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Caribbean Islands
Index
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.
Data as of November 1987
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