C ommo nwe a l t h memb e r c o u n t r i e s The most recent act relating to mental health in Grenada is the Mental Health Act 2008. Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. For Grenada to achieve its targets for the reduction of child mortality, which forms MDG 4, it would need to have reduced under-five deaths per 1,000 live births to seven, and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 12 deaths per 1,000 live births and measles immunisation at 94 per cent, so Grenada is unlikely to meet this goal when the 2015 data is analysed. The 2013 MDG progress report for Grenada provided suggestions from civil society organisations on potential methods of improving health care in the country and achieving those goals outlined in the millennium development framework. For MDG 4, while there has been an improvement in child mortality rates, it is suggested that further focus needs to be applied to early childhood care and development. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. For Grenada, therefore, maternal mortality should have fallen to nine per 100,000 live births. This figure stood at 23 in 2013, indicating that the target is unlikely to be met when the 2015 data is analysed. Part of the goal stipulates that 100 per cent of births must be attended by a skilled health professional – a goal that has already been met. The 2013 MDG progress report for Grenada suggested that further improvements in maternal mortality could be made if efforts were focused on educating Grenadians about contraceptives in order to combat widespread misunderstandings and stigmas concerning their use. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. The contribution of major communicable diseases to total mortality in Grenada is low. Malaria has already been eradicated in the country and the incidence of and mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis are also on the decline. Grenada has made considerable progress towards achieving MDG 6, but there is insufficient information from international agencies to confirm the country’s progress on this goal with regard to HIV/AIDS. The 2013 MDG progress report for Grenada highlighted the emergence of new initiatives to reduce mother-to-child transmission of HIV infections. There are inconsistencies in the supply of medication for HIV/AIDS. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage More than half of health care in Grenada (53 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 6.2 per cent of GDP in 2012, of which 47 per cent (US$479 per capita) was covered by the government. A 2000 report by the World Health Organization stated that Grenada had one of the best health care systems in the Caribbean. The health care system is organised and run by the Ministry of Health (MOH), which in recent years has focused on providing citizens with excellent primary care. As a result, primary health care services are largely free of charge and available at public health centres. A small fee is charged for medicine, lab work or other diagnostics, but fees are waived for the elderly, children and the poor. While there is no national health insurance, all Grenadians are required to participate in a social security programme, the National Insurance Scheme, which covers citizens against workrelated injuries. Grenada was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1991 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Around 7,000 people in Grenada are over the age of 65 – seven per cent of the total population (2013). At the age of 60 a person living in Grenada can be expected to live for an additional 18 years, on average (2013). Overall, public pension spending is equivalent to two per cent of the country’s total economic output (2006). The elderly in Grenada are given free primary health care as standard. Medicines, lab work and other diagnostics are also provided free of charge for the elderly. The government runs the Richmond Home for the Elderly, which offers free residential facilities to senior citizens. There are also several privately run services for the care of the elderly, including the Grenada Connections Care@Home Agency, which caters to the elderly in their own homes, offering services such as bathing, meal preparation, companionship, doctor service and help with household chores, for example, laundry and shopping. Grenada is a hotspot for expatriate retirees. Each year, high numbers of elderly people, mainly from the UK and Europe, relocate to the island in search of relaxing living conditions and warmer climates in which to spend their twilight years. Further information Ministry of Health and Social Security: www.gov.gd/ministries/health.html Commonwealth Health Online: www.commonwealthhealth.org/health/americas/grenada 180 Commonwealth Health Partnerships 2015 Population over 65 7%
Commonwealth Health Partnerships 2015
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