General health trends in St. Lucia improved noticeably in the 1980s. Life expectancy increased 4.5 percent from 1981 to 1984, with the average for men and women rising to 72.5 years. The improvement in infant mortality rates was even more dramatic for the same time period. Infant deaths under 1 year of age fell from 25 per 1,000 live births to 17 per 1,000, representing a decline of 32 percent. The mortality rate for those over the age of 65 was reduced by 23 percent, whereas the overall mortality rate fell by 20 percent.

Indicators of morbidity were less well defined, but they suggested that strides had been made in eradicating the most common diseases. By 1984 a country-wide immunization program existed for six basic preventable diseases--diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, tuberculosis, and measles--and other inoculation programs were being planned with the assistance of PAHO. The nutritional status of children under the age of five apparently also had improved, although definitive statistical evidence was lacking. Communicable diseases continued to be a major health problem, however, as evidenced by the increase in the incidences of venereal diseases. In 1986, PAHO reported three cases of acquired immune deficiency syndrome (AIDS) in St. Lucia.

Environmental health indicators were also encouraging. Approximately 75 percent of the population had basic sanitation facilities in 1985, and 85 percent of the population had access to piped water. Expansion of waste disposal facilities continued in 1985 and 1986, and government inspection of sewage treatment facilities, food handling businesses, and schools brought corrective action in those areas.

The general improvement in the health situation was directly attributable to efforts by the government to enact a comprehensive health care system. A coordinated health care policy was developed with the assistance of the World Health Organization (WHO), PAHO, and numerous other organizations, including foundations and universities. Priority was given to primary health care delivery by a network of health clinics.

The health care system was directed by the Ministry of Health, which provided two basic types of health services free of charge: preventive care and curative services. The former focused on prenatal, immunization, nutritional, and family planning programs, whereas the latter provided doctors and nurses to operate a network of health clinics. Government health services were offered throughout the country, which was divided into six health districts. The island had thirty-three health clinics, two district hospitals, two general hospitals, and one psychiatric hospital. The most complete facilities were located near Castries and Vieux Fort.

In an attempt to reach the entire population with some form of health care service, the Ministry of Health adopted a plan to train health care workers in various types of technical services to assist doctors and nurses with health care delivery. There were four types of health care representatives: community health aides, environmental health aides, family nurse practitioners, and community nutrition officers. As was evident in the structure of the health care system, the community health programs provided educational and preventive services, as well as actual hands-on health care. It was hoped that many health problems could be avoided by educating the population on nutrition, hygiene, and sanitation habits.

The success of St. Lucia's nutrition, immunization, health education, prenatal, and child health care programs was evident in the continued decline in morbidity and mortality rates, as well as the high population growth rate. Nevertheless, it was clear that a continued growth rate approaching 2 percent would place excessive constraints on the island's future health, employment opportunities, and quality of life. For these reasons, the Ministry of Health made reduction of fertility rates the health care priority of the late 1980s, targeting in particular the sexual behavior of adolescents.

In addition to health care programs, the government provided a social security system for workers who did not have a private pension plan. The National Insurance Scheme forced workers to contribute a portion of their wages to be held for their retirement at age sixty-five, at which time they would receive regularly scheduled payments.

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Source: U.S. Library of Congress