RESUMO
The delivery of health care in Grand Bahama was reviewed during the period October to December, 1984. In addition, during this same time frame, the health status and health problems of the population were assessed. It was found that health care is delivered at two levels, a primary and a secondary level, with patients in need of tertiary care being referred to New Providence. Emergency referrals are by way of private airplane charters. Primary health care delivery was found to be obtaining from three sources, community clinics in the outlying settlements, at the emergency room at the Rand Memorial Hospital in Freeport and private practitioners who are also based in Freeport. These three sources of primary health care were found to differ in scope of services, geographical accessibility and cost top the patient in addition, there is no locally organized framework that connects them. Secondary health care delivered at the Rand Memorial Hospital offers a fairly wide scope of services. In 1983 there were 3957 admissions to this institution of which 13.2 percent were Haitians. Deliveries, respiratory disorders, female pelvic and genital disorders and intestinal infections were the leading causes of admissions during 1983. Geographical accessibility to this institution varied with the distances of the outlying communities and access to transportation. Indicators of health status suggest that the health status of Grand Bahamians is not retarding family and community development and compares quite favourably to the more developed third world countries. The health problems isolated were cerebrovascular disease, accidental deaths, respiratory disorders, hypertension, drug abuse and female pelvic and genital disorders which probably reflects the degree of sexually transmitted diseases in the island (AU)
