ABSTRACT
Contents Introduction ............................................................................................................................ 380 Historical Aspects of Health Service Reforms ...........................................................................381 Historical Overview of the Aspects of Health Reforms .............................................................381 The Rise of New Managerialism as a Tool to Reform Health Systems ...................................... 384 The Legal Aspects of Health Service Reform .............................................................................385 The Substantive Aspects of Health Service Reform .................................................................. 390 Health Services Under Socialism in Cuba, Jamaica, Guyana, and Grenada ...............................391 The Impact of HIV/AIDS ........................................................................................................392 Health as an Enabler of the Free Movement of Skilled Labor .................................................. 394 Establishment of Health and Family Life Education ................................................................ 396 Focus on Noncommunicable Diseases ..................................................................................... 397 The Functional Aspects of Health Service Reform: The Rise of New Mutualism ...................... 399 Conclusion .............................................................................................................................. 407 Bibliography ............................................................................................................................ 407
the broadest sense, it also recognizes that several of the reforms grouped under these four major periods run concurrently with other national, regional, and global reforms. Additionally, this chapter provides readers with a comprehensive overview of health services as well as the regional response in dealing with communicable and noncommunicable diseases. It discusses the impact of labor mobility on national health systems and programs within the context of the Caribbean Single Market and Economy (CSME), a system designed to mitigate unforeseen social and economic changes that can devastate national systems. Overall, while the region has made slow progress in achieving the two Millennium Development Goals associated with health reform (maternal health and combating HIV/AIDS), new strategies are emerging in recognition that health service should accommodate prevention and treatment and be multi-sectoral. The chapter concludes by discussing the implications of the post-2015 development agenda or Sustainable Development Goals (SDGs), agenda on national health systems and the rise of institutional coordination and cooperation around health issues.
