The Government of Saint Lucia and the World Bank’s partnership to strengthen the island’s healthcare sector

The Health System Strengthening Project (HSSP) is one of the most recent initiatives forged out of a partnership with the Government of Saint Lucia and the World Bank Group.  The aim of the project is to improve the accessibility, efficiency, and responsiveness of healthcare delivery in Saint Lucia to its population.

Improvement of the island’s healthcare sector has been a long-standing priority for the Government of Saint Lucia however, the high prevalence of non-communicable diseases coupled with the continuing threat of highly infectious diseases such as Coronavirus (COVID-19) and dengue have highlighted the demand for a heightened momentum to this commitment.  NCDs in the form of Diabetes and Hypertension have been on the rise for several years globally and regionally. In the context of Saint Lucia, NCDs continue to be a growing burden to the island’s healthcare sector, the nation’s productivity and hinders the quality of life for many. Additionally, diseases such as Ebola and COVID-19 have allowed the health sector to identify the existing gaps in its preparedness and response and have provided the opportunity to strengthen the sector and bridge these gaps.

        Within the HSSP there will be focus on four (4) major components which are as follows:

1. Design and Implementation of an Essential Package of Health Services (EPHS).
2. Strengthening of the Health sector’s service delivery in support of the Essential Package of Health Services (EPHS).
3. Institutional Capacity Building, Project Management and Coordination, and;  
4.  Contingent Emergency Response Component (CERC).

The first phase of HSSP implementation comprises the component of the Design and Implementation of the Essential Package of Health Services.  Under the HSSP the current national health strategy comprises a standard package of services geared at the management of different ailments. Work is ongoing to finalise the contents of the package.  Under this component, the project will also facilitate the necessary structures such as the legislation and information technology required to facilitate the implementation of the EPHS.   

The aim of the second component is to strengthen the healthcare service delivery in support of the Essential Package of Health Services. The improvement of healthcare service delivery will be facilitated by the implementation of a Performance-Based Financing (PBF) system, the strengthening of the supply of healthcare services, and the improvement of public health emergency preparedness and response. PBF seeks to improve service delivery and efficiency through a system of providing incentives to health care providers and facilities based on their performance or meeting targets. The proposed PBF scheme focuses on the screening and management of Non-Communicable diseases at the Primary Health Care level. The PBF scheme primarily aims at the improvement of the quality of care for NCDs such as diabetes and hypertension.

To further execute the second component, steps will be taken to strengthen the supply of services at the primary health facilities and build capacity of the staff within the Department of Health and Wellness.   The HSSP will support the Department of Health & Wellness in identifying and addressing gaps in service provision inclusive of infrastructure, equipment, supplies and training of the healthcare sector workers and health facilities to ensure the necessary conditions and skills to provide the services. A health facilities assessment will be undertaken in the next few months as a first step to addressing service provision gaps in the primary health care setting.

 As part of the efforts to strengthen the healthcare system’s response to new and emerging diseases such as COVID-19 and Ebola and to address the growing threats of climate change in Small Island Developing States, specifically Saint Lucia, the HSSP also aims to address the weaknesses in the Public Health Emergency Preparedness and Response. This will involve improvements in surveillance and information systems, strengthened laboratory capacity, and preparedness for public health emergencies.

The third component will support project implementation efforts; including project management, fiduciary tasks, and Monitoring & Evaluation. The HSSP will be managed by a stand-alone Project Implementation Unit (PIU), located within the Department of Health and Wellness. The PIU is responsible for the execution of the project components which includes oversight of refurbishment projects, compliance with local safeguards and local permit requirements during refurbishments/rehabilitations.

The final component christened as the Contingent Emergency Response Component (CERC) is geared towards strengthening the capacity of Saint Lucia to respond to any eligible emergency. This component allows the country to reallocate funding from other components of the project to respond to any emergency which must be approved by the borrower. In this context the borrower would be the Government of Saint Lucia. The CERC has been activated in the event of the current public emergency, created by the COVID-19 Pandemic, and contains actions agreed to by the Government of Saint Lucia and the World Bank Group. Currently, the HSSP is procuring the required supplies and equipment to support the COVID-19 response.

The Project is not expected to have any negative social impacts over the four years of implementation, however, any person who feels that they have been negatively impacted by activities conducted under the project, can lodge a complaint via the established Grievance Redress Mechanism.  These complaints can be submitted in writing to the Permanent Secretary in the Department of Health and Wellness or via telephone number 1-758-468-6433.