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Feb 14, 2017

PAHO Director in Belize, Talks Cooperation

The Director of the Pan American Health Organization (PAHO), Doctor Carissa Etienne, is on a working visit to Belize since Monday. She has been meeting with a number government officials, as well as with Senior Ministry of Health Officials and various stakeholders. As a part of her visit, Belize signed the country cooperation strategy on Monday night, as well as engaged in a dialogue on health financing.  News Five’s Andrea Polanco has more.


Andrea Polanco, Reporting

The Ministry of Health, PAHO and local stakeholders hosted a dialogue on health financing on Monday night in Belize City. The forum was used to discuss the challenges and accomplishments of the health sector within the multi-sectoral framework. C.E.O. Ramon Figueroa explained that while the Ministry of Health has seen changes over the years – there are still many areas lacking that impact overall health care.


Ramon Figueroa

Dr. Ramon Figueroa, C.E.O., Ministry of Health

“We still continue to have a problem with inadequate supply of well trained professionals. We continue to have some problems in accountability attendance, discipline and customer service. We continue to have few meaningful incentives for human resources within the public sector. So, these are some of the challenges that persist to this day.  In terms of access and equity, I think we are striving to make some positive gains in some of these areas. We continue to have most of our budget still invested in personnel salaries; eighty percent of our budget is still tied to salaries. We still invest quite a bit in curative care as opposed to preventive care. Although, with the new model we started investing a lot more in preventive and primary care.”


Key on the agenda was the signing of the Country Cooperation Strategy 2017-2021. It is a medium-term vision to guide PAHO/WHO’s work in and with the country in support of the country’s national health policies, and plans towards the achievement of the Sustainable Development Goals (SDGs). The CCS seeks to respond to the specific priorities and needs of the country. Central to that discussion is sustainable health financing – something that Belize has struggled with.


Dr. Ramon Figueroa

“The only thing, in my mind, that is holding us back right now is a decision on sustainable financing.It is a difficult decision, I know, at the political level. It is a difficult decision to talk about any particular tax; it is a difficult thing to talk about a health fund because everybody wants it to go into general revenue. And we are saying, all our surveys are indicating that people are willing and able to pay for healthcare– if they are getting the kind of care that we provided in southside. We have done the surveys and people are willing to pay but they also want it to be a separate fun.  Presently, from general revenue we are investing about fifteen million dollars to cover about thirty-three percent of the population right now. Less than half of the population is being covered right now under the NHI scheme and as I said it has been fifteen years. We need to move on; we need to cover the rest of the population.   In Belize we’re only investing three point four percent over public funds into health. If you put public and private you get about four point five – five percent of the GDP. Only twenty to twenty-four percent of our budget is really invested in the primary care, but if we look at the area where we have NHI contracting their budget – ninety percent of that goes to the primary level. The twenty to twenty-four percent is on a national basis. If we realize that sixty to eighty percent of all the health problems can be addressed at the primary level; yet fifty percent of our budget goes to secondary care. Something is wrong.”


PAHO’s Director says that the principles behind financing health services take into consideration universal health coverage and universal access to health with impact on the underprivileged groups – those who can’t afford an increase cost of health services.


Carissa Etienne

Dr. Carissa Etienne, Director, Pan American Health Organization

“We have to be sure that the poor particularly has access to these health services. We have to be sure that that the people who live in vulnerable conditions have access to health care services. So, we have to be sure that they are not impoverished in so doing; that they do not become poor in seeking health services or that they payments when they seek care do not become a barrier to them seeking care. And so we advocate for two things. We need to reduce and the elimination of payment at the point of service – this means when you go to the doctor or the health care service that you pay.”


So to buffer those costs, PAHO says that pooling of resources is imperative. But there are different ways that the Government can increase budget for health services without necessarily passing those costs on to those seeking health care.


Dr. Carissa Etienne

“So we advocate for the pooling of service. We say that it is the Government’s responsibility that we ensure that all people have access to health service, but obviously the government alone can’t make all of the investments. However, we believe that a significant part of the investment must be from the public purse – that is about six percent of the GDP. But what we are advocating for is moving towards the pooling of resources – so government investments that are usually through taxation so you have to make sure you collect the taxes; or national insurance and it can also come from sin taxes such as on cigarettes, sugary drinks and unhealthy foods and some governments make decision to invest some of those taxes into the pooling mechanism.”


Reporting for News Five, I’m Andrea Polanco.

Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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