Comprehensive Report on Seychelles Health System: Policies and Reforms

This report provides a detailed analysis of the Seychelles health system, exploring its policies, initiatives, and past and future reports. It examines key influencing factors such as institutional, cultural, social, economic, and political aspects. The report highlights the collaboration between the Seychelles Ministry of Health and the WHO, including the biennial work plan and its focus on sustainable development goals. It also discusses the country's efforts in achieving the Millennium Development Goals and Sustainable Development Goals. The report further delves into the health system policies and initiatives, including free healthcare, universal access, and initiatives for women's health and gender-based violence. The organizational structuring within the health sector is also discussed, including the roles of the Healthcare Agency, Public Health Authority, and National Institute of Health and Social Services. Additionally, the report covers healthcare reforms, challenges faced by the system, and the government's efforts to improve healthcare delivery. The report also highlights the significance of healthcare reforms in enhancing healthcare access, efficiency, quality, and outcomes, as well as reducing inequalities. The information is contributed by a student and available on Desklib.

Health System

TABLE OF CONTENTS
Table of Contents.............................................................................................................................2
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
1. Health system policies and initiatives which focus on key institutional, cultural, social,
economic and political influencing factors..................................................................................1
2. Past and future health system reports......................................................................................4
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Health system is also referred as the health care system, which is an organisation of
institutions, people as well as resources which help in delivering the health care services in order
to meet the health care needs of the target population within a country (Zhao and et.al., 2016).
Within a particular country there are variety of health care systems with an aim to provide the
better health facilities, design and develop the health systems of the country as per their needs.
This report discusses about the performance of Seychelles health system over a period of time. It
will also discuss about the recent policies or the attempts which is made by the country for
reforming its health care system. Present report also includes the challenges as well the issues
which have an impact on the health system of Seychelles and also includes what are the steps
which are taken by the country in order to address the issue in a particular region of Seychelles.
MAIN BODY
1. Health system policies and initiatives which focus on key institutional, cultural, social,
economic and political influencing factors
Seychelles Ministry of Health and the WHO Liaison Officer have signed a plan for the
period of 2018 to 2019 which is called the biennial work plan which was signed at the event in
one of Seychelles hospital. This is framework or a plan which is a major attempt of the country
to improve its health care system within the country. Under this framework World Health
Organisation will provide the government of Seychelles with appropriate funding that will
support their heath development overall agenda (Workie and et.al., 2018). Entire biennial work
plan agreement is a framework which is total worth of $739,600 and is the priority as per the
Ministry of Health Seychelles. Officials from WHO and The Seychelles in the signing ceremony,
WHO Liaison Officer namely Dr. Gakuruh viewed that WHO and ministry of health framework
is built in order to achieve the sustainable developments goals of the country. Another focus of
this framework is that achieving the results of the KPIs within the line of transformation agenda
of the Regional Director. It was also stated that a work plan was a part of WHO support but there
is also need a lot of support in additional to monetary support like technical support, other
facilities and building of health development capacity within the region and at the headquarters
level and also should include the involvement of various activities like research. This framework
has given a right support for the country in implementation of National Health Strategic Plan
with addressing the major health development areas like non-communicable diseases,
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communicable disease and reinforcement of nation's public health facilities and capacities as
well country's health system in general (Heiniger and et.al., 2017). Also, Minister of Seychelles,
Adam has thanked WHO for their continuous support for the biennial plan as WHO have play an
important technical role which WHO cooperation has played in dealing with the threat of plague
in last year. Seychelles and WHO's framework plan is an ambitious plan as it support the key
health development of the country and also provides the clear framework for WHO's support
both monetary and technical cooperation with the country in coming next two years.
The support which is provided by WHO to the country has helped in setting up the
preventative as well as rapid response programme during the outbreak of plague which has swept
in Madagascar. Also, it has been added by the Minister Adam that Seychelles is putting their
efforts for achieving the (MDGs) Millennium Development Goals and also have a better
prospect for achieving the country's Sustainable Development Goals (Cardinale and et.al., 2016).
Within a report which was published in 2013, stated that nation has been able to achieve 3 out of
8 goals such as gender equality, universal primary education, maternal health and women
empowerment. Also, Seychelles is on its track in achieving the remaining 5 set targets which is
reduction of child mortality, reducing HIV, eradication of hunger and poverty, eradication of
malaria and other disease in the country. Government of Seychelles has also ensured the
development of global partnerships for development and is also ensuring to achieve the
environmental sustainability.
Seychelles is an island state which is situated in Indian Ocean, the national health policy
of Seychelles is national strategic framework 2006 to 2016. Country's health policy framework
has been positioned in between the national development which is considered as beneficial as
well as contributor of socio economic development. The health policy document of the country
affirms the Seychelles commitment towards the health with a purpose to guide the programmed
development, strategic planning as well as implementation, monitoring and evaluation of policies
in the context of national mid-term strategic plan (Biscornet and et.al., 2017). There are various
health system policies and initiatives which focus on the various influencing factors. Seychelles
constitution is ensuring the progressive economic and social rights which includes the health,
education, housing, food security, safe environment, etc. Seychelles health policy is to provide
free health care as well as universal access to healthcare facilities to people living in different
societies across the world. Country is putting various initiatives for improving its human
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development index and wants to eradicate the society from various issues such vector borne
disease. Also, Seychelles in its health policy have strengthened its food safety objective by
strengthening food control system and prevention of various food borne disease in the country.
Also, Country in order to improve the health of women in the country is making initiatives for
improving the health or women by offering equal opportunities to boys and girls (Purvis, 2017).
Also, in order decrease the gender based violence in the country, Ministry of Health is working
with collaboration with other departments of the country decrease such type of violence’s in the
country. For this an initiative have been taken by the government to adopt Risk Indicators
Framework which will help the country identifying the people who face the risk of being abused.
Also, MOH Seychelles is developing guidelines for rape, domestic violence, assault etc for
healthcare providers with a proper pathways and multi-agency cased management in order to
address the issue.
In order to achieve the goal of strengthening the health system within the country,
Seychelles public health sector have introduced organisational structuring within the various
health institutions of the country. From the year 2014, health sector have implemented new
structures within various health institutions within the three public bodies such as Health care
agency, public health authority and national institute of health and social services. Health care
agency is an autonomous agency for managing the secondary, primary and tertiary care within
the country (Nketiah-Amponsah, 2019). It will focus on the development of integrated healthcare
services of the country and also includes the strengthening of the community based healthcare
such as recruitment of family health specialists within regional health centres and enhancing the
use healthcare services in Seychelles hospitals. Public health authority is an entity which
regulates the entire health sector of the country and has to provide protection for people's health.
This institution is responsible for regulating the health services health practitioners and even the
commercial and environmental activities which have an impact on the health. On the other hand
National institute of health and social services is an entity which is involved in the academic arm
providing the pre-services education and also provides the continuous in-service education for
health workers, also is institutionalises the high level of healthcare research (Jeffery and Rotter,
2016).
Within the country health care facilities are provided free of charge and is being financed
by through the general tax revenues. It is the government of Seychelles who is responsible for
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financing the health which accounts to 87% in the year 2009 and it was 93% in 2013 of total
health expenditure. One of the major influencing factor which has resulted in the increase in the
health investment was increase in non-communicable diseases which requires highly expensive
tertiary care treatment which also includes the overseas treatment and ageing of the population
within the country (Gurría, 2018). There are also social and cultural factors which have
influenced in the development of health system objectives of the country such as Diversity. The
nation island is diverse in culture due to increase in population which is projected to reach
100,000 by the year 2020. There is also high literacy rate of 97% but on the hand country is
facing the economic and social vulnerability which is another influencing factor for development
of health system policies in the country. As, huge number of population come from different
parts of the country which have increased the concern of MOH of Seychelles for its local
population and for the tourists ( Faray, Claudia and Rezaei, 2019). Another influencing factor for
developing an effective health system in Political commitment to improve the health of the
people across the country. Due to this country has developed various health policy objectives in
order to improve the country health system. Like improving the health status of Seychelles
population, providing of highly and qualitative integrated healthcare services as well as free
primary healthcare services, etc within the country.
2. Past and future health system reports
Healthcare reform is a part of governmental policy that affects health care delivery in a
country. It helps in improving overall quality of health care, helps in decreasing overall cost of
health care, provides more care to citizens, improves access to health care and many more.
Healthcare reforms are important to improve the overall quality and delivery of healthcare
services. In Seychelles, healthcare service is mostly provided by government. Even though
Seychelles achieved independence in 1976, they have defined better roles and responsibilities in
health care sector, which has further helped them in enhancing their overall regulatory capacity
(Faray, Claudia and Rezaei, 2019). One of the major healthcare issues faced by Seychelles was
that their healthcare system was majorly dependent upon government i.e. most of the hospitals
present in Seychelles were government hospitals or healthcare services. In 2009, they started to
work on providing in depth training to technical team in order to improve the overall service and
quality of healthcare system as it was one of the main component of their healthcare system
reform program. Till 2013, they were able to successfully define roles of technical people present
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within their healthcare system. In 20013 they reorganized their healthcare sector where ministry
of healthcare was responsible for policy making, healthcare agencies were responsible for
providing better healthcare services, national AIDS council were responsible for advocacy in
relation to AIDS and HIV. Seychelles government also focused on increasing insurance agencies
within their country. 4 out of 10 insurance companies present are private insurance agencies and
because of this number of people with health insured also increased (Jeffery and Rotter, 2016).
This has also helped in rationalizing overall cost of healthcare services even though this burden
of healthcare service cost had been continuously increasing.
Government has increased their overall healthcare expenditure in order to enhance both
quality and service of healthcare system of Seychelles. In addition to this, additional private
healthcare agencies investment in this sector has also contributed in enhancing the overall
quality. Other than this such healthcare reforms had also helped in increasing healthcare access,
efficiency, quality and outcomes of healthcare services. Another issue faced by healthcare
system of Seychelles was inequalities within their healthcare system. This health care reform has
also helped in reducing inequalities in health outcomes as well as in use of health care services.
Seychelles continuously worked on these issues in order to provide excellent entry point for
healthcare system reform agenda.
In recent years Seychelles has been improving its health systems in the country and wants to
have the one of the best health systems in Africa. Seychelles have achieved this due to the major
investments in the public health systems with less distraction to complex health reforms
interventions which includes results based financing and health insurance programs. Seychelles
have offered an alternative approach in order to achieve Universal Health agenda by showing the
sensible increment improvements in their health system. Seychelles has now developed the
extensive network of improving the health infrastructure in the country which in some respect is
exceeding the WHO recommended norms. With the help of this extensive network country was
address it major health issue in the country like food safety, eradication of non-communicable an
communicable diseases and eradication of HIV/AIDS. Due to which government of Seychelles is
offering to provide fee access to care. Seychelles have boosted the utilisation of medical services
with in the country which is shown in the tables below:
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Illustration 1: Selected Health Indicators, 2016
Illustration 2: Health Infrastructure and Utilization in Seychelles, 2017.
It can be analysed from the table that Seychelles have improved its access for both
inpatient service and out patient services of all age cohorts in the country. This may include the
elderly people, pregnant mothers, children, etc and for them there is specific services tailored for
their well-being. In order to meet the social health issue country has developed a network of
community based adolescents centres as well as homes for elderly people where such population
can interact with each other. Seychelles is considered as a unique region in Africa which are
offering medical facilities which is mainly focused on mothers and children and less attention is
being paid to adults and elderly persons. In order to fight the issue of infection prevention,
country plan is to offer general services in 5 domains which includes basic equipment, basic
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amenities, diagnostic capacity, infection prevention as well as essential commodities and
medicine. For the Seychelles have increased it budget which will be spent on improving the
health system in the country working in collaboration with WHO in order to address the health
issues in the country.
CONCLUSION
From the above report it can be concluded that Seychelles is the only country in Africa
which has got the effective Health system and within the health system of a country there are
various policies based on the objectives which has to be achieved by the country in order to
address its health issue in a region. It can also be concluded from the above report that there are
various political, social, economic and cultural influencing factors for health system policies or
initiatives of the country. Also, Seychelles past and future health system reforms are totally
different in addressing the issues related to health and now country is continuously increasing its
efforts for enhancing its health system in the country.
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REFERENCES
Books and Journals
Biscornet, L., and et.al., 2017. Human leptospirosis in Seychelles: a prospective study confirms
the heavy burden of the disease but suggests that rats are not the main reservoir. PLoS
neglected tropical diseases. 11(8). p.e0005831.
Cardinale, E., and et.al., 2016. A concrete regional" One health" surveillance system and
management of epidemics: a success story in the South West Indian Ocean.[055].
Faray, A.N.J., Claudia, G. and Rezaei, H.M., 2019. Cost-effectiveness of treating hepatitis C in
Seychelles. The Pan African Medical Journal. 33.
Gurría, A., 2018. Our health systems must put people at the centre.
Heiniger, S., and et.al., 2017. Trends in prevalence, awareness, treatment and control of high
blood pressure in the Seychelles between 1989 and 2013. Journal of hypertension. 35(7).
pp.1465-1473.
Jeffery, L. and Rotter, R., 2016. Sustenance, nourishment, and cultivation: plants as living
cultural heritage for dispersed Chagossians in Mauritius, Seychelles, and the UK. Journal
of the Royal Anthropological Institute. 22(2). pp.296-313.
Nketiah-Amponsah, E., 2019. The Impact of Health Expenditures on Health Outcomes in Sub-
Saharan Africa. Journal of Developing Societies. 35(1). pp.134-152.
Purvis, M.T., 2017. Seychelles: Education Reforms. Education in South Asia and the Indian
Ocean Islands. 34. p.327.
Workie, N.W., and et.al., 2018. Who Needs Big Health Sector Reforms Anyway? Seychelles’
Road to UHC Provides Lessons for Sub-Saharan Africa and Island Nations. Health
Systems & Reform. 4(4). pp.362-371.
Zhao, P., and et.al., 2016. Sudden unexpected death from natural diseases: Fifteen years'
experience with 484 cases in Seychelles. Journal of forensic and legal medicine. 37.
pp.33-38.
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