Primary health care delivery in Carriacou, Grenada

ABSTRACT

The people of Carriacou utilize curative more than preventative services. Over a four month period of study a total of 1349 patients made encounters at the District Medical Officer's clinics. Most of the encounters were for problems which required treatment e.g. circulatory system diseases, respiratory system diseases, musculo-skeletal system diseases. Other clinics, including the chronic disease, dental, dressing clinics and casualty, were also involved in curative work. However, the low percentage of check-ups (2.2 percent), the limited number of Pap smears done (91 or 5.7 percent of females over 15 years old), the poor immunisation status and low contraceptive use all express the need for preventive care. The distribution of health problems in this lesser developed country appears to be similar to more developed countries. Problems which tend to affect developing countries such as infective and parasitic disease are not a cause of significant morbidity on this island. These illnesses rank seventh in the list of most common diseases. Hypertension, upper respiratory tract infections, and dyspepsia are among the three most common health problems. The position dyspepsia occupies is unlike findings in other countries. This may be the result of dietary factors, alcohol abuse or excessive use of aspirin. The problem needs further investigation. There appears to be rational drug prescribing in Carriacou. No prescriptions were written for more than three drugs during the study and 3.4 percent of prescriptions were for three drugs. Poly-pharmacy is avoided. Compared to some more developed countries there is limited use of psychotropic drugs. There is a need for back-up services in instituting health measures. This is brought out by the cessation of clinics at times when the health personnel assigned to certain duties is absent. Immunisation was one such activity that was affected. Carriacou has great potential to become a healthier nation in the Caribbean. One must, therefore alert health planners of the need for (1) Upgrading the present system of disease reporting (2) Health education programs (3) Cancer screening activities (4) Improved maternal and child health activities (AU)