ࡱ> LNM( / 0DArialngsd1(0(z[ 0 DTimes New Roman(0(z[ 0  DWingdingsRoman(0(z[ 0 @ .  @n?" dd@  @@`` PG        0AA@83ʚ;ʚ;g4PdPd@z[ 0ppp@ <4ddddl 0<1 80___PPT10 ? %O  =HEALTH SYSTEM CONTEXT&Working Group #1 Questions 1, 2, and 9Working Group MembersVishwa Mahadeo GUY Ann De Roche SAV Samuel Deane BAR Serge Lafond Health Canada Marjorie Parks BEL Bonne Richardon Lake ANG Elly Van Kanten SUR Marilyn Entwistle PAHO TRT ~-(     Demographic Trends DataNo Urban/Rural distinction in Anguilla and Barbados Collected data in the census but not available for all years requested in Table 1 (5 year periods) Additional distinction for some countries is remote/hinterland e.g. Guyana and Surinam "ZZDemographic Trends DataData on Urban/Rural distinction is not applicable to Anguilla & Barbados Data is available for indicators but there is not the capacity in some countries to analyse data by gender (SAV); however, it is available in other countries ,5`DDemographic Trends DataWithin last 5 years, countries have done censuses  beforehand, estimates Data on migratory balance unavailable  difficult to assess magnitude of illegal immigrants When providing data for rates, important to also provide absolute numbers if population is small Z Demographic Trends DataDifficulty in providing information on prevalence of exclusive breastfeeding - data would not be reliable Clarification needed if data unavailable for all the years within the time frame  is the reported figure an average of data available $5  Demographic Trends DataIf data is not disaggregated then how should data be presented e.g. data only available on a national level How should data be handled when only syndromic cases are reported & not confirmed  & Demographic Trends Data8Data on incidence of positive sputum-smears microscopy now available with introduction of DOTS  however data not available back to 1990 Annual incidence of HIV/AIDS  should be explicit in stating confirmed cases  should it be annual incidence of HIV & annual incidence of AIDS? ( Demographic Trends DataCould we introduce another indicator asking for incidence of HIV-TB co-infected persons? Mortality Rate Data  for some countries, data on ethic groups is unavailable Mortality Rate Data  if urban/rural, then should also include remote/hinterland Z Demographic Trends DataHMortality Rate Data  need to define  other External causes  Needs to be Defined Nutritional deficiencies as a cause of infant mortality limited to malnutrition  Process of Data CollectionReliance on stakeholders Difficulty in accessing information from private sector and reliability of data is questionable National Conferences of Regional Health officers in Guyana to discuss the data over periods  $Table 9 Constraints/Enabling FactorsData on prevalence of depression unavailable  constraint is under-reporting (only for mental health) or not reported at all Data on domestic violence is under-reported Child labour rate  BEL has official info  not known/collected for other countries J $Table 9 Constraints/Enabling FactorsDisaggregated data (i.e. by gender, by geographic area, by ethnic group) not available for all indicators Data could be presented on a 10 year basis related to the census not on the 5 year interval   , THANK YOU !!!! 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