Health care services improved steadily but slowly in the 1980s. With the exception of their youth and infant populations, both islands enjoyed generally good health by Eastern Caribbean standards. High rates of malnutrition and infant mortality were the worst health problems in the mid-1980s, despite the government's intention to target youths and infants for special health care attention.

Mortality rates in St. Kitts and Nevis went virtually unchanged from 1980 to 1984. Although life expectancy at birth in 1982 was about 70 years and the crude death rate hovered between 10 and 11 per 1,000 inhabitants, neonatal (first month) and infant death rates were the highest in the Eastern Caribbean. The infant mortality rate averaged 43.5 per 1,000 live births between 1975 and 1983, and the neonatal mortality rate averaged 23.8 for the same period. The Pan American Health Organization (PAHO) noted that there had been no noticeable improvement in these statistics in the 1980s and that infant mortality rates were unlikely to change in the near future.

Morbidity patterns, although statistically less verifiable, also indicated a need to improve health care delivery to infants and young children. In the mid-1980s, gastroenteritis was highly prevalent among young children, and the general level of malnutrition in this group was among the worst of the Caribbean Community and Common Market (Caricom--see Appendix C) countries. Low birth weight, a generally accepted measure of malnutrition, was a chronic condition, affecting nearly 12 percent of total births in 1984. The incidence of low weight among children age five and younger was also high, affecting nearly 40 percent of this agegroup in 1984. Combined with other medical problems associated with young children, these nutritional problems made the unusually high infant mortality rate inevitable. The development of national programs to improve the health care of expectant mothers, infants, and young children was expected to improve this situation in the future.

Although the nutritional problems of infants and young children were not solved by the mid-1980s, health services coverage, as measured by the success rate of the national inoculation programs, compared favorably with that of other Caricom countries. In 1983 nearly 90 percent of children under one year of age were given the diphtheria, pertussis, and tetanus vaccine; 93 percent were inoculated against poliomyelitis; and 69 percent were administered the tuberculosis vaccine. These levels were consistent with those of other Caricom countries, most of which were able to provide the same vaccinations to 90 to 95 percent of the targeted population.

Morbidity indicators for adults were not well documented, but available evidence suggested that diabetes, general infections, parasitic diseases, heart disease, and cancers were the most common afflictions. PAHO registered a rise in the number of hepatitis cases for 1984-85, but only one case of acquired immune deficiency syndrome was reported as of May 1986.

Environmental health indicators were up in the late 1980s. PAHO reported that nearly the entire population had access to potable water by 1983, and projects underway in 1986 included three new reservoirs in St. Kitts and well digging in Nevis. Solid waste disposal was available near Basseterre, and 96 percent of the combined population had access to sanitary waste disposal, including those serviced by pit latrines.

St. Kitts and Nevis' national health policy in the 1980s dictated that basic health services be made available to all inhabitants. This policy objective was formulated by the Health Department of the Ministry of Education, Health, and Community Affairs, which administered all public facilities, including hospitals and health centers.

In 1986 three hospitals were serving St. Kitts: the Joseph N. France General Hospital (164 beds) in Basseterre, the Pogson Hospital (28 beds) in Sandy Point, and the new Mary Charles Cottage Hospital (10 beds) in Molineax, which served the side of the island farthest from the capital. In 1986 the Pogson Hospital was renovated and expanded, and a new psychiatric wing was added to the Joseph N. France General Hospital. Nevis had one facility, the Alexandra Hospital (fifty-eight beds) in Charlestown, which was equipped for minor surgery and outpatient services.

Among St. Kitts and Nevis' specialized centers were a leprosarium and the Cardin House, a facility providing geriatric care. There were also seventeen health centers located throughout the two islands. These formed the basis for the provision of health care to the majority of the population, including the services of doctors, dentists, and nurses. Each parish was allocated at least one health center. Two or more centers were located in more heavily populated parishes. In 1984 there were about 4 doctors, 1 dentist, and 26 nurses per 10,000 inhabitants.

By the mid-1980s, the general welfare of the population was improving noticeably, largely because of government programs. Besides the water development projects on Nevis mentioned earlier, the government was instrumental in developing low-income housing projects on both islands. By 1987 the Central Housing Authority had added approximately 200 houses in new and existing neighborhoods. The government also created the Social Security Scheme in 1978 as a source of retirement benefits. The worker and employer each contributed 5 percent of the worker's salary or wages to the fund, which also represented the single largest source of public sector savings.

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Source: U.S. Library of Congress