Saint Kitts and Nevis
The Health in the Americas+ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. In some cases, the values of the indicators may differ from the most recent data available in the country.
Environmental and social determinants of health
The population of Saint Kitts and Nevis is aging (Figure 1). In 2000 people over 65 years of age accounted for 7,9% of the total population. This proportion increased to 9,7% in 2021 and is expected to rise further, to almost one-quarter by 2040. An aging population presents challenges for healthcare funding and social support. The dependency ratio (number of adults aged 65 and older for every 100 people aged 15–64) offers a simple metric for assessing a country's ability to fund its aging population. In Saint Kitts and Nevis in 2000 the dependency ratio was 59,2%, decreasing to 41,7% in 2022.
Life expectancy at birth was 71,7 years in 2021—lower than the average for the Region of the Americas and 1,9 years higher than in 2000.
Figure 1. Population pyramids of Saint Kitts and Nevis, years 2000 and 2021
Between 2005 and 2019, the average number of years of schooling in Saint Kitts and Nevis increased by 20,8%, reaching an average of 8,7 years in the latest year for which information is available.
During the period 2005–2019, the country improved its score on the Human Development Index, with an increase of 9,6% from a score of 0.711 to a score of 0.779; during the same period, the index rose 15% internationally and 11% in Latin America (Figure 2).
Figure 2. Human Development Index in the Region of the Americas, 2021
In 2019, public expenditure on health accounted for 2,7% of gross domestic product (GDP) (Figure 3), while out-of-pocket spending on health accounted for 46,4% of total health expenditure.
Figure 3. Public expenditure on health as a percentage of gross domestic product in the Region of the Americas, 2019
In 2017, 80.7% of people in Saint Kitts and Nevis had an Internet connection, representing a considerable increase from 2011, when 49.2% of the population had an Internet connection.
Maternal and child health
Between 2004 and 2020, infant mortality in Saint Kitts and Nevis decreased from 16,4 to 12,7 deaths per 1000 live births, a decrease of 22,6% (Figure 4). The percentage of low-weight births (less than 2500 g) decreased from 10,2% to 7,9% between 2004 and 2020.
Regarding the immunization strategy and as part of the Expanded Program on Immunization, Saint Kitts and Nevis remains one of the highest-ranking countries in the Americas with vaccination coverage rates exceeding 96% each year for routine antigens.
In the specific case of adolescent fertility, there was a 48,6% decrease, from 71,5 live births per 1000 women aged 15 to 19 years in 2000 to 36,8 in 2021. In 2017, Saint Kitts and Nevis achieved elimination of mother-to-child transmission of human immunodeficiency virus (HIV) and syphilis status. This validation status has been maintained through the strengthened Prevention of Mother to Child Transmission Program.
Figure 4. Infant mortality per 1000 live births, 1995–2020
In 2020, there were 3,8 new cases of tuberculosis per 100 000 population in Saint Kitts and Nevis.
In 2020, the estimated HIV infection incidence rate (new diagnoses) was 37.2 per 100 000 population.
Noncommunicable diseases and risk factors
In Saint Kitts and Nevis, the prevalence of overweight and obesity was 52,3% in 2016. As of 2011, 32.5% of secondary school age children were overweight, and 14.4% were obese.
At the end of 2020, the respective shares in the total number of cases of arterial hypertension in the public primary care setting were men 31.7% and women 68.3%. For diabetes mellitus in the primary care setting for the same period, the shares were men 31.5% and women 68.5%.
The health situation and the COVID-19 pandemic
In the Region of the Americas, Saint Kitts and Nevis was successful in preventing COVID-19 related deaths in 2020. In 2021, the death rate remained low, with deaths being confined mainly to the third and fourth waves. Since the onset of the COVID-19 pandemic, Saint Kitts and Nevis has reported only 46 COVID-19-related deaths.
Currently, 56,9% of the population has completed the vaccination schedule. The vaccination campaign began on February 2021, and two types of COVID-19 vaccine have been used to date.
Measures to achieve universal health coverage
Recognizing these high-priority health concerns and the need for prevention and control, the Ministry of Health has amplified its focus on primary and secondary disease prevention by strengthening community outreach programs, especially among harder-to-reach populations such as migrants and HIV key populations. The introduction of robust screening activities allows for early detection and management, ultimately reducing the disease burden at the tertiary level.
The Government of Saint Kitts and Nevis has recognized additional healthcare challenges, including healthcare accessibility for populations in situations of vulnerability without private health insurance; gaps in availability of tertiary care; sustainability of health financing due to the expenses related to the management of chronic diseases and injuries; challenges with maximizing service delivery capacity and quality of the public and private sectors; and the need to transform the health system into an evidence-driven institution. In response, the Government is working to ensure health service accessibility to all, and has maintained ongoing programs for improving access to care for all and overall functioning of the health system. These initiatives are part of the Government’s Fresh Start and Prosperity Agenda – an adoption of the global move toward universal health coverage.
This renewed policy attention on universal health care, and particularly on improved access through the national health insurance system, is being driven by ongoing concerns and challenges related to the changing burden of disease. The shifting national disease profile, with additional demands for lifelong and comprehensive chronic care, requires improved delivery and financing of efficient healthcare services, with a focus on sustainability, accessibility, and financial protection. To this end, the Ministry of Health is augmenting health service delivery capacity and quality by recruiting specialized healthcare workers in priority disciplines – nephrology, cardiology, radiology, and medical diagnostics.
Challenges related to population health
The population of Saint Kitts and Nevis is aging, and the increasing proportion of older adults is predicted to continue. In 2007, the proportion of Saint Kitts’s population aged 65 and older was 7.7%, and on Nevis this proportion was 10.4%. By 2020, the proportion of the population of Saint Kitts and Nevis aged 65 and older was 10.2 % overall. This proportion is predicted to rise further to 22.7% by 2040, and to almost one-third by 2060. The disease burden is dominated by noncommunicable diseases. Between 2015 and 2019, the prevalence of noncommunicable diseases increased from 52% to 68%, with noncommunicable diseases accounting for 58% of all deaths. The three main causes of noncommunicable disease deaths were cardiovascular diseases (35% of all noncommunicable disease deaths), cancers (32%), and diabetes (24%). These conditions were also the top three causes of disability, collectively accounting for about 40% of all healthy life lost. By the end of 2021, there were about 200 persons in the country living with HIV/AIDS, accounting for just below 2% of all healthy life lost between 2015 and 2019. The burden of neonatal disorders has dropped since 2000 but still accounts for over 3% of all healthy life lost.
COVID-19 pandemic response
Saint Kitts and Nevis escaped community transmission of COVID-19 until mid-2021 and has since seen four outbreak peaks, with most of the 40 confirmed deaths by May 2022 occurring in the third and fourth waves. The vaccination program in cooperation with international partners represents a major ongoing COVID-19 policy. With support from the Pan American Health Organization (PAHO), the Government expanded capacity for COVID-19 contact-tracing and surveillance, increased the availability of equipment for the management of critically ill COVID-19 patients, and provided training in health communication.
The country’s adoption of the all-of-government and all-of-society approach enabled the successful containment of each wave and ensured that the country was one the first in the Americas to achieve a COVID-19 vaccination coverage rate of 40% of total population. COVID-19 is one example of an external pressure, and these pressures are recognized as a major risk to ongoing healthcare improvements. Nonetheless, Saint Kitts and Nevis has maintained a strong commitment to stringent border surveillance. Extreme weather events are another external pressure that have long been a threat to Saint Kitts and Nevis. Like many islands across the Caribbean region, hurricanes remain a persistent threat between June and November. Disaster preparedness and management is a continual priority for the country, with a recognition in small island States that healthcare infrastructure is vulnerable to extreme weather events.