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Caribbean Islands Health and Welfare
General health trends in St. Lucia improved noticeably in the
1980s. Life expectancy increased 4.5 percent from 1981 to 1984,
with the average for men and women rising to 72.5 years. The
improvement in infant mortality rates was even more dramatic for
the same time period. Infant deaths under 1 year of age fell from
25 per 1,000 live births to 17 per 1,000, representing a decline of
32 percent. The mortality rate for those over the age of 65 was
reduced by 23 percent, whereas the overall mortality rate fell by
20 percent.
Indicators of morbidity were less well defined, but they
suggested that strides had been made in eradicating the most common
diseases. By 1984 a country-wide immunization program existed for
six basic preventable diseases--diphtheria, pertussis (whooping
cough), tetanus, poliomyelitis, tuberculosis, and measles--and
other inoculation programs were being planned with the assistance
of PAHO. The nutritional status of children under the age of five
apparently also had improved, although definitive statistical
evidence was lacking. Communicable diseases continued to be a major
health problem, however, as evidenced by the increase in the
incidences of venereal diseases. In 1986, PAHO reported three cases
of acquired immune deficiency syndrome (AIDS) in St. Lucia.
Environmental health indicators were also encouraging.
Approximately 75 percent of the population had basic sanitation
facilities in 1985, and 85 percent of the population had access to
piped water. Expansion of waste disposal facilities continued in
1985 and 1986, and government inspection of sewage treatment
facilities, food handling businesses, and schools brought
corrective action in those areas.
The general improvement in the health situation was directly
attributable to efforts by the government to enact a comprehensive
health care system. A coordinated health care policy was developed
with the assistance of the World Health Organization (WHO), PAHO,
and numerous other organizations, including foundations and
universities. Priority was given to primary health care delivery by
a network of health clinics.
The health care system was directed by the Ministry of Health,
which provided two basic types of health services free of charge:
preventive care and curative services. The former focused on
prenatal, immunization, nutritional, and family planning programs,
whereas the latter provided doctors and nurses to operate a network
of health clinics. Government health services were offered
throughout the country, which was divided into six health
districts. The island had thirty-three health clinics, two district
hospitals, two general hospitals, and one psychiatric hospital. The
most complete facilities were located near Castries and Vieux Fort.
In an attempt to reach the entire population with some form of
health care service, the Ministry of Health adopted a plan to train
health care workers in various types of technical services to
assist doctors and nurses with health care delivery. There were
four types of health care representatives: community health aides,
environmental health aides, family nurse practitioners, and
community nutrition officers. As was evident in the structure of
the health care system, the community health programs provided
educational and preventive services, as well as actual hands-on
health care. It was hoped that many health problems could be
avoided by educating the population on nutrition, hygiene, and
sanitation habits.
The success of St. Lucia's nutrition, immunization, health
education, prenatal, and child health care programs was evident in
the continued decline in morbidity and mortality rates, as well as
the high population growth rate. Nevertheless, it was clear that a
continued growth rate approaching 2 percent would place excessive
constraints on the island's future health, employment
opportunities, and quality of life. For these reasons, the Ministry
of Health made reduction of fertility rates the health care
priority of the late 1980s, targeting in particular the sexual
behavior of adolescents.
In addition to health care programs, the government provided a
social security system for workers who did not have a private
pension plan. The National Insurance Scheme forced workers to
contribute a portion of their wages to be held for their retirement
at age sixty-five, at which time they would receive regularly
scheduled payments.
Data as of November 1987
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