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.
Highlights
Equitable health according to the World Health Organization (WHO) is the bedrock of a just health care system, which ‘is built on having trained and motivated health workers, a well-maintained infrastructure and a reliable supply of medicines and technologies, backed by adequate funding, strong health plans and evidence-based policies’ [1]
Limited resources and system inefficiencies have facilitated the development of an environment that nurtures inequity
In Trinidad and Tobago’s health system, access inequity may arise from unavailability, a substandard public health environment, public policy dilemmas, or rule malinterpretation (Figure 1) and patient’s perception of the health service
Summary
Equitable health according to the WHO is the bedrock of a just health care system, which ‘is built on having trained and motivated health workers, a well-maintained infrastructure and a reliable supply of medicines and technologies, backed by adequate funding, strong health plans and evidence-based policies’ [1]. It involves the removal of obstacles in other sectors such as education, housing, or transportation [2] as well as alleviating difficulties in other social determinants of health, and is integral in delivering a quality health service. A study in Nepal reported the existence of a pro-rich distribution of healthcare utilization, both publicly and privately [5]
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