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¨đ đHœ(…,,ƒƒžž**   ;"#=%&'ƒ đ0ƒ†AżŔĹA˙@ń÷đ8ó€ó€Đ3ş“°öƚ;­”Çƚ;úgţý4/d/d@¸z[ 0ŕř˙˙âü˙˙pűppű@ <ý4ddddl¸ß 0¨š80Ÿ˙ ˆ8Š0ş___PPT10‹ pľpľ?Ů Ú %đąóŸ¨+Health Sector Reform in Trinidad and TobagoŸ¨ Overview, Issues & Challenges.Ą* (óŸ¨Historical ReviewĄ*Ÿ¨gJulien Commission, 1957 National Advisory council, interim Report, 1978 Toby Commission Report, 1982 ĄL0h#ŞbóŸ¨)Health Sector Reform Program IADB Funded Ą**(ŸŞ óŸ¨ Goal of HSRPĄ  0Ÿ¨Ë To improve the health status of the population by promoting and providing affordable quality health care in an efficient and equitable manner. This goal is supported by five (5) specific objectives: ĄRÉÉ##ó Ÿ¨ ObjectivesĄ  (Ÿ¨^Strengthening the policy-making, planning and management capacity of the health sector; Separating the provision of services from financing and regulatory responsibilities; Shifting public expenditures and influencing the redirection of private expenditures to high priority problems and cost-effective solutions; Establishing new administrative and employment structures, which encourage accountability, increase autonomy and appropriate incentives to improve productivity and efficiency; Educing preventable morbidity and mortality through promoting lifestyle changes and other social interventions. Ą$^PP_ó Ÿ¨ MilestonesĄ  0Ÿ f1989  1992: Eight IADB missions 1992: Government s decision to introduce HSR 1993: Two teams of consultants and local counterparts established 1994: A comprehensive Final Report with 40 Annexes prepared outlining i) proposed models for improvements ii) human resource requirements iii) estimated costs iv) strategy for the way forward [National Health Services Plan] 1994: Development of White Paper and creation of the RHA Act.Ą´P´ó Ÿ¨Features of the NHSPĄ0Ÿ rThe Plan s strategic intent was to guide the MoH in: Achieving significant shifts in resources; Reducing bed numbers; Introducing specialist services; Introducing new technology; Introducing new management and operating systems; Delivering new services based on need; and Effectively work with provider agencies. Ą*55Ş- ó Ÿ¨Critical Success FactorĄ0Ÿ¨The strategies embodied in the NHSP reflected significant changes from the old order. A large-scale program of Technical Assistance, that would provide the necessary institutional strengthening support to the MoH and the RHAs, was therefore critical to the success of the HSRP.ĄZŞ,Ô 5ó Ÿ¨Key Technical RequirementsĄ(Ş  Ÿ¨÷Human Resource and Change Management Strategies (Transition Plan); RHA Management Systems and Protocols; Quality Management; Need Assessment (National Disease Surveillance system); Health System Information Strategy Health Financing StrategyĄzřPD&8#Ş ř ó Ÿ¨Human Resource ManagementĄ(Ş  óŸ¨RHA Management SystemsĄ(Ş  óŸ¨"Health Services Quality ManagementĄ##(Ş # óŸ¨Health Needs AssessmentĄ(Ş  óŸ¨Health Information Systems Ą(Ş  óŸ¨Health FinancingĄ(Ş  ó  Ÿ¨ ConclusionĄ  Ş  Ÿ „HSR objectives were on target. 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Ą{{Ş&0  H Śř @`€đí đˆ Ł đ<€äÚl żƒżŔ˙?đP!X ň  đyŸ¨Decentralised decision makingĄŞ  Śř @`€đ đˆ Ł đ<€4äl żƒżŔ˙?đPň X Ă  đ‘Ÿ¨5Reductions in operation costs through bulk PurchasingĄ66Ş 6 Śř @`€đŕ đˆ Ł đ<€<íl żƒżŔ˙?đX ĺ`! đlŸ¨ ChallengesĄ  Ş  Śř @`€đâ đˆ Ł đ<€@öl żƒżŔ˙?đPĺX ! đnŸ¨ AchievementsĄ  Ş  Śř @`€đ`B đˆ ƒ đ0żŔËŸo×˙ ?żđPĺ`ĺđZB đ ˆ s đ*żŔËœ1˙ ?żđP!`!đ`B đ ˆ ƒ đ0żŔËŸo×˙ ?żđPĂ `Ă đ`B đ ˆ ƒ đ0żŔËŸo×˙ ?żđPĺPĂ đZB đ ˆ s đ*żŔËœ1˙ ?żđX ĺX Ă đ`B đ ˆ ƒ đ0żŔËŸo×˙ ?żđ`ĺ`Ă đZB đˆ s đ*żŔËœ1˙ ?żđPň X ň đH đˆ ƒ đ0ƒ“ŽŸ‹”Ţ˝hż˙ ?đ ˙˙˙ff3˙˙˙ff™™™™˙˙˙ˆ‘Љş___PPT10‹ië.?Ć•}Í+Dń='ń š˙˙˙˙=ń @Bń +î— ď €ůK0 – đŽ 0đ<Œđ& đ( đ đŒđx đŒ c đ$€Č€ ż˙Hˆđ*P`<đĂ  €  đ žđn đˆ đů] R đ<Œ đ#"ń"Ÿ Ă^rđ]ů RđĂ € đv đ'Œ Ł đ<€ř € żƒżŔ˙?đĺ ™ R đŸ ’Following key areas still absent: " Risk Management Policy Framework " Health Technology Assessment policy and guidelines " Inventory Management and " Review of Medical Record Policy and Procedures Ą*Ę"§Ş Ę Śř @`€đ( đ%Œ Ł đ<€ü€ żƒżŔ˙?đůr ĺ B  đ´Ÿ¨VHealth Services Accreditation Manual for T&T, approved and distributed to stakeholdersĄWWŞ W Śř @`€đ) đŒ Ł đ<€€ żƒżŔ˙?đů™ĺ r  đľŸ¨WReport on Regulating Health care Quality finalised by Quality Management Legal expert ĄXXŞ X Śř @`€đý đŒ Ł đ<€đ)€ żƒżŔ˙?đůB ĺ R đ‰Ÿ¨+Health Services Quality Council operationalĄ,,Ş , Śř @`€đŕ đŒ Ł đ<€Đ+€ żƒżŔ˙?đĺ ] ™ đlŸ¨ ChallengesĄ  Ş  Śř @`€đâ đŒ Ł đ<€h<€ żƒżŔ˙?đů]ĺ ™ đnŸ¨ AchievementsĄ  Ş  Śř @`€đ`B đŒ ƒ đ0żŔËŸo×˙ ?żđů] ]đZB đ Œ s đ*żŔËœ1˙ ?żđů™ ™đ`B đ Œ ƒ đ0żŔËŸo×˙ ?żđůR Rđ`B đ Œ ƒ đ0żŔËŸo×˙ ?żđů]ůRđZB đ Œ s đ*żŔËœ1˙ ?żđĺ ]ĺ Rđ`B đ Œ ƒ đ0żŔËŸo×˙ ?żđ ] RđZB đŒ s đ*żŔËœ1˙ ?żđůr ĺ r đZB đ&Œ s đ*żŔËœ1˙ ?żđůB ĺ B đH đŒ ƒ đ0ƒ“ŽŸ‹”Ţ˝hż˙ ?đ ˙˙˙ff3˙˙˙ff™™™™˙˙˙ˆ‘Љş___PPT10‹ië.?Ć•}Í+Dń='ń š˙˙˙˙=ń @Bń +îîď €ůK0 íđĺPđ ”đ}đ( đ đ”đx đ” c đ$€řD€ ż˙Hˆđ*P`<đĂ  €  đ žđĹđ€ đ'Š7—  đ” đ#"ńŸ Ăđm'7đĂ € đń đ” Ł đ<€TI€ żƒżŔ˙?đ Ć7—  đ}Ÿ¨!First nationwide HNA not yet doneĄ""Ş " Śř @`€đ đ” Ł đ<€ÜP€ żƒżŔ˙?đ'Ć —  đ’Ÿ¨4Baseline Assessment (Situation Analysis) Completed Ą55Ş 5 Śř @`€đŕ đ” Ł đ<€\Z€ żƒżŔ˙?đ Š7Ć đlŸ¨ ChallengesĄ  Ş  Śř @`€đâ đ” Ł đ<€0j€ żƒżŔ˙?đ'Š Ć đnŸ¨ AchievementsĄ  Ş  Śř @`€đ`B đ ” ƒ đ0żŔËŸo×˙ ?żđ'Š7ŠđZB đ ” s đ*żŔËœ1˙ ?żđ'Ć7Ćđ`B đ ” ƒ đ0żŔËŸo×˙ ?żđ'— 7— đ`B đ ” ƒ đ0żŔËŸo×˙ ?żđ'Š'— đZB đ ” s đ*żŔËœ1˙ ?żđ Š — đ`B đ” ƒ đ0żŔËŸo×˙ ?żđ7Š7— đH đ” ƒ đ0ƒ“ŽŸ‹”Ţ˝hż˙ ?đ ˙˙˙ff3˙˙˙ff™™™™˙˙˙ˆ‘Љş___PPT10‹ië.?Ć•}Í+Dń='ń š˙˙˙˙=ń @Bń +îĐ ď €ůK0 Ď đÇ `đ ˜đ_ đ( đ đ˜đx đ˜ c đ$€€ ż˙Hˆđ*P`<đĂ  €  đ žđ§đ€ đ'Š7ß đ˜ đ#"ńŸ ĂX˘đŠ'7ßđĂ € đr đ˜ Ł đ<€ €€ żƒżŔ˙?đ Ć7ß đţŸ zOriginal consultancy was not of the required standard and was aborted Delays in attracting a new National IT Director The Public sector s Information backbone (platform) not yet availableĄ>žF0FŞ ž Śř @`€đh đ˜ Ł đ<€`‹€ żƒżŔ˙?đ'Ć ß đôŸ¨˜Information Technology Strategic Pan including Hardware and software procurement requirements developed. IT strategic Plan revised within last 6 monthsĄ™™Ş ™ Śř @`€đŕ đ˜ Ł đ<€Ź{€ żƒżŔ˙?đ Š7Ć đlŸ¨ ChallengesĄ  Ş  Śř @`€đá đ˜ Ł đ<€ –€ żƒżŔ˙?đ'Š Ć đmŸ¨ AchievementĄ  Ş  Śř @`€đ`B đ ˜ ƒ đ0żŔËŸo×˙ ?żđ'Š7ŠđZB đ ˜ s đ*żŔËœ1˙ ?żđ'Ć7Ćđ`B đ ˜ ƒ đ0żŔËŸo×˙ ?żđ'ß7ßđ`B đ ˜ ƒ đ0żŔËŸo×˙ ?żđ'Š'ßđZB đ ˜ s đ*żŔËœ1˙ ?żđ Š ßđ`B đ˜ ƒ đ0żŔËŸo×˙ ?żđ7Š7ßđH đ˜ ƒ đ0ƒ“ŽŸ‹”Ţ˝hż˙ ?đ ˙˙˙ff3˙˙˙ff™™™™˙˙˙ˆ‘Љş___PPT10‹ië.?Ć•}Í+Dń='ń š˙˙˙˙=ń @Bń +îľ ď €ůK0 ´đŹpđ œđDđ( đ đœđx đœ c đ$€DĽ€ ż˙Hˆđ*P`<đĂ  €  đ žđŒđ€ đ'Š7:  đœ đ#"ńŸ Ă˜đŠ'7: đĂ € đ„ đœ Ł đ<€tŠ€ żƒżŔ˙?đ "7:  đŸ ´Numerous aborted attempts at new financing strategies have led to stakeholders scepticismĄ[[Ş [ Śř @`€đ: đœ Ł đ<€ź–€ żƒżŔ˙?đ'" :  đߨhNew Technical Secretariat to spearhead alternative financing for the sector implemented within last yearĄiiŞ i Śř @`€đŕ đœ Ł đ<€Řť€ żƒżŔ˙?đ Š7" đlŸ¨ ChallengesĄ  Ş  Śř @`€đâ đœ Ł đ<€8ŀ żƒżŔ˙?đ'Š " đnŸ¨ AchievementsĄ  Ş  Śř @`€đ`B đ œ ƒ đ0żŔËŸo×˙ ?żđ'Š7ŠđZB đ œ s đ*żŔËœ1˙ ?żđ'"7"đ`B đ œ ƒ đ0żŔËŸo×˙ ?żđ': 7: đ`B đ œ ƒ đ0żŔËŸo×˙ ?żđ'Š': đZB đ œ s đ*żŔËœ1˙ ?żđ Š : đ`B đœ ƒ đ0żŔËŸo×˙ ?żđ7Š7: đH đœ ƒ đ0ƒ“ŽŸ‹”Ţ˝hż˙ ?đ ˙˙˙ff3˙˙˙ff™™™™˙˙˙ˆ‘Љş___PPT10‹ië.?Ć•}Í+Dń='ń š˙˙˙˙=ń @Bń +î•ď €ůK0 ”đŒŔđpđ$đ( đ đpđr đp S đ€Ŕ˝€ ż˙Hđ*P`<đĂ  €  đ žđr đp S đ€h´€ ż˙HđĺP`pđĂ €  đ žđH đp ƒ đ0ƒ“ŽŸ‹”Ţ˝hż˙ ?đ ˙˙˙ff3˙˙˙ff™™™™˙˙˙ˆ‘Љş___PPT10‹ië.Ć@^ŃH+Dń='ń š˙˙˙˙=ń @Bń +r\pč3@éHžKjPGN PS°UMXęZä ‡]`$`÷jşuYƒOŒ'—ő? Ł™ ţ˙ŕ…ŸňůOhŤ‘+'łŮ0ˆ hp¤źĚ đü  , 8DLä,Health Sector Reform in Trinidad and TobagoAndrea YearwoodRefinedCaroline Azolino Ramagemrin19oMicrosoft Office PowerPoint@,ľÝ(@Ŕ¸1ó€Ć@€‡šȅĆ^G2˙˙˙˙‰g  ‘4  xőü-ú˙˙˙- @ !đxő˙˙˙˙ú-ü˙˙˙-'˙˙-- @ !đ0Ě--ú˙˙˙-ü- $IŕIŕ--đ'˙˙ú˙˙˙-- $EÚEÚ--đ'˙˙ú™--%2ĂÂĂ--đ'˙˙űŐ˙@Times New Roman-. ˙˙˙2 ]‡Health Sector     .űź"Systemdiä-đűŐ˙@Times New Roman-. ˙˙˙$2 †UReform in Trinidad      .-đűŐ˙@Times New Roman-. ˙˙˙2 Ż— and Tobago .-đűä˙ź@Times New Roman-. ™42 üDOverview, Issues & Challenges.      .-đţ˙ŐÍ՜.“—+,ůŽ0tˆ¨ÄĚÔÜ ä ěô ü   äOn-screen ShowoMinistry of Healthu ¤tA ArialTimes New Roman WingdingsRefined,Health Sector Reform in Trinidad and TobagoHistorical Review*Health Sector Reform Program IADB Funded Goal of HSRP Objectives MilestonesFeatures of the NHSPCritical Success FactorKey Technical RequirementsHuman Resource ManagementRHA Management Systems#Health Services Quality ManagementHealth Needs AssessmentHealth Information Systems Health Financing Conclusion  Fonts UsedDesign Template Slide Titlesö0_Ŕ‘ăĺŁôž Caroline Azolino RamagemCaroline Azolino Ramagem  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRţ˙˙˙TUVWXYZţ˙˙˙\]^_`abţ˙˙˙defghijţ˙˙˙ý˙˙˙mţ˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Root Entry˙˙˙˙˙˙˙˙d›Oφꪚ)čţ˙˙˙Current User˙˙˙˙˙˙˙˙˙˙˙˙cSummaryInformation(˙˙˙˙˙˙˙˙SPowerPoint Document(˙˙˙˙ ¤DocumentSummaryInformation8˙˙˙˙˙˙˙˙˙˙˙˙[˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙