The Bahamas Infant Mortality Rate Increases

Official Opposition Leader, Hubert Ingraham raised alarm over The Bahamas Infant Mortality Rate increase by stating that efforts by his administration drove the infant mortality rate from more than 24 per thousand live births to below 12.

"We expected to bring it to single digits by 2004," he said.  "Instead, under this neglectful government it has risen again to 19 per thousand live births.  Why are we moving in reverse?"

Infant Deaths Climbing

By Candia Dames

Nassau, The Bahamas

26 April 2006

Statistics from the Ministry of Health’s Information and Research Unit confirm a recent claim made by Opposition Leader Hubert Ingraham that the country’s infant mortality rate is on the way up.

Mr. Ingraham raised alarm over the increase Monday night saying that efforts by his administration drove the infant mortality rate from more than 24 per thousand live births to below 12.

"We expected to bring it to single digits by 2004," he said.  "Instead, under this neglectful government it has risen again to 19 per thousand live births.

Why are we moving in reverse?"

The infant mortality rate is considered internationally to be a sound indicator of a nation’s health and development.

Information from the Ministry of Health, however, does not provide any evidence to show that the figure has risen to 19.  The most recent data available is for the year 2004 when the rate was 17.3 deaths per 1,000 births, up from 12.7 deaths per 1,000 in 2001.

Minister of Health Dr. Bernard Nottage was not available yesterday to comment on the matter, as Tuesday is a day when the Cabinet meets most of the day.  But in a press statement issued early yesterday, he responded to Mr. Ingraham’s claim by saying only that there is no connection between the infant mortality rate and a shortage of vaccines.

No other health official would return the Journal’s calls yesterday either, but the Journal was able to obtain a copy of what is reportedly the minutes of a meeting of health officials that took place on Friday.

In the minutes, a senior nursing officer stated that the meeting had been called to discuss the minister’s mandate to strategize ways to reduce the infant mortality rate and the maternal mortality rate "as both were on the rise".

Officials reportedly plan to convert the Blue Hill Road Clinic into a Child Health facility, while Flemming Street Clinic will be converted into a Women’s Health Clinic, run by midwives.

The senior nursing officer quoted in the minutes impressed upon the midwives that should the need arise, they should inform persons inquiring about the vaccine shortage that supply should be available in about two weeks.

She said that the midwives should explain that the government does not owe any money for vaccines, but that there was a misunderstanding between the Ministry of Health and the Pan American Health Organization (PAHO), which has since been cleared up.

In its statement to the press yesterday, the Ministry of Health acknowledged that there is a shortage of supply of the Measles Mumps Rubella (MMR) vaccine due to an error in the billing by its suppliers.

The ministry said through no fault of its own, the suppliers had failed to send an invoice for some $865 and held up the latest order when they did not receive payment.  It is this mistake, the ministry said, which was corrected as soon as it was discovered.

"I am happy to report, however, that an inventory has been carried out, which confirms that we do have in stock a supply of all vaccines, including MMR, although some individual clinics may not have supplies in their possession," Dr. Nottage reported in that statement.

"Additionally, there is a shortage of one of the components of the Pentavalent vaccine, and that is due to the fact that the manufacturer sent us supplies with differing expiration dates.  There is no shortage of Polio, Diphtheria, Pertussis or Tetanus vaccines, all of which are in adequate supplies."

Dr. Nottage indicated that his ministry had made arrangements to obtain those vaccines that were in short supply and expected the delivery of those vaccines yesterday, which should be available to the public today.

But as mentioned, the statement said very little about the infant mortality rate.

In the health meeting minutes, another senior nursing officer in response to queries from the midwives present regarding the shortage of family planning/contraceptive methods said that there were no monies available for the purchase of these methods.

She indicated that at present her unit had only one inject - able method and few oral methods available.  The senior nursing officer said she would seek permission to inform clients of the situation via mass media or by notices posted in the clinics to avoid a disclosure similar to that made by Mr. Ingraham regarding the vaccine shortage.

The Promised National Health Insurance (NHI) Plan in The Bahamas

No Definite Plan on How National Health Insurance Would Be Financed in The Bahamas

Timing of National Health Insurance Remains Uncertain

By: Candia Dames

candiadames@hotmail.com

Nassau, The Bahamas

21 October 2005

It remains unclear whether the government will establish the promised National Health Insurance Plan before the end of this term, but Prime Minister Perry Christie said on Wednesday that he is still committed to making such a scheme a reality.

The National Health Insurance Plan was a major campaign promise of the Progressive Liberal Party in 2002, with Mr. Christie continuing to tout the importance of it as prime minister.

Early in his term, he appointed a 15-member Blue Ribbon Commission on National Health Insurance, headed by Dr. Perry Gomez, to examine the feasibility of such a scheme.

On Wednesday, Member of Parliament for South Andros Whitney Bastian asked Prime Minister Christie whether national health insurance will be in place before the end of this term.

It was a question that the prime minister failed to answer in any specifics, saying only that Cabinet will make a decision on that.

He did, however, point to the "urgency" of looking into such a plan.

"From a personal point of view I wanted it to happen," he said.  "Cabinet obviously has to make a decision on it.  It is something that I heralded from the platforms during the last campaign.  It is something that I have always believed to be of vital importance to the poor of this country."

Mr. Christie said the recent poverty study tabled in the House of Assembly by Minister of Social Services and Community Development Melanie Griffin is evidence that there is a significant portion of the population desperately in need of national health insurance.

The poverty study found that just under 10 percent of the population is living below the poverty line.

"Poverty obviously creates a real problem in our country, particularly as you go to the islands," the prime minister acknowledged.  "When you reach Andros and go farther south it’s from 12 percent to 20 percent."

The prime minister did not give a timeline, but he said that he will make a communication to parliament as soon as his government makes a decision on national health insurance.

Dr. Gomez told The Bahama Journal several months ago that the government had appointed a planning committee to formulate specifics as it relates to national health insurance after signing off on all of the recommendations of the commission.

But while the committee was working aggressively to come up with the right formula for the scheme, it had not yet come up with a definite plan for how national health insurance would be financed, he said at the time.

Nevertheless, he indicated that the plan is no longer a matter of "if", but "when".

"The social health insurance levels the playing field in health," Dr. Gomez told The Bahama Journal.  "I believe that health is a right of individuals, not a gift; it’s not a privilege.  All people are entitled to the best of health care that their countries can afford, regardless of the individuals’ ability to pay.

"That’s a problem we have in our country to a large extent.  There is a discrepancy between the health care of the haves and those who have not and I think the best way of trying to address this issue is by finding some means of insuring the entire population and the best way to do that from all I have looked at and the Blue Ribbon Commission has studied is through this programme of social health insurance."

At the time, Dr. Gomez indicated that the development of the scheme is "highly technical" and he indicated that one of the more difficult challenges faced by authorities is coming up with a cost structure for the plan.

Educating Women on The Deadly Disease HIV/AIDS in The Bahamas

The HIV/AIDS transmission rate in The Bahamas is an important success story

Rapid Growth Of HIV In Females

By Candia Dames

candiadames@hotmail.com

Nassau, The Bahamas

29th November 2004

Women in The Bahamas have caught up with men in new HIV cases, prompting serious concerns for health officials.

Although the number of new HIV infections declined for a third consecutive year in 2003, the fact that more and more women are being infected with the virus that causes AIDS means that there needs to be renewed focus placed on educating women on the deadly disease, according to Nurse Rosa Mae Bain, director of the HIV/AIDS Centre.

Last year, 289 cases of HIV were reported. This compares to 332 in 2002- 385 in 2001 and 404 in 2000, according to health officials. Around the world 38 million people are infected.

In the early years of the epidemic, men far outnumbered women in new cases.

But that has changed.

The ratio of males to females is now 1:1. The disturbing trend is a global one, according to health officials.

So it is no coincidence that women and girls are the focus of this year’s World Aids Day on December 1.

“We as women have caught up with and in some countries have even past the men,” she said.  “Consequently, we need to focus in on women being able to negotiate safer sex practices.  That is crucial.  We need not to be getting infected.”

She said, “Women, because they account for all these single homes are the people out there providing that nurturing to the bulk of our children.  So the message that we want to give is ‘look, you men support our women.  Provide them with the support so that they can use preventative methods so that they do not become HIV infected’.”

Nurse Bain said women are particularly vulnerable because they tend to allow their partners to take the lead in safe sex practices.

Around the world this week, it will be a time of remembrance for the millions of people who have died from AIDS.  It will also be a time to focus on the 14 million children who have been orphaned by the disease.

Nurse Bain said AIDS orphans are also a serious concern in The Bahamas, but she said new drugs are making it possible for people to live longer, which means that the numbers of orphans are getting smaller.

Because of antiretroviral medications, she said, there are also fewer and fewer babies who are becoming infected with HIV from their mothers.

The percentage is now down to 3 percent, according to Nurse Bain.

“If we look at the statistics closely we would find that not one mother who attended the clinic, who took her medication, who kept all her appointments had a baby born HIV positive,” she said.  “That three percent was because we had a cohort of pregnant persons who did not attend so consequently they did not receive the medication and their baby was born positive and that’s why we’re still at three percent.”

She said the reduction in the transmission rate in The Bahamas is an important success story.

Another success, she said, is that the children who were born with the virus are living to see their teen years.

“Yesteryear, most of our children died before their first birthday, but with the use of anti-retrovirals or the use of AIDS medication as we call it- these children now look good, they feel good, they’re in school and we need to go to another level and provide them with a home setting.” 

The Bahamas is The Only Country in The Region that is Witnessing A Downward Trend in New HIV Cases

Anti-AIDS Education Programme Yields Positive Results Throughout The Bahamas

New HIV Cases Decline 

By Candia Dames

candiadames@hotmail.com

Nassau, The Bahamas

15th November-2004

The number of new HIV cases reported in 2003 declined for the third consecutive year, but health officials say there are still serious concerns regarding the spread of the deadly virus in the country.

Last year, 289 cases were reported.  This compares to 332 in 2002; 385 in 2001 and 404 in 2000, according to newly released numbers from the Infectious Disease Division of the Princess Margaret Hospital and the Department of Public Health.

The most recent figure is also the lowest number of cases reported in a given year since officials reported 710 cases in the period 1986-1988.

Director of the HIV/AIDS centre Nurse Rosa Mae Bain reported that The Bahamas is the only country in the region that is witnessing a downward trend in new HIV cases.

She believes this positive trend has resulted from a consistent anti-AIDS education programme throughout The Bahamas.

“We’re marketing the condom use because it’s crucial that everybody who has sex with somebody knows the status of their partner,” Nurse Bain said.  “If they don’t know, then they need to protect themselves with the condom.”

Her department is also getting set to launch a marketing campaign promoting the use of the female condom.

“They’ve been available for a while, but we’ve not really pushed it,” she said.

Officials of the National AIDS programme have also expanded their outreach in schools, working with grade six students encouraging them to delay the initiation of sexual activity.

“What we are also doing is training them if they are sexually active to protect themselves, that is crucial.  They need to know about the availability of condoms, how to store them; how to use them; how to put them on and how to take them off,” Nurse Bain said.

The new numbers also show that the sexually active age group 15 – 44, continues to be the main group of people infected with the virus that causes AIDS.

AIDS is the leading cause of death in the age group 15 – 29.

The National AIDS programme has monitored the epidemic since 1983.  As of December 31, 2003, there was a cumulative total of 9,725 total HIV infections, 4,758 cases of AIDS and 4,697 persons who are non-AIDS HIV positive.

Of the total 4,758 cases of AIDS, 3,309 have died.  Of the total 9,725 infections, 6,920 occur in young adults between the age group of 15 – 44.  The ratio of males to females infected with HIV is now 1:1.

Nurse Bain said there is still a serious concern as it relates to older men passing the virus on to young girls.

It’s a dilemma authorities continue to tackle.  They say because of the high numbers of single mother homes, many girls are often easily enticed by material possessions and are therefore more inclined to have sex with men who can provide these things.

“We’re very well aware that approximately 70 percent of our babies are born to single parents,” Nurse Bain said.  “Because of that, within the home-setting, there is not the male figure…we want to send a message out there, ‘Older men, please leave our young girls alone.’”

There is another practice of grave concern.

Nurse Bain said there are many girls who are engaged in rectal sex as protection from getting pregnant.  They also see it as a way of having sex and remaining virgins.  But she said there is serious danger in this practice.

“Once the lining of the rectum is torn and somebody has HIV, [men] can pass that on very, very quickly to our young girls,” she said.  “This is a concern for both male and females.  Next to blood transfusion, rectal sex is the easiest way to get HIV infected.”

The first clinical case of AIDS was reported in1983 and confirmed on post mortem in 1985.  The first confirmed case of AIDS was reported in The Bahamas in August 1985 when antibody elisa testing became available, according to the Bahamas National HIV/AIDS Programme.

The Bahamas has the highest annual incidence rate of AIDS in the English speaking Caribbean, and is among the three nations with the highest incidence rates in the world.