 Hello and welcome to HealthFocus, a production of the Ministry of Health and Wellness. I am Fenel Neptune. Today we have with us at the Health Planner in the Ministry of Health, Lauren James, who will speak with us on the Health System Strengthening Project. Welcome to the program. Thank you Fenel, thank you for having me. Wonderful. Can you tell us what is the Health System Strengthening Project and its objectives? The Health System Strengthening Project is a four-year project funded by the World Bank. It is being implemented in the Ministry of Health. It is basically, it basically looks at strengthening our primary health care system as well as strengthening our preparedness for any public health emergency that we may have as well as the implementation of national health insurance. And you mentioned it's a four-year project. When did this project start? It started approximately a year and a half ago. Basically, for the first year we were busy preparing the project unit for the implementation of the project. But it is fully-fledged now and it is ongoing now. Okay, and which organization is funding this project and what is the total cost? The World Bank is funding this project to a tune of 25 million US dollars. What are the different areas to be achieved under this program? First of all, let me just give a brief background as to why this project came about. As far back as 1997, when the health task team was commissioned to look at the health reform that was needed in our health system. Basically, they came in for health sector reform white paper which basically outlined a number of areas that need strengthening within our primary health care system. Our health system as a whole, sorry. It looked at the financing, it looked at our primary health care, looked at the burden of disease and what needs strengthening to address those issues. So basically, right now, although we had all this dream, that dream list, there was really no funding for that. But right now, you could say that we actually got what we wanted from way back when. So we actually have the financing now to implement all that we have been seeking to do in the health system. Basically, we have four components under this project. We have the first component which looks at the implementation of our essential benefits package, which really is the implementation of the health insurance. We have the second component which looks at the strengthening of primary health care system and which also look at the implementation of our pilot program for the performance-based financing program. We are also looking at the public health response preparedness, especially in light of all the public health emergencies we've been having. For example, Zika, Chikungonia, we had SARS, there was Ebola and now we have COVID-19. So we recognise that need to strengthen that aspect of our response. The third component looks at basically our overhead costs for running the project. And the fourth component is basically a emergency response component which allows you to deploy funds when necessary for dealing with any emergency that you may have. In this case, we were able to activate it for COVID-19 where an amount of five million was allocated to deal with the COVID-19 response. Great. And how would you say this project is expected to assist the government as it relates to the delivery of its health care services to synclusions? Well basically, recognising the burden of disease, that we have the chronic, non-communicable diseases and for a long time that has been the burden, recognise there was something to do, that we had to do something different. While we adopted the primary health care approach, recognise that there was a need to strengthen our primary health care, focus has really been on our secondary health care, but now they recognise there's a need to focus on our primary health care to avoid people from going to hospitals where it is less, where it is more costly to treat. So basically it is intended to strengthen our primary health care while providing people with means to finance access in health care that they don't have to pay out of pocket. Great. And so far the implementation of that project, what has the feedback been like? Well basically we, at the stage we are at is basically putting structures in place so not many persons are aware of the programme. Basically we are setting down the framework for the implementation of our quality programme, our essential benefits package. So there has not been much visibility with the public. But you can definitely say that the implementation so far has been burning smoothly. Yes, I could say that. Okay, well we are due for a break, we'll be back in a moment. Good day everyone. I am Dr Sharon Belmont George, Chief Medical Officer in the Ministry of Health and Wellness. In the management of COVID-19, there are actions that must be taken if you begin to feel unwell. First, you must monitor your symptoms. If you develop respiratory symptoms such as fever, cough, runny nose, sneezing, sore throat, call one of the clinical support telephone numbers for advice. If the medical care provider tells you that the symptoms are mild, please follow the recommended steps of care. If your symptoms are moderate to severe, you will be advised to go to the respiratory clinic closest to you. Wear face mask when leaving the house, especially if you are coughing or sneezing. This will prevent others from getting the infection. We recommend regular hand washing and the use of hand sanitizer when away from home. Also avoid direct contact with others and also to reduce touching other surfaces. When going to the medical facility, please go directly to the medical provider. Do not sit among the other patients. Testing and treatment and care to persons with COVID-19 is free of charge. Work with the Ministry of Health and Wellness as we reduce the impact of COVID-19 on you and your families. For further information, please contact the Bureau of Health Education at 468-5347-468-5349 or 468-5350. Welcome back. We will continue our discussion with Lauren James on the Health System Strengthening Project. Before we took the break, you were mentioning the ways in which this project would help to assist in the delivery of services. One of the main areas is the strengthening of the primary health care services. How do you intend to actually do this? As you know, there has been a lot of criticism about our services, about the availability of services at our primary health care centres. We have about 32 wellness centres, two district hospitals, one polyclinic. Basically, that project will look at... We will basically do the assessment of what is missing and then attempt to strengthen in terms of looking at our infrastructure, looking at our equipment, our supplies, what is needed, looking at our human resource, what's the gap that is needed to really provide a level of service that is needed, especially in light of the implementation of a national health insurance. So we recognise the need to augment those services to meet the demand. And if we are saying that we are going to now be asking persons to access the health care services there, we have to ensure that the services are available there. Okay, and before we go into the insurance that you mentioned, what benefits does this project have for citizens as a whole? Okay, citizens can expect to have a more strengthened primary health care system in terms of being able to access services there in terms of certain tests, the doctors being available, looking at the supplies, there's no shortage of supplies. We are also looking at persons not having to pay out of pocket to access services. So there will be a prepayment mechanism which is really what the health insurance is. And then if there's any, based on the package of services, then you'll be able to access care without having to think of where you're getting those services. They also expect to have a more strengthened public health response, so that when we are hit with things like COVID, that we are not scrambling to try and put structures in place that we already have it there. Great. And the first phase of the implementation has to do with the essential package of health services. Can you speak on this? Okay. Basically, what the ministry has done is to determine a basic package of health services that includes a number of key areas based on our burden of disease, because as you know, no one country can provide the whole gamut of services in the health sector. So we have to start small and then persons, we will be requiring persons to pay a premium for this package, pre-pay, so that whenever they need to access that they don't have to pay out of pocket. The first phase is supposed to be launched sometime this year, and persons can expect to not pay out of pocket for the services in the package. Okay. And can you speak a little more as it relates to the insurance? The insurance is basically the policy direction is that to employ the services of private health insurance to provide this coverage for persons. We have been in discussions with different stakeholders already about the need for the health insurance through the private health insurer. And basically, they would be covering the population and persons would be able to claim when they go to the different healthcare facilities that they would have some card to provide and they wouldn't have to pay out of pockets. So that would be the first phase of the or lower small package, but services that are really required at this point in time. Okay. So right now you'll only add the first phase of the project. Yeah, we look at the implementation of the first phase. That is just a smaller package. And as the fiscal space becomes better that we are hoping to expand this package to include more services. Okay. And it also benefits not just the citizen but also healthcare providers. That persons that are the healthcare system will be able to generate the much needed cash that is that's needed to continue services. So we could expect that both private and the public sector would benefit from this new financing mechanism. It's really more of a financing mechanism for the health system that we are able to generate the needed cash to keep the services going at a certain level of quality. Great. And what final message would you like to leave with St. Lucien as it relates to the health system strengthening project? For some of them they might not know about that project. Well, what this project aims to do is really to strengthen all of the weaknesses that persons have been clamoring about in terms of going to health centers and not be able to see a doctor on the test and not available. The project is basically get towards that. The government has recognized the need for persons to be able to access services without having to think about where the money is coming from. So it is really a mechanism to really remedy all the issues that we have been seeing in the health system for a while now in terms of quality, financing, etc. So the government has actually put its money where its mouth is and now we have the money to implement all the measures that we have been seeking for so long. So we can definitely say that as time goes persons will definitely get to see the benefits under this project. That's correct. Wonderful. Well, thank you so much for being part of our program today. It was definitely a pleasure providing us with such valuable information on the health systems strengthening project. Thank you. Thank you for now. Thank you. Well, that's how we come to the end of Health Focus. On behalf of the entire production team, I'm Fenel Neptune. Thanks for watching.