SEYCHELLES NATIONAL HEALTH STRATEGIC PLAN

SEYCHELLESNATIONALHEALTHSTRATEGICPLAN2016- LLESNATIONALHEALTHSTRATEGICPLAN.docx23122015

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ain areaHEALTH IMPACTIndicator1.2.3.4.5.6.7.8.9.Health impacttrendsLife expectancy at birthInfant Mortality rate (per 1,000)Under five mortality rate (per 1,000)Maternal Mortality Ratio (per 100,000)Neonatal Mortality Rate (per 1,000)Total Fertility RateAdolescent fertility rateAIDS-related mortality rateMortality between 30 and 70 years of age from cardiovascular diseases, cancer, diabetes or chronicrespiratory diseasesMortality by key conditions of public health concern1.   Leptospirosis mortality2.   Mortality from road traffic injuriesIncidence of key conditions of public health concern,1.   Hepatitis C incidence,2.   HIV incidence,3.   Measles incidence rate,4.   Cancer incidence by type of cancer ,5.   Sexually transmitted infections (STIs) incidence rate6.   Renal disease incidence7.   Self harmPrevalence of key conditions of public health concern1.   HIV prevalence rate2.   Hepatitis C prevalence3.   Contraceptive prevalence rateService4.   Client satisfaction indexresponsivenessHEALTH & RELATED SERVICES OUTCOME TARGETS1   Immunization coverage rate by vaccine for each vaccine in the national schedule2   Antenatal care coverage3   Postpartum care coveragePrevention and4   Percentage of HIV positive pregnant women provided with ART to reduce the risk of mother to childcontrollingtransmission during pregnancycommunicable5   Percentage of hepatitis C positive patients on treatmentdiseases6   Vector population- leptospirosis (to be defined – COMBI Plan)7   Mosquito density – vector borne diseases8   Percentage of patients with STIs on treatment (to be defined)Environment1.   Population using safely managed drinking-water services2.   Population using safely managed sanitation servicesPromoting andNutritionprotecting3.   Incidence of low birth weight among new-bornshealth4.   Anaemia prevalence in children5.   Anaemia prevalence in women of reproductive age6.   Percentage of under-fives with stunting7.   Exclusive breastfeeding for 6 months1.   Total alcohol per capita age 15 years) consumption2.   Tobacco use among persons aged 18 yearsPreventing and 3.   Children aged under 5 years who are overweight4.   Overweight and obesity in adults & adolescentscontrolling noncommunicable5.   Raised blood pressure among adultsconditions6.   Raised blood glucose/diabetes among adults7.   Insufficient physical activity8.   Illicit drug use (to be ocx23122015BaselineTarget (2020)

Domain areaIndicatorCoverage of services for severe mental health disorders (to be defined) and neuro-degenerativedisorders (Alzheimer's, MS, Parkinson's, etc)10.   Screening for breast, cervical and colorectal cancerInjuries11.   Intimate partner violence prevalence12.   Incidence of injuries caused by RTAs1.   Abortion rate2.   Percentage of women of child bearing age using modern contraceptive methods vs couple years ofprotectionProviding3.   Proportion of population testedessential4.   People living with HIV who have been diagnosedclinical andrehabilitative5.   Antiretroviral therapy (ART) coverageservices6.   Percentage of persons on ART with undetectable viral load7.   Number of cases of Methycillin Resistant Staphylococcus aureus ( MRSA) above epidemic threshold8.   Clinical output indicator (to be defined)OUTPUT TARGETS1.   Outpatient visits per capita2.   Hospital bed occupancy rateImprovingaccess3.   Average waiting time –specialist outpatient & community facility outpatient4.   Occupied bed nights1.   Average length of stay2.   Perioperative mortality rate3.   Number of hospital acquired infections4.   Proportion of preventable maternal deathsImprovingquality of care5.   Proportion of preventable infant deaths6.   Proportion of inpatient deaths7.   Proportion of health facilities that are ready to provide services8.   Community health services quality (define quality index)THEMATIC AREA TARGETS1.   Availability of clinical pathways for the 10 most common conditionsStrengtheningintegrated2.   Referralshealth care3.   Availability of essential medicines and commodities (to be defined)1.   Health worker distributionHumanresources for2.   Output training institutionshealth3.   Health worker density1.   Total current expenditure on health (% of gross domestic product)2.   Current expenditure on health as percentage of general government expenditureSustainablefinancing for3.   Out-of-pocket payment for health (% of current expenditure on health)health4.   Externally sourced funding (% of current expenditure on health)5.   Total capital expenditure on health (% current capital expenditure on health)1.   Percentage of health budget spent on researchResearch and2.   Number of thematic areas with ongoing / new researchinnovation3.   Number of best practices based on application of innovative technologies.1.   Proportion of partnerships in conformity with the health sector coordination and partnershipframeworkPartnership,participation2.   Proportion of health coordinating bodies in conformity with the health sector coordination andandpartnership frameworkcoordination3.   Stakeholders regularly provide input to government and health provider organizations aboutpriorities, services, and resources.1.   Regulatory: Implementation of health sector legislation and regulations monitored annually2.   Accountability: annual Health of Our Nation reviewGovernanceand leadership3.   Efficiency: sector efficiency (to be defined; methodology DEA- Data envelopment analysis )4.   Stewardship: Proportion of strategies with clearly defined multisectoral approaches1.   International Health Regulations (IHR) core capacity indexInformation2.   Percentage of facilities reporting complete, timely and accurate reports3.   Percentage of facilities reporting using electronic health records systemBaselineTarget cx2312201590%0

TEGICPLAN.docx23122015

ListoftablesTable1:Seychellesage- ‐specificmortalitytrends,2010- ure2:Seychellespopulationtrends,2010- putsfromthehealthsystemvi P a g e46721Error!Bookmarknotdefined.29

DefinitionsAbortion: Termination of a pregnancy before it is viable as an independent life outside of the womb. This can occur spontaneously,or be induced by external actions. Current medical expertise can sustain a viable life outside the womb from 24 weeks of gestation.As medical expertise improves, this should reduce further.Disease: Any condition that causes pain, dysfunction, distress, social problems, and / or death to the person afflicted, or similarproblems for those in contact with the person. It may be caused by external factors, such as infectious diseases, or by internaldysfunctions, such as cancers. Diseases usually affect people not only physically, but also emotionally, as contracting and livingwith many diseases can alter one's perspective on life, and their personality.Emergency: Any event / crisis that exceeds the community’s ability to respond.Emergency Health services: Health care services necessary to prevent and manage the damaging health effects from anemergency situation. It involves services across ALL aspects of health care services, and includes first aid treatment of ambulatorypatients and those with minor injuries; public health information on emergency treatment, prevention, and control; andadministrative support including maintenance of vital records and providing for a conduit of emergency health funds acrossGovernment.Essential Health Services: The set of health promotion, disease prevention, curative and rehabilitative services and theirinterventions that are critical to addressing the health needs of the population in Seychelles. The purpose of the health system isto facilitate delivery of these services to the people that need themHealth: A state of complete physical, mental and social well-being and not merely the absence of disease or infirmityi . This isensured through actions in health and related sectors through addressing all determinants of healthHealth care professionals: The workforce that delivers the defined Essential Health Services. The workforce includes all thosepersons whose prime responsibility is the provision of health care services guided by a formal training received, irrespective oftheir organizational base (public, or non-public). The workforce is specific to the respective health services for which they havereceived training.Health System: The mechanism to ensure access to quality health care services as demanded by the population, when andwhere they need them. This requires an appropriate mix of inputs that are available, functional and ready to provide services(health workforce, infrastructure and medicines/supplies), together with appropriate processes to assure efficient use of theseinputs (systems for organization of service delivery, financing, governance, information and research).Humanitarian actions: All actions to mitigate effects of an emergency. These include emergency health services.Illness: A state of poor health. When conditions of health are not fulfilled, one can be considered to have an illness or be ill.Incidence: The number of new cases of a variable of interest, in a defined period of time for a given populationInjury: Physical damage to a personMedical Care Services: The management of disease, illness, injury, and other physical and mental impairments in humans. Thisinvolves diagnosis, treatment and rehabilitation of persons, following a disease, illness, injury or other impairment. As opposed topublic health services focusing on population health, it is concerned with managing of individual healthMortality: Susceptibility to death. While this is a natural event, avoidable mortality is not. The health sector seeks to prevent deathsdue to avoidable eventsPrevalence: The proportion of the population having a variable of interest – be it a disease, or risk factorPublic Health Services: The health care services concerned with the science and art of preventing disease, prolonging life andpromoting health through the organized efforts and informed choices of society, organizations, public and private, communitiesand individuals" It is concerned with threats to the overall health of a community.Referral: The process by which a tier of health services that has inadequate capacity to manage a given health condition or event,seeks the assistance of a higher level of health care delivery to guide, or take over its management. It ensures establishment ofefficient health service delivery system linkages across levels of care that ensure continuity of care, for holistic management ofhealth needs of the population.Referral health services: The health care services whose function is specifically to manage, or facilitate the referral process.These services are defined, for different levels of health care delivery.Routine Health Services: Health care services necessary to prevent and manage the damaging health effects from nonemergency situations. It involves services across ALL aspects of health care services.vii P a g e