 50.2%. In 2014, there were 332 deaths, which accounted for 26.3% of mortality for all causes (222 male deaths and 110 female deaths), In 2014, the leading causes of deaths in that age group were injuries and accidents, diseases of the circulatory system, and cancers.
Mortality rates increased slightly between 2012 and 2014 (6.9 per 1,000 population and 7.6 per 1,000, respectively). During that period the total number of deaths was 3,554, 1,937 male deaths (54.5%), and 1,617 female deaths (45.5%). Male mortality is higher than female mortality by cause and by age, and male mortality from external causes, including unintentional and violence-related injury, was five times greater than female mortality. With the rare exception of cancers, premature mortality was highest for males across all broad groups when compared to females.
NCDs remained as the leading causes of death in 2014. Although communicable diseases no longer rank among the leading five causes of death, influenza, pneumonia, and perinatal conditions remain among the top 10. Perinatal conditions are the main contributors to infant mortality.
Among vector-borne diseases, dengue is endemic, with 1,253 confirmed cases for 2010-2014 (749 cases in 2011 and 282 in 2013). There were three deaths associated with dengue in 2011 and one in 2014. An outbreak of chikungunya in April of 2014 resulted in 899 suspected cases. Women were more affected than men, and children 0-4 years old accounted for 22% of all cases. It was estimated that roughly 60% of reported suspected cases were true infections. Zika was first confirmed in 2016, and up to September of that year there had been 50 cases, with one Zika case associated with Guillain-Barré syndrome and 40 cases confirmed in pregnant women. The household mosquito index for Aedes aegypti was 15.1% for April 2015 to March 2016; the Breteau index was 25.7%. Prevention and control activities to reduce A. aegypti mosquitoes are ongoing.
There were 101 cases of leptospirosis, with 6 deaths.
Saint Lucia has an HIV/AIDS strategic plan designed to decrease the spread of the disease and mitigate its impact on the population. This plan targets men who have sex with men, sex workers, and pregnant women. Since 1985, 1,091 HIV cases have been diagnosed (55% males and 41% females); as of this writing, 65% of these cases are persons living with HIV and 83% are on antiretroviral therapy. Between 2011 and 2016, vertical transmission of HIV has been consistently at zero.
Other Health Problems
Oral health services are mainly targeted to children up to 12 years. This program is an integral part of the health service delivery program for children and is available at five health clinics. About 46% of children in Saint Lucia had preventive dental care during 2016.
As part of its efforts to improve ocular health, the Ministry of Health collaborates with St. Lucia Blind Welfare Association, a nongovernmental organization mandated by the Parliament to coordinate the education, rehabilitation, eye health, and general welfare of the blind and visually impaired. There is also collaboration with the Cuban Medical Brigade, which operates at the Victoria Hospital. From January to October 2016 a total of 15,724 cases were seen and 708 cases operated on.
Risk and Protective Factors
Saint Lucia’s 2012 STEPS Survey provided information on risk factors for NCDs such as tobacco use and exposure, alcohol consumption, dietary patterns, physical activity, being overweight or obese, having high blood pressure, having elevated blood glucose levels, and degree of adherence to hypertension medication. Although poorer outcomes (higher levels of low physical activity, overweight, obesity, blood cholesterol, and blood glucose) were observed in females, mortality is higher for males than for females for diseases with these associated modifiable risk factors, such as cardiovascular diseases and heart disease. Alcohol use remains the exception, in that men consistently exceeded women in typical drinking frequencies and quantities as well as in rates of heavy drinking episodes. Table 3 shows the results of a survey assessing risk factors for NCDs.
Table 3. Selected risk factors for noncommunicable diseases, by sex and for both sexes, Saint Lucia.
|NCD risk factor||Malea||Femalea||Botha|
|Tobacco use and exposure|
|Currently smoking tobacco||25.3||4||14.5|
|Smoke tobacco daily||16.2||2.5||9.3|
|Exposure to smoke for ≥ 1 day/week at home||20.3||13.7||16.9|
|Exposure to smoke for ≥ 1 day/week at work||23.6||13||18.3|
|Drank in past 30 days||74.3||44.7||59.3|
|Heavy episodic drinking in past 30 days||49.5||19.5||…|
|Ate < 5 servings of fruit and vegetables per day||86.9||89.7||88.3|
|Other NCD risk factors|
|Average Body Mass Index (BMI)||26||30||28|
|Overweight and obese (BMI ≥ 25 kg/m²)||53.9||77.1||65.6|
|Obese (BMI ≥ 30 kg/m2)||17.1||46.4||31.9|
|Raised blood pressure||28||26.7||27.3|
|Raised blood pressure and on medication||23.4||12.7||18.3|
|Impaired or raised fasting blood glucose (≥ 100 mg/dl)||37.1||46.2||42.2|
a Percentage of respondents that answered “yes” to the question.
Source: Saint Lucia, Ministry of Health and Wellness, Behavioral Risk Factor Survey 2012
A World Bank report shows that there is a shift toward overweight among children in the countries of the OECS, and projects that by 2015 almost 60% of females in Saint Lucia will be obese (). According to the abovementioned STEPS survey, recreational fitness programs for all age groups, including the elderly, were introduced at 24 health centers.
Low socioeconomic status is a risk factor for many diseases, with a higher risk for poor nutrition, lack of exercise, and smoking (). Young adults with children aged 0 to 14 years comprised 39% of those living below the poverty line, while older persons aged 65 years and older made up approximately 7%. Poverty in Saint Lucia is considered mainly a rural phenomenon, with rural districts showing poverty prevalence rates in excess of 35% ().
Accidents and Violence
Between 2010 and 2012, there were 49 motor vehicle accidents, responsible for 270 hospitalizations and 48 deaths (3:1 male-to-female ratio). The most affected age group were 15-44-year-olds, which represented 65% of those deaths. In 2010-2014 there were 98 deaths related to traffic accidents, with a male-to-female ratio of 5:1. Homicides decreased by 28.2% between 2011 and 2015, ranging from 39 in 2011 to 28 in 2015, with a total of 166 homicides for the period. There were a total of 54 recorded suicides, ranging from 4 in 2010 to 14 in 2014.
Table 4. Police crime statistics, by year, 2011-2015
Source: Saint Lucia, RoyalPolice Force.
As the Ministry of Health moves into its next planning cycle in 2007, it will focus on continuing to strengthen Saint Lucia’s health system, particularly by boosting the Ministry’s stewardship role and improving health outcomes. The new strategic plan will attempt to complete the unfinished agenda. Specifically, it will work on establishing the virtual integration model and fine-tuning the health financing strategy and the quality management framework. In terms of human resources for health, including training and succession planning, the new plan will identify key indicators for service delivery, outcomes, and health status.
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2. International Monetary Fund. St. Lucia: 2015 Article IV Consultation–press release; and staff report. (Country report no. 16/52). Washington, D.C.: IMF; 2016. Available from: https://www.imf.org/en/Publications/CR/Issues/2016/12/31/St-43713 Accessed on 29 November 2016.
3. Kairi Consultants Limited; National Assessment Team (Saint Lucia). Trade adjustment and poverty in Saint Lucia 2005/06: volume I, main report. St. Michael, Barbados: Caribbean Development Bank; 2007. Available from: http://www.caribank.org/uploads/publications-reports/economics-statistics/country-poverty-assessment-reports/SLUCPAMainReport.pdf Accessed on 6 June 2017.
4. World Bank. Microdata Library. St. Lucia – Multiple Indicator Cluster Survey 2012 [Internet]. Washington, D.C.: World Bank/International Bank for Reconstruction and Development; 2014. Available from: http://microdata.worldbank.org/index.php/catalog/2209 Accessed on 6 June 2017.
5. Chitolie-Joseph E. Education for All 2015 national review report: Saint Lucia. Castries: Ministry of Education; 2014. Available from: http://wedocs.unep.org/bitstream/handle/20.500.11822/9760/-National_Education_for_All_Report-2015StLucia_NationalEducationforAllReport_2015.pdf.pdf?sequence=3 Accessed on 29 November 2016.
6. Solid Waste Management Authority (Saint Lucia). Solid waste management report; 2011. Castries: SLUSWMA; 2011.
7. Knoema.com. World Data Atlas: Saint Lucia health—total health expenditure as a share of GDP, 2003–2014 [Internet]. McLean, VA: Knoema; 2017. Available from: https://knoema.com//atlas/Saint-Lucia/topics/Health/Health-Expenditure/Health-expenditure-percent-of-GDP Accessed on 6 June 2017.
8. World Bank. The growing burden of non-communicable diseases in the Eastern Caribbean. Washington, D.C.: World Bank/International Bank for Reconstruction and Development; 2012. Available from: http://documents.worldbank.org/curated/en/954761468224410323/The-growing-burden-of-non-communicable-diseases-in-the-Eastern-Caribbean.
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1. The proportion of weighted deprivations that the poor experience in all the total potential deprivations that the society as a whole might experience.