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Ministerials Paragraphs Related to the Theme Paragraphs VII Summit
Reports
Date:  5/15/2012 
Health-Related Issues
24. The Ministry of Health has indicated that with respect to:

I. Strategies to advance toward universal access to Quality Comprehensive Health Care

25. The Government of The Bahamas has made serious commitments through infrastructural improvements and financial support, as well as provisions for human resources to improve the health of the population while increasing access to high quality comprehensive health care.
26. Through a series of primary health care clinics located throughout the Country, residents on all of the major populated Islands (approximately 30 Islands) have direct access to primary health care services. Secondary and tertiary health care facilities are located in the major population centres of New Providence and Grand Bahama, with the major referral facility being located in the Capital City of Nassau. The Bahamas has recently embarked on a major expansion and renovation of its Government-owned tertiary health care facilities and completed plans for the introduction of new “mini-hospitals” in three of the more populated rural Islands (Family Islands). These improvements are designed to increase access to more specialised services for a greater proportion of the population.
27. The Government has maintained policies that increase access to health care, including the provision of free health care for all children and the provision of free ante-natal care for all pregnant women through Government-owned health care facilities, as well as the recent introduction of the stated National Prescription Drug Plan, designed to allow patients with select chronic conditions to procure their prescription medications, free of charge, from Government-owned as well as private-owned pharmacies throughout the Country. Antiretroviral medications have also been provided free of charge to all HIV-infected individuals since 2003 as part of a programme to decrease the mortality associated with this disease.
Paragraphs: 26 Paragraphs VII Summit: -

Date:  5/15/2012 
II. Reducing maternal mortality and mortality in infants and children under 5 years

28. Deaths due to maternal mortality occur infrequently in The Bahamas, with numbers ranging from 1 to 4 per annum. This is as a result of the policy that all deliveries take place in a health care institution under the supervision of trained health care personnel, which is the case in approximately 99% of all deliveries. Those mortalities that do occur are reviewed to determine if processes were in place that could have prevented them.
29. The low mortality rate for those under 5 years is primarily due to conditions associated with the neo-natal period. This is a result of the increasing number of infants that are born at earlier gestational ages and very low birth weight who are surviving, in large part, due to increasingly complex technologies which act to mitigate the increased risk of complications, particularly neo-natal sepsis. While this remains a focus at the level of the tertiary health care facility, there is also increased attention being given to deaths in children under 5 years as a result of motor vehicles accidents and other causes of external injuries. In recent years, The Bahamas has instituted several initiatives aimed at decreasing injuries and deaths associated with motor vehicle accidents, including the introduction of new seat belt laws and laws that prevent children from riding unrestrained in trucks and other open vehicles. Monitoring the trends in these death rates assists in identifying further interventions to prevent these and other preventable deaths.
30. Deaths due to infectious diseases in children under 5 years are largely a thing of the past. The Expanded Programme on Immunizations (EPI) has been very successful in attaining immunization rates approaching 100% (97.5% in 2009) for infants by their first birthday. This has had an impact on not only infant deaths, but has also resulted in decreasing numbers of cases of vaccine-preventable diseases in children and adults.
Paragraphs: 27 Paragraphs VII Summit: -

Date:  5/15/2012 
III. Reducing the burden of Non-Communicable Diseases and increasing surveillance and reporting systems of the same

31. The Bahamas began monitoring the presence and impact of Chronic Non-Communicable Diseases (CNCD) in 2005 with the first CNCD Risk Factor Survey revealing that approximately 70% of the population was overweight or obese, 7% of the population reported having been diagnosed with diabetes, and 22.9% reported being diagnosed with high blood pressure.
32. The CNCD Unit in the Department of Public Health is responsible for the monitoring of CNCDs in the Primary Health Care Clinics and coordinating the surveillance and reporting of CNCDs for The Bahamas. In 2010, a CNCD register was developed which is designed to gather CNCD data across all of the clinics and provide a single repository for data for analysis and decision-making purposes, as well as to assist in meeting international and regional reporting requirements. This has resulted in improved and more efficient data capture of information relating to CNCDs, the monitoring of the use of best practice protocols to provide outcome data for clinicians, and provide data and reports to improve decision-making for programme changes and implementation.
33. In 2009, The Bahamas joined the CARMEN network, a regional body aimed at increasing surveillance and networking to improve the identification of best practices in CNCD management.
Paragraphs: 28 Paragraphs VII Summit: -

Date:  5/15/2012 
IV. Implementation of the PAHO Regional Strategy on Nutrition and Health Development 2006-2015

34. The Nutrition Unit in the Ministry of Health has been actively engaged in responding to the Regional Strategy on Nutrition and Health in Development since the PAHO Directing Council passed the resolution accepting the strategy in 2006. By 2008, the Unit, key stakeholders and strategic partners had drafted a Food and Nutrition Policy that was diverse in nature and incorporated not only nutrition issues at the agricultural level, but spanned education and health issues and also brought forth policy issues at the governmental level.
35. Through consultations with strategic partners, The Bahamas has been working to strengthen the health care system, inclusive of primary and preventative health and nutrition care. The Nutrition Unit in the Ministry of Health is an integral part of the primary health care system and interacts with key stakeholders such as the Ministries of Agriculture and Education. The Unit also collaborates with the National AIDS Programme, and addresses maternal and child health care, and chronic non-communicable diseases. In addition, the Nutrition Unit provides education to the public, and assists in providing technical advice to develop health policy.
36. The Bahamas continues to work towards a strengthened information management system across the health care sector, but remains challenged at the present time with data separated by different technical platforms and limited knowledge of applying data for effective decision-making. Furthermore, surveillance for nutritional information remains limited by financial and human resource constraints.
37. The Food and Nutrition Policy, which was drafted in 2008, addresses diverse areas such as physical activity, food quality and security, nutrition related programmes and Partner Agency activities and programmes. This policy includes an action plan and a monitoring and evaluation framework to determine the effectiveness of the policy. This policy aligns with the Regional Strategy on Nutrition and Health Development.
38. Further, this Food and Nutrition Policy is designed to build and/or strengthen existing partnerships and networks to improve the nutritional status of the residents of The Bahamas. The Caribbean Food and Nutrition Institute (CFNI) and the Caribbean Community (CARICOM) sub regional networks have worked together to address nutritional issues and needs, and to promote research.
Paragraphs: 29 Paragraphs VII Summit: -

Date:  5/15/2012 
V. Supporting efforts to address malnutrition

39. The Ministry of Health monitors indices of malnutrition in various populations throughout the Country. School Health monitors indices in children in Grades 1, 6 and 10. The Maternal and Child Health Programme monitors indices in infants, children and ante-natal women. The chronic non-communicable disease Programme monitors indices in CNCD patients. The Programmes that address malnutrition span a number of national Programmes and involve key Partners and Agencies to correct nutritional problems in these populations.
40. Social programmes that address nutritional needs cover infants through to the elderly, including those in institutional settings. The School Lunch Programme brings healthy meals to children from poor and lower-income families. Of greater concern are the numbers of persons that are nutritionally challenged by the consumption of foods high in saturated fats and sugars with poor nutritional value, resulting in increasing levels of overweight and obesity. School health programmes have identified an increasing number of overweight and obese children upon entry into school, which is increasing yearly and proportionately within cohorts as they age through Grade 10. The focus on school gardens, by which to increase the intake of fresh fruit and vegetables by students, requires continued commitment and further integration into the school systems throughout the Country to expand their availability to all students.
41. The main national thrust to address malnutrition is undertaken by the Ministry of Health. However, the Ministry of Agriculture and Marine Resources has supported the Garden Based Learning Programme of the Ministry of Education, which was supported by the FAO. Additionally, some schools were provided with greenhouses to assist with agricultural programmes.

42. The Ministry of Labour and Social Development has indicated, concerning nutrition, that the chef at the Simpson Penn and Willie-Mae Pratt Centres has been able to revise the menus for the residents with the aid of the nutritionist at the Sandilands Rehabilitation Centre, thus providing more nutritious and balanced meals.
Paragraphs: 33 Paragraphs VII Summit: -

Date:  5/15/2012 
VI. Health regulations to prevent the spread of communicable and non-communicable diseases

43. The Government of The Bahamas, through the Ministry of Health, the Ministry of Agriculture and Marine Resources and the Ministry of the Environment, along with other key partners and stakeholders, have strengthened the national response and core capacity to meet requirements for the implementation of the International Health Regulations (2005). The Country has met the challenges posed by the influenza pandemic in 2009, a dengue outbreak in 2011, and the risk of the importation of cholera in 2011.
44. Tuberculosis control has resulted in a decrease in the annual number of new cases and its reversal in connection with HIV/AIDS deaths. This has been as a result of a strengthened health care system that has come about partially as a response to the revised International Health Regulations.
45. The Bahamas continues to face unique challenges. The risk of importation of potentially contaminated food items remains ever present, as there is little local production of food and the Country relies almost exclusively on the importation of food items. Trans-shipment of containers will continue to pose a risk for the importation of dangerous substances. However, multi-Agency cooperation and programmes are addressing this risk, and thereby building capacity within the Country.
Paragraphs: 34 Paragraphs VII Summit: -

Date:  5/15/2012 
VII. Millennium Development Goal (MDG) of halting and beginning to reverse the spread of HIV/AIDS by 2015

46. The Bahamas has been in the forefront of HIV/AIDS prevention since the onset of the epidemic. As early as 1985, The Bahamas focused on prevention messages as a means of combating transmission. While prevalence rates in this small Island Nation approach 2% of the general population, The Bahamas has made great strides in reducing transmission rates in selected populations. The Bahamas began offering antiretroviral therapy to HIV-infected pregnant women, free of charge, in 1995, when the AZT studies demonstrated the benefits of ante-natal therapy. More recently, the transmission rate has dropped to 0 for women taking advantage of ante-natal antiretroviral therapy (ART). The challenges that we now face include pregnant women who opt not to receive ante-natal care and thus do not receive ART prior to delivery, and, a highly mobile migrant population that does not present for ante-natal care and also does not receive ART to prevent mother to child transmission.
47. The Bahamas has continued to see a decrease in deaths associated with HIV disease since the introduction of ART for all HIV infected individuals who require treatment. The occurrence of HIV-associated deaths has now shifted to a more mature population, with the largest percentage occurring in the 45 to 64 years age group, highlighting the benefits of ART for long-term survival with HIV disease.
48. With free universal access to ART, persons are living longer lives. The decentralization of HIV health care services has been in the planning stages for several years, and in 2011, the Department of Public Health’s Primary Health Care clinics began routinely managing HIV infected patients. This shift from a more centralized to a more decentralized programme will allow for an increase in access to both health care services and ART.
49. The use of data to drive the design of new programmes and the refinement of existing programmes is essential in continuing to improve the outcomes for this select population. The National AIDS Programme is currently strengthening its information management strategy to improve patient care, monitor outcomes and use data to inform decisions and respond to regional and international reporting requirements.
50. The Bahamas has also recently hosted and cosponsored the 2011 Caribbean HIV Conference: Strengthening Evidence To Achieve Sustainable Action, in November 2011, which was aimed at sharpening the regional focus on HIV, as the Caribbean has the world’s second highest adult HIV prevalence.
Paragraphs: 35 Paragraphs VII Summit: -

Date:  5/15/2012 
Fighting transnational organized crime and illicit trafficking in drugs
88. The Bahamas National Anti-Drugs Secretariat (NADs) has advised that The Bahamas fully supports the position taken by the OAS on transnational organized crime and the global drug trade.
89. The Government of The Bahamas continues to actively participate in regional and hemispheric Bodies such as CARICOM and OAS/CICAD where one of the primary objectives is to address the problem of drugs in all of the thematic areas.
90. The Government of The Bahamas has signed and/or ratified, and continues to adhere to all major Conventions relating to drugs, corruption, firearms trafficking, terrorism, etc.
91. The Government of The Bahamas established a national entity (National Anti – Drug Secretariat) to coordinate the efforts of all those Agencies and Organizations within the Country that are involved in drug control activities.
92. The Government of The Bahamas continues to conduct scientific studies aimed at determining the prevalence of drug use and abuse among key sectors of the population.
93. The Government of The Bahamas established a public/private sector Project (Inner City Transformation Project) with the objective of going into the inner cities to identify the root causes of the problems that create involvement in drugs trafficking, use and abuse, and criminality, with an aim to addressing the problem in a holistic manner.
94. The Ministry of Labour and Social Services has indicated that, until recently, the Staff at Her Majesty’s Prison facilitated group sessions with males who have an association with or used illegal drugs. The staff in the Health Social Services Division of the Department of Social Services facilitates group sessions in drug rehabilitation on a needs basis for the residents at the Simpson Penn Center.
Paragraphs: 30 Paragraphs VII Summit: -

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