Located off of the coast of Venezuela, the island of Grenada is a Caribbean nation with over 110,000 citizens. Grenada gained its independence from Britain in 1974 and emerged from Marxist rule by the early 1980s. As a relatively young constitutional monarchy, Grenada has endured political strife, natural crises and extreme poverty. The consequences of such factors have left many Grenadians in challenging conditions.

Healthcare in Grenada has improved dramatically in recent years but still has a critical need for expansion. Comprehensive healthcare in Grenada, a political and humanitarian dilemma for decades, has emerged as one of the nation’s key goals. Its government and nonprofits have made progress in recent years providing care for hundreds of thousands.

Developing Goals

Healthcare funding and goals are dynamic: Grenada’s public healthcare system, overseen by its Ministry of Health, includes 36 primary care facilities, 30 satellite care facilities, three hospitals and one psychiatric hospital. Primarily funded through general taxation, healthcare in Grenada also receives support through grants from the E.U. through the Primary Health care and Caribbean Development Bank Basic Need Program (BNTF) and by The Caribbean Public Health Agency.

These government and humanitarian entities have collaborated to bolster Grenada’s preventative healthcare, laboratory diagnosing and testing capacity. In 2015, the Ministry of Health released a healthcare action plan. By 2017, the WHO pledged its support for the plan by releasing a Grenadian Cooperation Strategic Agenda for 2018-2024 with bolstered resources for the nation. Grants also target specific public health goals, such as the current objective to eliminate mother-to-child transmission of HIV. Within communities, NGOs have translated much of that funding into tangible community health improvements. For example, Grenada National Organization of Women educates women about sexual and reproductive health and provides HIV prevention resources.

A Dynamic System

The public and private healthcare sectors support each other: In 2014, healthcare in Grenada made up 6.1% of the total GDP, yet 53.6% of that was from the private sector. With a total GDP of $911.5 million in 2014, roughly $55.6 million of that derived from the public healthcare sector and over half of that amount from the private sector. Based on the population of over 108,000 that year, less than 20 cents per capita was dedicated to public healthcare in Grenada in 2014.

The healthcare system in Grenada, mimicking a universal healthcare system, leverages those who can afford private sector healthcare to help keep costs low for its public expenditure, allocating 10%-12% of its total budget on healthcare between 2008 and 2014. The gaps in Grenada’s current healthcare systems leave both the wealthy without luxury services and the vulnerable without basic care. Without these gaps, the lucrative private sector could not thrive.

The Work that Remains

Health has improved but some populations remain vulnerable: a history of poor children’s health outcomes has led Grenada’s healthcare system to intervene earlier in the population. Grenada now has a relatively low infant mortality rate of 10.3 deaths per 1,000 births. It also has a 95%-100% essential vaccination coverage rate in its primary schools, with more healthcare in primary and secondary schools. Additionally, wasting rates in children dropped from 7.9% in 2011 to 3.4% by 2014.

Now, chronic and non-communicable diseases, including diabetes, cancer, cardiovascular and respiratory diseases, have emerged as the main cause of death and morbidity in Grenada. Risk factors for these diseases include overconsumption of alcohol, poor nutrition, obesity, lack of physical activity and hypertension. In rural areas, risk factors for chronic and non-communicable diseases are more prevalent than in urban Grenada. As of 2019, upwards of 71,000 Grenadians lived in rural areas, predominantly below the poverty line.

Despite healthcare in Grenada otherwise improving, medically vulnerable rural Grenadians essentially exist outside the mainstream economy. They lack access to efficient and consistent medical treatment and consequently have worse health outcomes than their wealthier urban counterparts.

Socioeconomic factors within and medical outcomes derived from systems of healthcare in Grenada have undoubtedly improved. Still, the Grenadian government grapples with implementing a universal healthcare system. Life-saving preventative and emergency treatments remain inaccessible for the most vulnerable populations. Grenada continues to receive essential support from NGOs and humanitarian and public health organizations implement action plans. A shift in healthcare equity will alleviate the financial and medical conditions that negatively impact hundreds of thousands of Grenadians.

– Caledonia Strelow
Photo: DVIDS