St Lucia is an island nation in the Caribbean, which obtained full independence from the United Kingdom of Great Britain and Northern Ireland in 1979 and remains a member of the Commonwealth of Nations. With a per capita million, the World Bank Group classifies Saint Lucia as an upper middle income country.
In 1997, the government of Saint Lucia constituted a Health Sector Reform Task Force, which led to the approval of the 2000 Health Sector Reform White Paper. The paper examined various health financing options, which ultimately led to a first phase of universal health coverage (UHC) implementation in 2022. This included free drugs for diabetes and hypertension, as well as free primary health care at the time of use for an essential care package including vaccination, HIV/AIDS drugs and diagnostics, and treatment and drugs for communicable diseases such as Hansen’s disease and tuberculosis. The country’s Ministry of Health, Wellness and Elderly Affairs (MOHWEA) continues to work on improving health financing UHC and recently finalized a new white paper specifically on UHC.
Health financing sustainability in question
Multiple challenges and a range of potential approaches
The 2024 White Paper on Universal Health Coverage recognizes that OOP spending remains high in Saint Lucia, above the Caribbean (30.6%) and Latin America and Caribbean (28.1%) averages in 2021, and that government expenditure on health as a share of general government expenditure should be closer to the 15% Abuja target. Furthermore, the white paper quotes a report stating that health coverage is low and skewed to the better off.
The government of Saint Lucia is committed to advancing UHC and recognizes that health financing reform is crucial, despite cost pressures. The mix of above-mentioned health financing sources composing CHE in the country demonstrates a need to address equity and access issues, especially high OOP spending.
A UHC unit exists within the MOHWEA to spearhead efforts, supported by the World Bank Group. The current World Bank Group International Development Association loan will include analysis of further services to be included in the package of primary care – provided free of charge at point of use at first level health care services – and the implementation of a performance-based financing pilot.
References
[1] World Health Organization, Global Health Expenditure Database, Indicators and Data (choose country)
[2] World Health Organization, Global Health Expenditure Database, Health Expenditure Profile (choose country)
