Sint Maarten - Territory 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 Sint Maarten was 30 773 inhabitants; by 2024 this figure had risen to 43 350, representing a 40.9% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 13.9% of the total population, an increase of 11.0 percentage points compared to the year 2000. In 2024, there were 105.5 women per 100 men and 92.1 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 70.9% of the total population of the country in 2024 ( 30 745 people). When we add these figures to the potentially passive population (6 562 under 15 years of age and 6 044 over 65 years of age), the result is a dependency ratio of 41.0 potentially passive people per 100 potentially active people. This ratio was 40.8 in 2000.

Life expectancy at birth in 2024 was 76.5 years, lower than the average for the Region of the Americas and 2.1 years higher that in 2000 (74.4).

Figure 1. Population pyramids of Sint Maarten, years 2000 and 2024

Health situation

Maternal and child health

Between 2013 and 2018, infant mortality in Sint Maarten increased from 13.7 to 14.6 deaths per 1000 live births, a decrease of 6.6% (Figure 2). The percentage of low-weight births (less than 2500 g) decreased from 18.0% to 16.6% between 2013 and 2018.

Regarding the immunization strategy, measles vaccination coverage was 90% in 2018 an increase of 8 percentage points over 2007.

In relation to fertility, it is estimated that in 2024 women had an average of 1.4 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 60.5% decrease, from 42.1 live births per 1000 women aged 15 to 19 years in 2000 to 16.6 in 2024. Between 2013 and 2018 the percentage of pregnant people who received antenatal care increased from 90% to 100%. In 2018, 100% of births were attended by skilled birth personnel.

Figure 2. Infant mortality per 1000 live births, 2013–2018

Communicable diseases

In 2021, there were 2 new cases of tuberculosis per 100 000 population in Sint Maarten.

In 2020, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 0 per 100 000 population.

Noncommunicable diseases and risk factors

In 2022, there were 5 new cases of tuberculosis per 100 000 population in Sint Maarten. In 2020, Sint Maarten ranked 11th in the Region of the Americas in terms of the number of deaths from COVID-19, and 23th in 2021.

As of 31 August 2022, at least one dose of COVID-19 vaccine had been given to 64,2% of the territory's population. As of 31 August 2022 (latest available data), 59,7% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and one type of COVID-19 vaccine has 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

Perspective

Measures to achieve universal health coverage

The Government of Sint Maarten is pursuing several initiatives, including a targeted universal health coverage project. Together these initiatives promote a sustainable and universally accessible healthcare system and represent an adoption of the global move toward universal health coverage. Government policy is focused on reducing perinatal mortality and improving uptake of reproductive health care by groups in situations of vulnerability. The Ministry of Health is developing a road map for an equitable and financially sustainable social insurance fund that can ensure access to health insurance for all residents of Sint Maarten. Also, strategic action area four of the Multisectoral Action Plan for the Prevention and Control of Noncommunicable Diseases in Sint Maarten (2021–2030) is to strengthen noncommunicable disease care to ensure availability and access to standardized noncommunicable disease services for all, with special focus on populations in situations of vulnerability. The universal health coverage project aims to provide access to emergency health care to nonresidents who are not covered by general social health insurance.

The national noncommunicable disease plan for Sint Maarten describes an overall goal to "create and promote a supportive environment that enables and empowers people to make healthier choices that will prevent and reduce NCDs and their risk factors by 2030". The plan outlines four areas for strategic action: (1) strengthen health systems for surveillance, research, monitoring, and evaluation on noncommunicable disease prevalence and risk factors; (2) establish governance and coordination mechanisms for multisectoral involvement, decision-making, and implementation of a the Multisectoral Action Plan for the Prevention and Control of Noncommunicable Diseases; (3) reduce noncommunicable disease risk factors by creating awareness, promoting healthy lifestyles, and addressing determinants of health; and (4) provide quality, people-centered, integrated, and comprehensive services for the effective management of noncommunicable diseases, including self-management. The Multisectoral Action Plan for the Prevention and Control of Noncommunicable Diseases focuses on key noncommunicable disease groups (cardiovascular diseases, diabetes, cancer, chronic respiratory disease, and mental health), risk/protective factors (physical activity, diet, smoking, harmful use of alcohol, and air pollution), and social determinants of health. These noncommunicable diseases and risk factors were defined as targets for intervention at the Third United Nations High Level Meeting on Non-Communicable Diseases in New York in September 2018.

Challenges related to population health

Sint Maarten’s population is aging, and the increasing proportion of older adults is predicted to continue. In 2020, the proportion of Sint Maarten’s population aged 65 and older was 11.7%. This proportion is predicted to rise dramatically to 26.5% by 2040, and then remain steady at just above 26% by 2060. Life expectancy was estimated at 78.8 years in 2020 (76.4 years among men, 81.3 years among women), and is expected to rise towards the mid-80s, reaching 83.1 years by 2040, and 86.6 years by 2060. These anticipated life expectancy rates are below estimated rates for much of Western Europe, but above many life expectancy estimates for the Caribbean. As with much of the region, the main challenge for Sint Maarten is the increasing burden of noncommunicable diseases and mental health conditions, and a national strategic plan for noncommunicable diseases (2021–2030) has been approved by the Government.

Response to the COVID-19 pandemic and disasters

Preparedness for infectious disease outbreaks is now a key agenda point for the health ministers within the Kingdom of the Netherlands, where national, regional, and local plans are being developed to improve preparedness and response to infectious disease outbreaks. The Pan American Health Organization (PAHO) continue to provide technical cooperation to maintain essential functions. Sint Maarten was severely impacted by Hurricanes Irma and Maria, which significantly damaged infrastructure, resulting in strained national resources and constraints to economic growth. Since then, Sint Maarten has taken measures to rebuild and develop a resilient health sector. PAHO and the European Union are assisting the Government of Sint Maarten to increase the capacity to respond to disaster preparedness and other related public health emergencies.

Measures to reduce inequalities in health

In 2022, an assessment is planned to collect information on health inequalities in the territory, and a strategy to address inequalities will be based on the outcomes of this assessment. The Ministry of Health aims to reduce health inequalities among the population of Sint Maarten by ensuring multilanguage health promotion campaigns, and the operation of community help desks that are strategically placed within communities in situations of vulnerability to improve access to healthcare services.

References

1. Pan American Health Organization. Health in the Americas+. Washington, DC: PAHO; 2022. Available from: https://hia.paho.org

2. United Nations. Time to Deliver: Third UN High Level Meeting on Non-Communicable Diseases. New York: UN; 2018.

3. United States Census Bureau. International database: world population estimates and projections. United States Census Bureau; 2021 [cited 15 September 2022]. Available from: https://www.census.gov/programs-surveys/international-programs/about/idb.html.

4. Government of Sint Maarten, Ministry of Public Health, Social Development and Labour. National Multisectoral Action Plan for the Prevention and Control of Noncommunicable Diseases In Sint Maarten (2021–2030).

5. Pan American Health Organization. PAHO Annual Report 2020 Universal Health and the Pandemic – Resilient Health Systems. Aruba, Curaçao, Sint Maarten, Bonaire, Sint Eustatius, and Saba. Washington, DC: PAHO; 2021. Available from: https://iris.paho.org/handle/10665.2/54563.

6. Pan American Health Organization. PAHO Annual Report 2020 Universal Health and the Pandemic – Resilient Health Systems. Aruba, Curaçao, Sint Maarten, Bonaire, Sint Eustatius, and Saba. Washington, DC: PAHO; 2021. Available from: https://iris.paho.org/handle/10665.2/54563.