#BTColumn – Healthcare that truly cares

Disclaimer: The views and opinions expressed by this author are their own and do not represent the official position of the Barbados Today Inc.

by Monique Lavine-Hinds

When discussing healthcare, it is important to understand the difference between the availability and accessibility of healthcare systems. In many instances the success of the Barbadian healthcare system is determined by the availability and expansion of services being provided.

One determinant of success of healthcare in a small island developing state like Barbados is the decentralisation of these services to the community. Decentralisation refers to the physical movement of the structure to various locations. This is evident given the relatively rapid expansion of polyclinics, geriatric hospitals and district hospitals in Barbados.

The premise behind this idea was that those in rural communities would be more readily able to access these facilities and seek treatment. However, while these services may be more available the question that needs to be asked is if these services are accessible, what are the barriers which may prevent some individuals from accessing care?

There are four areas to consider when discussing the accessibility of healthcare services.

• If services are available, in terms of an adequate supply of services, then a population may ‘have access’ to healthcare.

• The extent to which a population ‘gains access’ to healthcare also depends on financial, organisational and social or cultural barriers that limit utilisation. Thus, utilisation is dependent on the affordability, physical accessibility, and acceptability of services and not merely the adequacy of supply.

• The services available must be relevant and effective if the population is to ‘gain access’ to satisfactory health outcomes.

• The availability of services, and barriers to utilisation, have to be evaluated in the context of the differing perspectives, health needs and the material and cultural settings of diverse groups in society.

In Barbados there has been an improvement as it pertains to the accessibility of healthcare services as compared to twenty-years ago. However, it is important to acknowledge the impact financial, organisational, social, and cultural barriers may have on accessibility of these services even though they appear to be in adequate supply.

Culture in the Caribbean plays an important role as well as people’s perception of these services and how others would perceive them if they were seen utilising these services. The introduction of polyclinics was to assist those who can’t afford to seek private treatment and who were unable to travel to the city to gain access to healthcare.

As Barbados evolved as a nation these institutions were a means of defining status in society where if you can afford to pay for private care you will go elsewhere.  Economic barriers also play an important role in the affordability to healthcare especially now with the current economic situation Barbados is facing. Persons now have to prioritise their spending as they
have to pay over three dollars to take a bus to get to a polyclinic which can make a difference for some persons trying to make ends meet.

This is important to consider when developing outreach community programs to seek to make greater availability of services not only in the physical movement but making sure that every vector of society is exposed to these services. This means going into communities and ensuring that care is being provided for those who need it.

By doing so it may lessen the negative connotations persons may have and perceptions may change as it is not where care is accessed but that care is being provided. Another aspect to consider is the demographic changes in Barbados as it develops.  For many years the population of Barbados has been predominantly those of African and European heritage.

However, with the introduction of Caribbean Single Market and Economy (CSME) and the free movement of people in the Caribbean, it is important to examine the barriers it presents for some persons accessing various healthcare services as religious persuasions. Moreover, language barriers may also inhibit new members of the population from accessing healthcare. Also, ethnic diseases differ, whereas persons of African descent are more likely to suffer from chronic illnesses such as diabetes and Hypertension compared to those of Indian descent who have a genetic predisposition to suffer from heart disease or develop type II Diabetes.

It is important to identify where these persons live in our communities and record the relevant data to see what impact the integration of persons have on the accessibility of healthcare services, ensuring that the services being provided are relevant in today’s society.

These are just a few of the issues that need to be addressed when discussing healthcare reform and policy to ensure that the changes being made are effective and efficient as we develop
as a nation.

Monique Lavine-Hinds holds a  BA in Psychology, MSc in Healthcare Management (Honours) and is passionate about  people and healthcare in the region. She can be contacted at healthcarethatcares246@gmail.com