Jamaica
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Audit of Health Ministry reveals weaknesses in delivery of health services

By Halshane Burke 

A performance audit of the Ministry of Health and Wellness has revealed glaring weaknesses in the delivery of health services.

Low doctor and nurse to patient density and the lack of a prepared plan and protocol in response to previous health crises are among the findings of the inspection conducted by the Auditor General.

The audit report was tabled in Parliament on Tuesday.

The performance audit was undertaken to determine the extent to which the country's institutional framework is progressing to enable a strong and resilient public health system.

It also revealed that the health services suffer from low hospital bed capacity ratios which limit the capacity to adequately respond to public health emergencies.

The audit report also stated that the ministry did not demonstrate that it tracked doctor-to-population and nurse-to-population density in the public health sector to know whether doctors and nurses were sufficiently available to address the health care needs of the population.

The Auditor General said the analysis of population data and the number of doctors and nurses in the public health system revealed a density of 2.71 doctors and nurses per 1,000 people, which is below the global threshold of 4.45 skilled health workers per 1,000 in the population.

The audit further found that despite prepared management plans and protocols in response to previous public health emergencies such as the Zika and Chikungunya viruses, there was no evidence that the Health Ministry assessed and documented the lessons learnt from these health emergencies and incorporated post-event reviews to support response to future health emergencies.

An evaluation of the lessons learnt from the COVID-19 pandemic has not yet been conducted.

Additionally, the audit found that health facilities are working in silos, creating fewer opportunities to build synergies in the sharing of information such as patients' records, prescription drugs, and medical equipment.

The Auditor General said there were administrative weaknesses in how the ministry and the regional health authorities handled preventative and corrective maintenance of public health facilities and medical equipment as well as patient complaints which are critical to the effective delivery of health care.

The recommendation is for better coordination among key stakeholders, particularly the Ministry of Health and the Ministry of Finance to implement the health-related actions under the Vision 2030 national development plan to build the capacity and the resilience of the public health system and to achieve the targets by 2030.