Barbados

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Latin America and the Caribbean

6.3%CHE/GDP

46.7%OOP/CHE

8.7%GGHE-D/GGE

6BGDP (USD)

282.3KPopulation

Barbados is an island nation in the Caribbean with a population of 281,200 in 2021.^[1] The World Bank Group classifies it as a high-income country. The following historical description of their health system is extracted from a Ministry of Health (MOH) of Barbados discussion paper.

The Health Services Act 1969 CAP 44 of the Laws of Barbados provides the policy framework for the “promotion and preservation of the health of Barbadians. … It also allows for the administration of the health services through funds voted by Parliament. … Successive Development Plans since independence in 1966, and the Barbados Strategic Plan for Health articulate the philosophical basis of the health services, through which the State has responsibility for the provision of a comprehensive health service, funded by general taxation and available to citizens and approved permanent residents free at the point of service delivery”.

Multiple sources of financing for health

The MOH receives its funding through annual provisions voted by the Barbados Parliament. Private financing contributes to health expenditure via health insurance, fee-for-service and other types of out-of-pocket (OOP) expenditure including prepayment schemes. Pooled insurance funds finance health services via a combination of employer-employee contributions.

Health care through the public care system is officially free at the point of delivery in Barbados and publicly funded (through the “consolidated fund”). Successive National Health Accounts (and associated estimates) show, however, that OOP expenditure and voluntary prepayments (private insurance) have consistently contributed 40% or more to health expenditure for the last two decades.

Domestic general government health expenditure accounted for 3.75% of GDP (below the 6% recommended by the Pan American Health Organization) in 2020, and, in 2021, OOP expenditure was 38.9% of current health expenditure.^[2] The Organisation for Economic Co-operation and Development estimates suggest that 16.4% of the population of Barbados may be spending more than 10% of their budget on health (higher than the regional average), which could be pushing 1.4% of the population below the poverty line.

Ongoing challenges and how to address them

High OOP expenditure and potential for catastrophic costs remain a concern. The nation is experiencing both a demographic and epidemiological shift, with an increasing prevalence of noncommunicable diseases. Reducing costs and ensuring access to affordable medicines (with pooled procurements) could contribute to efficiency.

References

[1] World Health Organization, Global Health Expenditure Database

[2] World Health Organization, Global Health Expenditure Database – Health Expenditure Profile