Resource Plan in British Virgin Islands Health Sector
Introduction
Resources come in many forms. “The money resource refers to what an organization has plus what it can receive through grants, donations, entitlements, credit financing or long term borrowing. The equipment resource can vary from a basic computer to an MRI; it enables the organization to perform certain tasks. In addition, the organization also needs methods or policy and procedures, which are its “how-to” systems. The organization must also take account of time, the question being whether we have time on our side or whether the task must be performed now. Time, of course, is the one resource that can never be recaptured. Finally, the organization must take account of space; this involves the location decision which is sometimes referred to as site control, and concerns the physical geography or environment that is needed to perform or provide services.” (, 1992)
The critical resource management decision problem is that of allocating scarce resources amongst competing activities under the restrictions of a variety of constraints, both physical and administrative in character. Scarce resources may be workforce, capital, raw materials, energy, machine capacities, space, and by-products.
The provision of quality health care is increasingly demanding on physical resources such as buildings, equipment, and supply systems. Appropriate building and equipment are the major motivation factor for health workers.
The following are the physical resources to be considered to best support program goals and objectives of health care services.
- Environment (space), structure
- Utilities, services, such as oxygen, suction
- Office equipment and supplies
- Ward equipment and supplies
- Medical equipment and supplies
- Safety, security, emergency policies, procedures
- Medications, therapeutics
The paper attempts to provide a resource plan for physical resources needed in the health care sector in British Virgin Islands.
Managing Resources
Health Care Physical Resource Analysis in British Virgin Islands
British Virgin Islands provides district clinics or private doctors to provide prenatal care to pregnant women in which appraise hemoglobin levels, treat anemia, perform VDRL tests, and administer tetanus toxoid. District clinics provide a full range of child health services, including growth and nutritional monitoring, development assessment, treatment of common illnesses, counseling, school health, vision and hearing screening, and screening for anemia, including sickle cell anemia.
In addition, there is a 12-slot facility, Fort Charlotte School, in which cater with the special needs of children run by the Department of Education. Special attention is given to children with Down’s syndrome, cerebral palsy, physical disability, autism, and attention deficit disorder.
There is also a community mental health center in Road Town in which provides most of the ambulatory care for the territory. Its approach emphasizes treating individuals in their community, including monitoring and administering medication, providing family counseling, and promoting self-care.
In addition, there is a medical ward in Peebles Hospital for psychiatric patients. There are only two secured rooms on the medical ward and non-disruptive patients are admitted on the general medical ward. There are no psychiatric nurses on staff and quarters are cramped. In 1995, a drug rehabilitation facility was opened within walking distance of the community mental health center.
Road Town Health Center and Peebles Hospital support district clinics. Catchments populations for district clinics range from 141 persons at the Jost van Dyke Clinic to 9,106 persons at the Road Town Health Center on Tortola, numbers augmented by tourists and temporary residents, such as yacht dwellers. The Road Town Health Center serves as a referral point for the district clinics and includes a family planning service. Other primary care facilities available include a drug-treatment center, a community mental health center, and a dental unit, all of which provide services that are not routinely available at district clinics. The drug-treatment center and mental health center are based in Road Town.
Moreover, in Tortola, there is a 50-bed Peebles Hospital which is the main provider of secondary care and is administered by the Government. It offers surgical, obstetric, medical, pediatric, and psychiatric care on an inpatient basis. All service areas are covered by local doctors, except for psychiatry, which is served by a part-time consultant psychiatrist based in Barbados. Clinical support includes physiotherapy, x-ray, and laboratory services. The Community Mental Health Center also provides psychiatric service on an outpatient basis.
In Road Town, there is a three-chair dental unit. There is one dental chair in Virgin Gorda and one in Anegada, where services are provided one day per week and one day per month, respectively. Government oral health services mainly treat children; the dental officer treats adults in private clinics part-time on a split-fee basis with the Ministry.
Furthermore, there is an active and well-established private health sector. An eight-bed clinic performs reconstructive, general, and hand surgery, and had an annual average of 354 patients during the review period. There are two private dental clinics in Road Town. In addition, there are several private medical practices; the two largest are located in Road Town, and one has a branch in Virgin Gorda. Both centers have a pharmacy and mammography, ultrasound, and x-ray diagnostic equipment.
Physical Resources Requirement
Implicit in the definition of an organizational field is the importance of attending to the environments – local as well as societal – in which organizational populations function. , and (forthcoming) differentiate environmental factors into two analytic categories: those pertaining to the material resource environment, including factors involved in the demand for and supply of medical services as well as the competitive structure of the industry; and those pertaining to the institutional environment, in particular, the identities of organizational and field-level actors, and the logics and governance systems that operate in the field.
As defined by and (1983: ), a field consists of “those organizations that, in the aggregate, constitute a recognized area of institutional life: key suppliers, resource and product consumers, regulatory agencies, and other organizations that produce similar services or products.” Health economists have analyzed dynamics on the demand side in terms of market segmentation (, , and , 1993). Demand has been shown to reflect differences in demographic characteristics and ability to pay; supply-side differences are evident in physician density and market concentration of organizational providers ( and , 1985; , 1988).
Aside from these resource bases, industry structure – the number of buyers and sellers and the ways in which they are related to one another – also greatly affects the flows of resources, their exchange and consumption, within a field.
“Between 1992 and 1995 there were 1,208 hospital deliveries, an average of 302 annually. Between 1992 and 1995, an average of 84 deaths were registered annually in the British Virgin Islands. About 6 % of them were coded as ill-defined conditions. Diseases of the circulatory system accounted for 36% and malignant neoplasms for 18% of all deaths. External causes accounted for 7%, conditions originating in the perinatal period for 8%, and communicable diseases for less than 5% of the total.” (, 2007)
British Virgin Islands has an estimated population of 23,098 as of July 2006 with an average of 14.89 births per 1,000 population and a growth rate of 1.97 per cent (, 2007). Hospital and clinics requirements increases with the continuous increase in population.
Medical care in the British Virgin Islands consists of a small general hospital with an emergency room staffed 24-hrs/day by physicians, several clinics on Tortola, and one clinic in Virgin Gorda. Both islands are served by ambulances staffed with paramedics. There are no medical facilities on the other islands. A volunteer organization, Virgin Islands Search and Rescue (VISAR), responds 24-hrs/day to medical emergencies at sea or on outer islands. VISAR transports casualties to the nearest point for transfer to ambulance. To reach VISAR, dial SOS (767) or call on Marine Channel 16.
There is no hyperbaric chamber in the BVI. Patients requiring treatment for decompression illness are transferred to St. John, U.S. Virgin Islands. Most sensitive medical cases are transferred to San Juan, Puerto Rico.
It has been noted that British Virgin Islands lack the physical resources in order to assess the health care requirements of the population of the country. They lack facilities in order to cater some illness.
The territory has a vigorous private health sector, encompassing both inpatient and ambulatory care. However, many residents also go off-island for health care, mainly to the United States Virgin Islands or Puerto Rico, either through choice or because they require specialized care unavailable locally.
Monitoring
The Ministry of Health and Welfare is responsible for providing public health and social services, as well as for monitoring and regulating private sector providers. The Minister in consultation with the Director of Health Services and the Permanent Secretary makes policy decisions. The Director of Health Services is charged with the day-to-day management and planning of health services. The Permanent Secretary is responsible for the administration of the Ministry headquarters and for supporting the Minister in his policy role.
The Public Health Department is responsible for managing government health services. The Department is organized into hospital and primary health care services; each is headed by a senior manager who reports to the Director of Health Services. Budgetary responsibility is devolved to the heads of the respective units.
Mandatory Compliance
Laws dealing with safety, health, and accessibility for physically impaired persons, and other regulatory issues, are evaluated and proposed projects placed in the compliance strategic facility plan for future consideration and funding. Remodeling and new space also increased safety, health, and with Disabilities Act compliance
Community Involvement
Research on motivational factors involved in staffing voluntary community organizations suggests that people participate in these organizations when they perceive social and environmental problems within a community to which they are attached and find organizations that they expect to be successful in mitigating these problems ( & , 1990; & , 1984). Such studies have found that participation in community groups is significantly related to three types of benefits (personal, social, and purposive) and their corresponding costs (, , , , & , 1990). Moreover, members’ sense of individual and collective self-efficacy, and thus their motivation to participate, is enhanced when these organizations are empowered by successfully influencing actions taken by the community.
Thus, encouraging community participation can lead to community commitment which would also lead to effectiveness of the projects and programs.
Managing Financial Resources
Funding
The Government almost wholly finances public health services. However, there still some organizations that are committed to funds programs for the welfare of the citizens such as the Community Foundation of the Virgin Islands which is committed to using resources from unrestricted sources to fund innovative programs and projects that show promise of developing into longer-term responses to the needs of children and families in the Virgin Islands
Budgeting for Hospital Equipments
The table below shows the estimated costs of the equipments for the clinics and hospitals to be constructed in British Virgin Islands.
Table. 1. Estimated Costs for Equipments
Type of Equipment
Total Cost
Facility
, 990,000
Technology
,000,000
Capital
0,000,000
Total
6,990,000
References
Credit:ivythesis.typepad.com
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