Grenada - Health and Welfare
Health care in Grenada compared favorably with that in other Eastern Caribbean islands in 1983, and mortality rates were actually lower than those of many neighboring countries. Grenada had an infant mortality rate of 21.2 per 1,000 live births, which was slightly below the average for the English-speaking Caribbean islands. The overall death rate was 7.3 per 1,000 inhabitants. In 1984 the average life expectancy at birth was sixty-six years.
Morbidity indicators for the same time period reflected mixed results. Immunization against diphtheria, pertussis, and tetanus reached 68 percent of the population; 78 percent had been inoculated against poliomyelitis. Inoculation against measles, however, was provided to only 7 percent of the targeted population, and other immunization programs, such as against typhoid fever, were not available. Approximately 85 percent of the inhabitants had access to potable water; infectious or parasitic diseases caused only 1 percent of reported deaths in 1983. Three cases of acquired immune deficiency syndrome were reported as of 1986.
Attempts to reduce morbidity levels in the mid-1980s included expanding immunization programs, increasing the number of health inspectors, and improving solid waste management. Only a small percentage of meat, food, and restaurants were inspected for sanitary conditions, and at least 35 percent of all solid waste went uncollected, causing high levels of rodent and fly infestation. Efforts were underway after 1983 to correct these deficiencies with assistance from the Pan American Health Organization, World Health Organization (WHO), United States Agency for International Development (AID), and Project HOPE.
Grenada's health care system was patterned after WHO's primary health care model. Its immediate goals were to provide essential health care to the entire population. Priority was given to maternal and child care, as well as the development of a dental program. Other efforts sought to expand the potable water base, improve disposal of solid waste, increase prevention of vectorborne and communicable diseases, initiate health awareness education programs, and improve the allocation of drugs and medication.
Implementation of the health care policy was conducted by the Ministry of Health. Operations were financed through the national government budget; only 3.4 percent of capital expenditures went to health care development in 1985. Grenada's health care infrastructure consisted of six hospitals and thirty-five outpatient clinics, including twenty-seven visiting stations, six health clinics, one maternity unit, and one outpost unit.
Foreign aid had been an essential component of the health care system for many years. Cuba provided a large amount of foreign assistance prior to the United States-Caribbean intervention. This effort peaked in 1983 with donations of approximately US$40 million in medical relief. The overall health care effort by the PRG, however, remained mediocre at best.
Project HOPE, under contract with AID, was the primary provider of assistance to the health care system of Grenada after 1983. Its goal was to provide immediate health care delivery and assist with planning technical and managerial development programs. This included providing doctors and nurses while simultaneously helping the Grenada government design a self-sufficient national medical program.
The success of AID-sponsored projects was critical if Grenada hoped to achieve its long-term health care goals. The government lacked the ability to organize a comprehensive national health care delivery system. Developing such a system required both administrative and clinical expertise, in addition to technically trained medical professionals. The successful completion of the AID-sponsored projects, however, could eventually provide Grenada with one of the best health care programs in the Eastern Caribbean.
A compulsory retirement plan was first instituted among urban workers by the PRG in the early 1980s and expanded to include agricultural workers under the Herbert Blaize administration after 1983. The National Insurance Scheme, administered by the Ministry of Social Security, was established to ensure that all workers would have income following their retirement after age sixty-five. It averaged approximately 20 percent of total transfer payments in 1984.
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