PAHO and Montserrat advance a comprehensive health system strengthening agenda

Bridgetown, Barbados, 29 September 2025 (PAHO/WHO) - The Pan American Health Organization/World Health Organization (PAHO/WHO) and the Government of Montserrat are partnering to accelerate health system strengthening through a focused package of technical cooperation made possible, in part, by Montserrat's national voluntary contributions to PAHO.

Led by the Ministry of Health and Social Services (MoHSS) under the leadership of Dr. Ingrid Buffonge, Minister of Education, Health, Social Services and Youth Affairs, the initiative aims to optimize service delivery, improve access, reinforce governance and integration across all levels of care, and ensure financial sustainability.

A recent high-level briefing with the Cabinet of Montserrat, attended by Premier Reuben T. Meade and Dr. Amalia Del Riego, PAHO/WHO Representative for Barbados and the Eastern Caribbean, provided an update on progress and next steps. The session enabled collaborative construction of the plan of work and reaffirmed the government's commitment to advancing universal health coverage and resilient health systems.

A multi-pathway framework, tailored to Montserrat

PAHO is supporting Montserrat in strengthening its health system, guided by global PAHO/WHO frameworks and tailored to the island's needs and priorities. Work is being advanced through four key areas:

1. Strengthening access and coverage - Improving essential health services and emergency preparedness, including upgrading oxygen systems, enhancing access to medicines, and building multi-hazard response capacity.

2. Strengthening integration of care - Promoting a seamless continuum of care by advancing digital health, rolling out the HEARTS initiative for NCD risk management, and expanding outreach services such as screening, education, and linkage to care.

3. Strengthening governance and leadership - Enhancing oversight and management of the health sector through updated legislation, a customized governance structure for universal health coverage, and training programs for stewardship and leadership.

4. Strengthening health financing - Supporting financial sustainability through cost analyses of overseas care, exploring "Taxes for Health" options, and defining a minimum benefits package to guarantee equitable access to essential services.

This framework represents a bold step toward building a resilient, equitable, and efficient health system in Montserrat. By aligning with PAHO/WHO's broader goals for universal access to health and universal health coverage, and sustainable development, Montserrat is setting a precedent for small island states seeking to modernize their health system and improve population health outcomes.

Implementation status and near-term milestones

The initiative is progressing steadily, with several components already underway or scheduled for completion in late 2025. Key milestones include:

• Finalizing service delivery planning and digital transformation strategies.
• Advancing the HEARTS initiative and integrated care model.
• Continuing work on overseas care cost optimization and health financing reforms.

What this means for people in Montserrat

The multi-pathway approach brings tangible benefits at every level.

• For the public - more timely access to essential services, smoother referrals between primary care, hospital, and overseas care, and stronger financial protection.
• For health workers and managers - standardized protocols, clearer governance, improved information systems, and targeted training.
• For policy-makers - an evidence-based roadmap to guide resource allocation, strengthen regulation, and sustain improvements over time.

PAHO/WHO Representative for Barbados and the Eastern Caribbean, Dr. Amalia Del Riego reaffirmed PAHO's commitment to the health system strengthening partnership. "Montserrat's national voluntary contributions to PAHO are helping to extend the scope and depth of technical cooperation, mobilizing multidisciplinary expertise, accelerating analysis-to-action, and supporting the institutional changes needed to deliver universal health. This partnership underscores how country leadership and targeted investment can catalyze system transformation, even in small island settings".