PAHO report underscores need to prioritize primary healthcare in the Caribbean

A new report from the Pan American Health Organization (PAHO) emphasizes the importance of prioritizing primary health care to achieve universal health coverage across the Americas, including the Caribbean. The report highlights the progress made by countries in the region, as well as the ongoing challenges they face in ensuring access to health services without placing an unsustainable financial burden on individuals.

“Progress in universal health in the Americas: addressing unmet healthcare needs, gaps in coverage, and lack of financial protection through primary health care,” was presented on the occasion of Universal Health Day (known globally as Universal Health Coverage Day), celebrated each year on December 12.

PAHO said the day highlights “the urgent need to overcome the barriers that limit access to health services for millions of people”.

PAHO’s Director, Dr Jarbas Barbosa, emphasised that “the report reflects PAHO’s commitment to advancing towards universal health in a region that has made great progress, but also faces persistent challenges that require innovative solutions, particularly regarding primary healthcare.”

In this context, he stressed that the COVID-19 pandemic exposed deep vulnerabilities in health systems, such as fragmentation, access barriers and inequalities that disproportionately affect vulnerable populations.

The report emphasises that unmet healthcare needs affect more than one-third of the surveyed population in the Americas, primarily impacting the poorest communities.

It added that while higher-income countries report fewer unmet needs, in lower-middle-income countries, these needs exceed 40 per cent, contributing to higher rates of preventable mortality.

“The causes of these unmet needs are varied and differ between countries, but include organisational, financial, availability, acceptability and geographic barriers,” the report says.

Another major concern highlighted in the report is the economic burden of out-of-pocket expenses on households, including direct payments for medical services, medications and treatments, which affect millions of people every year.

It is estimated that up to 79 million people in the region face financial difficulties due to healthcare costs, according to the report.

PAHO stressed that a renewed focus on primary healthcare is essential to address these issues, offering more accessible care, reducing economic barriers and improving system resilience.

“This will be key to ensuring access to care, and to strengthening the resilience and equity of our health systems, and primarily to address the diverse needs of communities,” he added.

The report also points out that regional disparities remain a major obstacle to achieving universal health coverage in Latin America and the Caribbean.

According to the report, 35.2 per cent of the region’s population reports unmet healthcare needs, with disparities more pronounced in lower-income communities, where 38.5 per cent of the population faces barriers to accessing healthcare.

While some countries have made substantial progress, others lag behind, the report says.

In many rural and remote areas, it says health services are insufficient or of poor quality, exacerbating disparities between urban and rural areas.

PAHO has urged governments in the region to prioritise investment in health infrastructure and the training of medical personnel, particularly in underserved areas.

It also recommended eliminating co-payments and expanding health insurance coverage to protect families from catastrophic and impoverishing expenses.

PAHO said these changes are essential for making health systems inclusive and fair, especially in middle- and low-income countries, where economic barriers are one of the main causes of exclusion.

To strengthen health systems, PAHO underscored the importance of intersectoral actions involving various sectors of society such as road infrastructure, telecommunications and education, which are essential to ensure equitable access to health.

In addition, PAHO highlighted the importance of integrating cultural and gender-sensitive approaches into health service delivery to ensure that all communities, especially the most vulnerable, can access the care they need.

The PAHO report makes clear that achieving universal health in the Americas is not only about expanding coverage but also ensuring that this coverage is of quality, accessible and financially sustainable.