Fitness reform must be driven by way of empirical records, quality practice and evidence based totally practice. A spread of fitness data; along with mortality, manpower needs, technology functioning and affected person satisfaction; need to be analyzed and hired in strengthening health systems. In trinidad and tobago the contemporary gadget of healthcare is noticeably centralized. The ministry of health continues operational oversight of five regional fitness government. These are the north west nearby, north critical nearby, eastern nearby, south west nearby and tobago nearby. South west, north west and north primary are the biggest areas; each catering for the healthcare needs of extra than three hundred thousand humans. A giant reform ought to be the specialization of the ministry of fitness in fewer functions aimed to improve healthcare performance.