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reduced under-five deaths per 1,000 live births to eight and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 19 deaths per 1,000 live births and measles immunisation at 99 per cent. The country will need to have reduced under-five mortality by more than half to meet this target. However, the target for measles immunisation is close to being met and is likely to have been achieved by the time that the data is analysed in 2015. 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. When applying this target to SVG, the maternal mortality ratio should fall to 15 cases per 100,000 live births. In 2013 the adjusted ratio was estimated at 45 deaths per 100,000 live births by UN agencies and the World Bank. This figure shows that the ratio has fallen by less than a quarter since 1990, so the country is unlikely to meet its target by 2015. Another target of this goal stipulates that 100 per cent of births must be attended by a skilled health professional. In 2012 this figure stood at 99 per cent, so this target is virtually achieved. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. There was an overall rise in estimated mortality (when data excludes cases comorbid with HIV) from tuberculosis in the period 1990–2013, from one death per 100,000 to 2.8 deaths. Overall incidence of TB cases has decreased very gradually over the MDG period, from 27 per 100,000 people in 1990 to 24 in 2012. There is not enough information from international agencies to confirm the country’s progress on this goal with regard to HIV/AIDS. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Less than a fifth of health care in St Vincent and the Grenadines (18 per cent) was paid for by patients or funded by other nongovernmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.2 per cent of GDP in 2012, of which 82 per cent (US$279 per capita) was covered by the government. In running with other Caribbean nations, Saint Vincent and the Grenadines is working towards the achievement of universal health coverage. Consequently, in 2014 the Ministry of Health, Wellness and the Environment, in collaboration with the Pan American Health Organization (PAHO), hosted a one-day consultation to develop a National Strategy for Universal Health Coverage. S t V i n c e n t a n d t h e Gr e n a d i n e s St Vincent and the Grenadines was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1981 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 St Vincent and the Grenadines are over the age of 65 – seven per cent of the total population (2013). At the age of 60 a person living in St Vincent and the Grenadines can be expected to live for an additional 20 years, on average (2013). Overall, public pension spending is equivalent to 1.5 per cent of the country’s total economic output (2006). Population over 65 In 1999 St Vincent and the Grenadines adopted the Caribbean Regional Charter on Ageing and Health, thereby registering its commitment to meeting the rights and improving the lives of the elderly. As a result, the government agreed that care of the elderly should be regarded as a priority area. Since then, initiatives have been implemented to continue improving the well-being of older persons. The government has also taken steps to ensure that all elderly persons receive a pension either through social welfare or the National Insurance Services (NIS). In 2006 the NIS provided two daycentres for older persons. In 2012 there was one public and six private elderly care homes in the country. Further information Ministry of Health, Wellness and the Environment: www.health.gov.vc Commonwealth Health Online: www.commonwealth health.org/health/americas/st_vincent_and_the_grenadines Commonwealth Health Partnerships 2015 251 7%


Commonwealth Health Partnerships 2015
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