Saint Kitts and Nevis - Country Profile

By PAHO/OPS, 19 September, 2022

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

In 2000 the total population of Saint Kitts and Nevis was 45 248 inhabitants; by 2024 this figure had risen to 46 843, representing a 3.5% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 11.2% of the total population, an increase of 3.4 percentage points compared to the year 2000. In 2024, there were 108.9 women per 100 men and 61.7 older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country’s population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 70.6% of the total population of the country in 2024 ( 33 064 people). When we add these figures to the potentially passive population ( 8 521 under 15 years of age and 5 259 over 65 years of age), the result is a dependency ratio of 41.7 potentially passive people per 100 potentially active people. This ratio was 58.9 in 2000.

Life expectancy at birth in 2024 was 72.3 years, lower than the average for the Region of the Americas and 3.1 years higher that in 2000 (69.2).

Figure 1. Population pyramids of Saint Kitts and Nevis, years 2000 and 2024

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 2005-2022, the country improved its score on the Human Development Index, with an increase of 10.4% (from a score of 0.759 to a score of 0.838); during the same period, the index rose 14.6% internationally and 11.2% in Latin America (Figure 2).

Figure 2. Human Development Index in the Region of the Americas, 2021

In 2021, public expenditure on health accounted for 3.54% of gross domestic product (GDP) (Figure 3) and 7.91% of total public expenditure, while out-of-pocket spending on health accounted for 38.85% of total health expenditure.

Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2021

Digital coverage

In 2021, 79.5% of the population had an internet connection, representing a considerable increase from 2000, when 5.9% of the population had an internet connection.

Health situation

Maternal and child health

Between 2004 and 2022, infant mortality in Saint Kitts and Nevis decreased from 16.4 to 12 deaths per 1000 live births, a decrease of 26.8% (Figure 4). The percentage of low-weight births (less than 2500 g) decreased from 10.2% to 8.6% between 2004 and 2021.

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. Measles vaccination coverage was 95.0% in 2022, a decrease of 5.0 percentage points from 2000.

In relation to fertility, it is estimated that in 2024 women had an average of 1.5 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 46.6% decrease, from 68.2 live births per 1000 women aged 15 to 19 years in 2000 to 36.4 in 2024. In 2022, 100.0% of births were attended by skilled birth personnel. 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, 1998–2022

Communicable diseases

In 2021, there were 0 new cases of tuberculosis per 100 000 population in Saint Kitts and Nevis. In 2022, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 49.2 per 100 000 population.

Noncommunicable diseases and risk factors

In Saint Kitts and Nevis, the prevalence of overweight and obesity was estimated to be about 52.3% among the general population in 2016. among peoble over 15 years, the prevalence of overweight and obesity was 75.5% in 2022.

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%. Also in 2016, 32.2% of the population reported insufficient physical activity. In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 25.3%, a decrease of 0.2 percentage points compared to 2000 (25.5%). The prevalence of diabetes mellitus, which stood at 9.9% in 2000, increased to 14.5% in 2014.

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.

During 2020, there were a total of 32 cases of COVID-19 in Saint Kitts and Nevis, representing 672 per million population. In 2021, the number of identified cases amounted to 2 967, equivalent to 62 285 per million inhabitants, while in 2022, the number of reported cases was 3 542, 74 356 cases per million inhabitants. With regard to deaths directly caused by COVID-19, in 2020, no deaths of persons diagnosed with COVID-19 were reported. In 2021, 28 were reported, representing 588 deaths per million inhabitants and 18 total deaths by 2022, equivalent to 378 deaths per million inhabitants. In the Region of the Americas, Argentina ranked 47th in the number of deaths due to COVID-19 in 2020, moved to position 40th in 2021 and in 2022 ranked 19th, with a cumulative figure for the years of 965, 6 deaths per million population (Figure 7).

Currently, 56.9% of the population has completed the vaccination schedule. The vaccination campaign began on 22 February 2021, and two types of COVID-19 vaccine have been used to date.

The sources of the interagency indicators used in this profile can be found in this table.

For the latest data on health indicators for the Region of the Americas, be sure to visit the PAHO Core Indicators portal.

Country COVID-19 Perspective

Prospects

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.