The Nurse Workforce in the Eastern Caribbean Carpio and Fuller-Wimbush

The Nurse Workforce in the Eastern Caribbean in the Eastern Workforce Nurse The DIRECTIONS IN DEVELOPMENT Human Development Carpio and Fuller-Wimbush Carpio The Nurse Workforce in the Eastern Caribbean Meeting the Challenges of Noncommunicable Diseases Carmen Carpio and Danielle Fuller-Wimbush The Nurse Workforce in the Eastern Caribbean DIRECTIONS IN DEVELOPMENT Human Development The Nurse Workforce in the Eastern Caribbean Meeting the Challenges of Noncommunicable Diseases Carmen Carpio and Danielle Fuller-Wimbush © 2016 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington, DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved 1 2 3 4 19 18 17 16 This work is a product of the staff of The World Bank with external contributions. 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Under the Creative Commons Attribution license, you are free to copy, distribute, transmit, and adapt this work, including for commercial purposes, under the following conditions: Attribution—Please cite the work as follows: Carpio, Carmen, and Danielle Fuller-Wimbush. 2016. The Nurse Workforce in the Eastern Caribbean: Meeting the Challenges of Noncommunicable Diseases. Directions in Development. Washington, DC: World Bank. doi:10.1596/978-1-4648-0830-2. License: Creative Commons Attribution CC BY 3.0 IGO Translations—If you create a translation of this work, please add the following disclaimer along with the attribution: This translation was not created by The World Bank and should not be considered an official World Bank translation. The World Bank shall not be liable for any content or error in this translation. 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All queries on rights and licenses should be addressed to the Publishing and Knowledge Division, The World Bank, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: pubrights @ worldbank.org. ISBN (paper): 978-1-4648-0830-2 ISBN (electronic): 978-1-4648-0831-9 DOI: 10.1596/978-1-4648-0830-2 Cover photo: © Carmen Carpio. Further permission required for reuse. Cover design: Debra Naylor, Naylor Design, Washington, DC. Library of Congress Cataloging-in-Publication Data Names: Carpio, Carmen, author. | Fuller-Wimbush, Danielle, author. | World Bank, publisher. Title: The nurse workforce in the Eastern Caribbean : meeting the challenges of noncommunicable diseases / Carmen Carpio, Danielle Fuller-Wimbush. Other titles: Directions in development (Washington, D.C.) Description: Washington, DC : The World Bank, 2016. | Series: Directions in development | Includes bibliographical references. Identifiers: LCCN 2016015273 (print) | LCCN 2016016936 (ebook) | ISBN 9781464808302 (pdf) | ISBN 9781464808319 | ISBN 9781464808302 (pdf) | ISBN 9781464808319 () Subjects: | MESH: Nursing—manpower | Chronic Disease—prevention & control | West Indies Classification: LCC HD5724 (print) | LCC HD5724 (ebook) | NLM WY 16 DW5 | DDC 331.13/602461073—dc23 LC record available at https://lccn.loc.gov/2016015273 The Nurse Workforce in the Eastern Caribbean • http://dx.doi.org/10.1596/978-1-4648-0830-2 Contents Acknowledgments xi About the Authors xiii Executive Summary xv Abbreviations xix Chapter 1 Overview of the Eastern Caribbean Health Sector 1 Introduction 1 New Health Challenges and Shortages of Human Resources for Health 1 CARICOM Road Map to Strengthen the Health Workforce 5 References 6 Chapter 2 The Noncommunicable Disease Landscape in the Eastern Caribbean 7 Introduction 7 NCD Service Delivery 7 Implications of a Changing Burden of Disease 9 Strategies to Address NCDs 10 Note 11 References 11 Chapter 3 Needs-Based Analysis of the Eastern Caribbean Nurse Workforce 13 Introduction 13 Density Level 13 Lack of Primary Health Care and Specialized Skills 14 Note 16 Reference 16 Chapter 4 Assessing the Eastern Caribbean Nurse Workforce Using a Health Labor Market Approach 17 Introduction 17 Supply of Nurses 17 Demand for Nurses 19 The Nurse Workforce in the Eastern Caribbean • http://dx.doi.org/10.1596/978-1-4648-0830-2 v vi Contents Productivity of the Nurse Workforce 20 Performance of the Nurse Workforce 20 References 22 Chapter 5 Nursing Education and Training in the Eastern Caribbean 23 Introduction 23 Dominica 24 Grenada 25 St. Lucia 26 St. Vincent and the Grenadines 27 Note 27 Chapter 6 Legislation Supporting Human Resources for Health Planning and Management in the Eastern Caribbean 29 Introduction 29 Inventory of HRH-Related Legislation 29 Chapter 7 Human Resources for Health Planning to Address Noncommunicable Diseases in the Eastern Caribbean 33 Introduction 33 Role of HRH Planning in Combatting NCDs 33 Core HRH Planning Functions 34 Enhanced HRH Planning Functions 36 Notes 36 Chapter 8 Managing Human Resources for Health to Address Noncommunicable Diseases 37 Introduction 37 Core HRH Management Functions 37 Enhanced HRH Management Functions 42 Chapter 9 Toolkit, Conclusions, and Recommendations 43 Toolkit 43 Conclusions and Recommendations 43 Appendix A Country Case Studies 47 Introduction 47 Country Benchmarks 47 Dominica 50 Grenada 60 St. Lucia 68 St. Vincent and the Grenadines 78 Notes 85 References 86 The Nurse Workforce in the Eastern Caribbean • http://dx.doi.org/10.1596/978-1-4648-0830-2 Contents vii Appendix B Resource Persons Interviewed for the Country Case Studies 89 List of Resource Persons 89 Appendix C Core Data Set for Developing a Human Resources for Health Information System 91 Background 91 Data Characteristics 91 Potential Data Sources 92 Data Collection 93 Appendix D Terms of Reference Template and Discussion Outline for a Human Resources for Health Multisector Taskforce 99 Introduction 99 Draft Terms of Reference for an HRH Taskforce 99 HRH Taskforce Terms of Reference Discussion Points 100 Appendix E Toolkit to Support Evidence-Based Practice 103 Background 103 Definitions 103 EBP Competencies 104 Questionnaires 105 References 114 Appendix F Toolkit to Support Interprofessional Teamwork 117 Background 117 Definitions 117 Interprofessional Team Working Competencies 118 Teamwork Perceptions and Team Structure Questionnaires 121 References 123 Appendix G Toolkit to Support Patient-Centered Care 125 Background 125 Definitions 125 Patient-Centered Care Competencies 126 Departmental Assessment Tool 127 Patient Experience Questionnaires 133 References 137 Appendix H Toolkit for Using Informatics 139 Background 139 Definitions 139 Four Key Tasks 139 References 141 The Nurse Workforce in the Eastern Caribbean • http://dx.doi.org/10.1596/978-1-4648-0830-2 viii Contents Appendix I Toolkit for Supporting Quality Improvement 143 Background 143 Definitions 143 Quality Improvement Competencies 144 Department Initial Readiness Assessment 145 Notes 148 References 148 Appendix J Human Resources for Health Governance in the Eastern Caribbean 149 Introduction 149 Global HRH Initiatives 149 Regional HRH Initiatives 150 International Legal Agreements and Obligations Governing Policies for Health 154 NCD Instruments and Initiatives 155 Notes 159 References 159 Figures 1.1 Prevalence of Obesity (BMI ≥30 kg/m2) Ages 30–100, 2002–15 3 C.1 Characteristics of Quality Data 92 C.2 Data Levels and Formats 92 J.1 Timeline for the Development of Caribbean NCD Initiatives 158 Maps A.1 Dominica’s 10 Parishes 50 A.2 The Six Parishes of the Main Island of Grenada 60 A.3 St. Lucia’s 11 Quarters 69 A.4 St. Vincent and the Grenadines 78 Tables 1.1 Demographic and Health Indicators, Latest Available Year 2 1.2 Age-Standardized DALYs (per 100,000 Population) for Communicable and Selected Noncommunicable Diseases, 2004 2 1.3 Health Care Financing, Latest Available Year 4 2.1 Primary Health Care NCD Prevention and Treatment Services 8 3.1 NDC Health Resources by Professional Category 14 3.2 Human Resources for

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