The North East Health Region has a health care delivery network formed by 73 health centres, 4 general hospitals and 2 community hospitals (Table # 10). A total of 1,408 health and administrative workers staff this network (Table # 11).

Table # 10

NORTH EAST HEALTH REGION

HEALTH CARE DELIVERY NETWORK – 2000

Source: Departments of OP&M NERHA

*Figures included in report for Type 3 health centre in district in which clinic is located

Table # 11

NORTH EAST HEALTH REGION

STAFFING – 2000

 Source: Department of HRM&IR – NERHA

The ratio of medical officer per 10,000 inhabitants is 1.7. As in the rest of the nation there is a shortage of nurses, in 2000 NE Region had 10 nurses per 10,000 population (Table # 12).

Table # 12

NORTH EAST HEALTH REGION

RATIO OF SELECTED HUMAN RESOURCES (2001)

  Source: MIS/HRM&IR NERHA

Primary Care:

The primary health care network in the NE Region is greatly under-utilized. As in the rest of Jamaica, there is evidence that large numbers of people bypass their nearest primary level facility to seek care, either in a more complex health centre elsewhere, or a hospital facility⁴.

The concentration of health centres per million/population in the NE is the largest in Jamaica, with 210 health centres per million/population while the national average is of 136 per million/population. The explanations offered for this is that the difficult terrain and bad roads in the rural areas were a key and influential factor in planning and establishing health centres to facilitate geographical access.

Forty-four (44) of these health centres are type 1 facilities, staffed by a Midwife and a Community Health Aide (and, very often, only by the CHA), and have a density of 122 per million population contrasting with the national average of 61.

The health centres deliver, according to their type and staffing, services that covers curative visits, dental, ante and postnatal, child health, family planning and reproductive health, immunizations, nutrition, laboratory and pharmaceutical services. (See annex # 3). The staffing situation is critical in some specialities (i.e. doctors, pharmacy, nursing) and this affects considerably the quality of services delivered.

However, the number of visits to health centres per 1000 population in the NE Region is above that for Jamaica and the second highest nation-wide. The highest number of visit per 1000 population in the NE is registered in Portland, followed by St. Mary. It would seem that the use of health centres is inversely proportional to the degree of urbanization in the area, i.e. the more developed the parish, the easier it is for people to bypass primary care and present themselves at hospital.

During the year 2000, the primary health care network registered 253,724 visits in the various programs. Forty-one percent (41%) or 103,696 of those visits were for curative services, 12% (31,143) were for dental services, 10.5% (26,548) and 2.6% (6,479) were for antenatal and postnatal care respectively. Nineteen point six percent (19.6%) or 49,775 visits were recorded in child health clinics and 14.2% (36,083) for family planning/reproductive health services (See Annex # 1).

Children 0-35 months attending Child Health Clinics in the NE Region with nutritional deficiencies (weight below normal for age) and excesses (weight above normal for age) reported were 1,450 (4.0%) and 2,954 (8.1%) respectively for the year 2000.

Of the three (3) parishes St. Mary recorded the highest percentage of nutritional deficiency in weight below normal for age (2.2%) 803, representing more than one half of the total figure for the region. St. Ann on the other hand recorded the highest percentage of those children with weight above normal for age (3.5%) or 1,260.

Secondary Care:

The regional health care network is complemented, on the secondary care level, by a regional type B hospital (St. Ann’s Bay Hospital) with a bed complement of 155 and two functional type C hospitals (Annotto Bay Hospital [118 beds] and Port Antonio Hospital [115 beds]). The Port Maria Hospital is going through refurbishment and rationalisation of beds in an ongoing process aimed at improving the utilization of hospital beds in the region and getting rid of old and condemned infrastructure.

These hospitals are greatly affected by poor staffing due to the fact that doctors and nurses prefer to accept positions in more urbanized cities.

The hospitalization rate is 66.3 per 1,000 population for the region, which is similar to the figure for Jamaica of 66.9/1000 population.  Hospitalisation rate is highest in St. Ann with 77.5/1000 population and lowest in Portland with 45.5/1000 population.

In the year 2000, the hospitals in the region reported a total of 23, 588 admissions with a total of 108,883 inpatients days. Twenty-three thousand five hundred and seventy (23,570) patients were discharged for a total discharge days of 97,998 (Table # 13).

Table # 13

NORTH EAST HEALTH REGION

Hospital Statistics – 2000

Source:  HMSR Annual Report 2000, Planning and Evaluation Unit, MOH.

The Average Length of Stay (ALOS) for the region was 4.2 days, which is lower than the national average of 4.9 days.  However, the average occupancy of all specialities for the region is the lowest for Jamaica, at 66% compared to a national average of 74.9%. In the NE the highest occupancy rate is observed in General Medicine with 72.4% and the lowest in Paediatrics with 61%. The Port Antonio Hospital has the lowest occupancy rate at 44.1%. This would suggest that on average, over the year, less than half of the bed complement is in use at this hospital. A similar situation is observed in Port Maria and Annotto Bay hospitals with just a little over 50% occupancy, while St. Ann’s Bay hospital is under pressure with an occupancy level of 96.2% (Table #13).

During the year 2000, 6,294 deliveries were reported at the four hospitals of the NE Region. Arising from these deliveries were 6,382 births, of which 6,258 (98%) were live births and 178 perinatal deaths (still births [124] and newborn deaths 0-6 days [54]). This gives a foetal death rate of 19.4 and a perinatal mortality rate of 27.9 per 1000 births. A total of four (4) maternal deaths occurred in these hospitals (Table # 14).

Table # 14

NORTH EAST HEALTH REGION

Hospital Statistics – 2000

Source:  HMSR Annual Report 2000. Planning and Evaluation Unit, MOH

It is reported that 96.4% of babies are born in hospitals in this region. However, only 74.6%⁵ of these pregnant women were seen in the antenatal clinics at health centres in the region (first visits as a % of estimated births). For the year 2000, one maternal death occurred on the district during home deliveries attended by registered midwives.

In the same period, 3,792 surgeries were conducted at the four hospitals in the region. Fifty percent were major surgeries, 25% were emergencies and 22% correspond to day surgeries (Table  #15).

Table # 15

NORTH EAST HEALTH REGION

Hospital Statistics 2000

Source:  HMSR, Annual Report 2000. Planning and Evaluation Unit, MOH

A total of 94,295 patients were seen in the casualty departments. Twenty-five deaths were registered at this level, 11 (44%) of them in Port Antonio and 10 (40%) in St. Ann’s Bay Hospital. Self-referral continues to be the outstanding form of presentation at hospitals casualty and A&E departments. Seventy percent (70%) of the patients seen at this level during the year were self-referred.

Bronchial Asthma crisis is one of the leading causes of consultation in all age groups and gender, as indicated in Table 16.

Table # 16

NORTH EAST HEALTH REGION

Hospital Statistics

Source:  HMSR, Annual Report 2000. Planning and Evaluation Unit, MOH

Outpatients’ Speciality clinic serviced 15,931 patients in the year 2000. A total of 14,692 patients received services in the radiography departments for a total of 20,655 x-ray films. A total of 26,195 physiotherapy treatments were given to 2,207 patients, 69.5% (1,533) of whom were outpatients, who received 86% (22,432) of these treatments. Pharmaceutical services (in hospitals) dispensed 108,544 items, while 163,305 exams were completed in the laboratory department.

Geographical Location  Regional Profile     Demographic Profile    Environmental Profile    Epidemiological Profile

Health Infrastructure    Organization Structure    Socio- Economic Profile     Footnotes and Annexes