The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

An extra 14,500 Bahamians will benefit from the Government’s decision to expand its investment in Family Island public health clinics by more than 50 percent, it has been revealed.

An Inter-American Development Bank (IDB) paper seen by Tribune Business reveals that the addition of $5.7m in European Union (EU) grant monies, and the repurposing of some $5.862m from the original loan, will enable the Government to double the number of newly-built and upgraded clinics to 18 in its “biggest public healthcare investment for 15 years”.

The repurposing, combined with the extra money, is set to increase the investment in the clinics, their medical equipment and fit-out by some 54.5 percent above what was initially conceived, taking this from $20m to almost $30.9m - a rise of nearly $11m.

In doing so, the IDB report projected that the expanded network of clinic upgrades will touch and benefit more Bahamians, especially residents on Family Islands, increasing the number impacted from 60,000 to 74,500. And it estimated that 220,000 will benefit from moving the National Reference Laboratory to an upgraded facility.

The IDB is providing the bulk of the necessary financing through two loans, worth a combined $60m, with the EU grant taking the available funding pool to more than $65m. “The Ministry of Health and Wellness has embarked on essential upgrades to public health and primary care services,” the multilateral lender’s paper said.

“With IDB support, it will invest the sum of $60m during the next four years through two investment loans that complement each other. In more than 15 years, the Ministry of Health and Wellness has not invested in this scale to strengthen and modernise its public health and primary healthcare services.”

Confirming that the Ministry of Health had requested that more funding be redirected and redistributed to addressing existing deficiencies with the public health clinics themselves, the IDB added: “It will finance the construction of nine primary health clinics, the retrofitting of nine primary health clinics and the upgrade of the building where the Ministry of Health and Wellness will relocate the National Reference Laboratory.

“This component will still finance the procurement of new medical equipment, such as basic medical devices, diagnostic devices, equipment for emergency care, dental and preventive care and six ambulances.... The MInistry of Health and Wellness prioritised aged primary health clinics vulnerable to environmental hazards, lacking maintenance and outdated medical equipment.”

As to the benefit of doubling the number of public sector health clinics, the IDB added: “In the original version of the programme, it was estimated that about 60,000 people would benefit after improving the infrastructure of nine clinics.

“The increase from nine to 18 primary health care clinics with climate resilience and energy efficient measures, including reinforcing the medical infrastructure furniture and new medical equipment, will facilitate access and improved services to approximately 74,500 people living in 11 Family Islands.

“The reallocation of the National Reference Laboratory to an upgraded facility will benefit 220,000 people. The introduction of the digital health technology in 85 clinics will improve healthcare quality for the total population in The Bahamas, 349,939 persons.”

Although the financing has been cut from the originally-envisaged $10m to $6.9m, another component of the IDB-financed healthcare upgrade involves modernising the public healthcare sector’s information management system. Despite the funding cut, the bank estimated that the number of clinics set to benefit will still increase from 54 to 85 due to ongoing improvements being facilitated by both itself and the Government.

All locations will receive Internet connectivity and see the implementation of electronic patient records, together with the necessary cyber security protections. “The decision to increase from 54 to 85 clinics will allow the Ministry of Health and Wellness to speed up the digitisation of the health information system and health care services in all primary health clinics of the public healthcare system” the IDB paper added. 

“The Ministry of Health and Wellness considered the feasibility of the connectivity and the implementation of the electronic health records, given the country’s geographical conditions.” Dr Michael Darville, minister of health and wellness, was said to be travelling and could not be reached for comment before press time last night.

However, it was previously revealed that the nine new clinics will be built in Moore’s Island, Abaco; Fresh Creek and Mangrove Cay, Andros; Smith’s Bay, Cat Island; Staniel Cay and Black Point, Exuma; Long Cay; and Rock Sound and Palmetto Point, Eleuthera.

The National Reference Laboratory in New Providence will be relocated to the former Bahamas Mortgage Corporation Building on Russell Road, while the primary healthcare clinics set for upgrade and renovation are based at Matthew Town, Inagua; Marsh Harbour and Fox Town, Abaco; Mastic Point, Andros; Simms and Deadman’s, Long Island; Alice Town, Bimini; and Fox Hill Clinic in New Providence.

The IDB, agreeing that the project’s financial repurposing is justified, said: “The COVID-19 pandemic had severe economic effects in reducing the fiscal space and curtailing further investments to improve supply capacity to deliver primary healthcare services.

“The Government of The Bahamas prioritised most resources for the pandemic response. It temporarily repurposed health personnel, medical equipment and health facilities for COVID-19 cases. For instance, it transformed a polyclinic in southern New Providence into a ten-bed negative pressure COVID-19 care centre. This facility remained a COVID-19 treatment centre from April 20, 2020, to October 31, 2021.

“The clinic’s conversion allowed for the management of COVID-19 patients and disrupted primary health care services in New Providence. Reallocating health personnel and repurposing facilities allowed the Ministry of Health and Wellness to effectively manage the public health emergency. However, it also strained further its capacity to provide primary health care services and widened previous deficiencies,” the IDB added.

“Before the pandemic, the population had limited access to primary healthcare services due to geographic barriers and the inadequate conditions of primary health care clinics and medical equipment. Moreover, the social distancing measures, lockdown, curfews also affected the demand for primary healthcare services.

“Therefore, the Ministry of Health and Wellness request to reallocate the resources of the loan is justifiable and allocate the EU grant funds to strengthen the facilities and renovate the medical equipment. Moreover, the modernisation of the model of care for non-communicable disease patients and the introduction of digital health technology, including telemedicine services, will facilitate access and increase coverage in more Family Islands.”