Health Equity and Access to Health Care in Trinidad and Tobago

Abstract

Health inequity persists, particularly in developing countries. This study explores access to public health care and equity. This descriptive study was conducted using a review of the literature, print media, health reports, and patient experiences. Health accessibility links to equity were analysed, focusing on inequity in healthcare access, challenges in accessing services (long waiting times, non-available pharmaceuticals), poor public health (murder, rape, and other crimes, traffic accidents, traffic congestion, divorce, and unemployment), and misrepresentations of health guidelines. The necessary out-of-pocket spending disfavours the poor and favours the rich who, by purchasing basic health services, have greater access to public health services. The negative public health environment increases the health burden and imposes healthcare requirements which further disfavour the poor in particular, while informal networks favour the rich. Shortfalls in health services and public health necessitate out-of-pocket spending, which also dis-favours the poor and favours the rich.

Access to WHO Essential Medicines for Childhood Cancer Care in Trinidad and Tobago: A Health System Analysis of Barriers and Enablers

“…Our findings are relevant to broader health systems strengthening in T&T, because many proposed enablers of drug access would enhance overall health system performance. For instance, recent reports have suggested that institutional process inefficiencies, such as delays in hospital diagnostics resulting from inadequate staffing, create significant barriers to accessing health services in T&T. 24,25 Themes for policy reform from our study, such as increased standardization of intra-and interinstitutional processes in the pharmaceutical sector, may therefore be relevant in addressing other health system inequities as well, including access to diagnostic services and wait times for specialist care. 25 An underlying objective of our study was to develop health system capacity in T&T by equipping local stakeholders with policy-relevant data.…”

Safety and Cost-Savings of Same-Day Discharge Trans-Radial Percutaneous Coronary Intervention in Trinidad and Tobago

“…With the high economic burden of non-communicable diseases (NCDs), appropriate funding of the health sector in this small island developing state is a major step towards tending to the needs of the population. Public health services are currently free for patients, however, there has been a multitude of reports highlighting the poor performance of the public health sector in large part due to overcrowding [8,9]. This has been attributed to poor hospital throughput -defined as the number of patients served in a unit of time [8].…”

An Analysis of the Problems Users Experience in Public Health Care Facilities in Trinidad and Tobago

“…In another study, Bahall [10] notes that the health environment was inequitable in terms of accessibility gaps in public policy, public health, and secondary services which warrant out-of-pocket funding. He purports that out-of-pocket funding for basic services which the poor cannot manage or can only pay at a tremendous burden; gives an unfair advantage to others who can access more expensive and advanced services.…”

“…He purports that out-of-pocket funding for basic services which the poor cannot manage or can only pay at a tremendous burden; gives an unfair advantage to others who can access more expensive and advanced services. Bahall [10] contends that poor public health and ambiguous public policies further disadvantage patients of low socio-economic status, resulting in access inequity, (Bahall [10]).…”

“…Bahall's [10] claim of inequity in health has been supported by The Trinidad and Tobago Guardian Newspaper. The newspaper claims that long waits for medical attention and for surgeries, no beds, poor healthcare, verbal abuse, negligence and prescriptions not filled in a timely manner are some of the major complaints levied by sick patients and their families against public health institutions.…”