The Tribune

By RASHAD ROLLE

Tribune News Editor

rrolle@tribunemedia.net

MATERNAL and infant mortality in The Bahamas have fluctuated at concerning levels in recent years, with the latest available data pointing to persistent weaknesses in the country’s health system despite reform efforts, a new regional health strategy warns.

A report by the Pan American Health Organisation (PAHO) said the maternal mortality ratio climbed to a high of 248.8 deaths per 100,000 live births before easing to 212.1 in 2022, while infant mortality rose to 29 deaths per 1,000 live births before declining to 22.7.

Though both indicators have shown some improvement, the latest available data suggest they remain elevated and volatile for a country at The Bahamas’ level of economic development, pointing to uneven outcomes in areas closely tied to the health system's performance.

The findings are contained in PAHO’s Country Cooperation Strategy for The Bahamas for 2026 to 2031, the first such framework outlining priority areas for collaboration with the government.

The report relies on the most recent available health data, much of which runs up to 2022, and links the country’s challenges not only to lifestyle-related illnesses but also to structural issues within the system, including access gaps, resource constraints, and the complexities of delivering care across an archipelago.

It comes as noncommunicable diseases continue to dominate the country’s health profile, accounting for nearly 60 percent of all deaths. Conditions such as heart disease, stroke, diabetes, and hypertension remain the leading drivers of mortality.

The report paints a picture of a population facing significant health risks. More than three-quarters of adults are overweight or obese, while hypertension affects over a third of the population. Physical inactivity and poor diets are also widespread, contributing to the growing burden of chronic disease.

At the same time, the country’s demographic profile is shifting, with an ageing population expected to place additional strain on health services in the coming years.

Beyond disease patterns, the report highlights persistent barriers to care. Access to services remains uneven, with residents in the Family Islands face logistical challenges in obtaining timely treatment.

Clinics in New Providence serve far larger populations than those on less populous islands, reflecting disparities in resource distribution. Patients also face long wait times for specialist care, limited availability of certain services in the public system, and cost barriers when forced to seek private treatment.

The health system is described as complex, with overlapping responsibilities between public and private providers and multiple funding sources that contribute to inefficiencies.

Against this backdrop, PAHO’s strategy outlines a series of priorities to strengthen the system, including improving access to quality care, expanding the health workforce, enhancing surveillance and data systems, and increasing resilience to public health emergencies and climate-related threats.

The plan also points to continued expansion of the National Health Insurance programme, greater integration of public and private healthcare delivery, and increased use of digital health technologies, including telemedicine.

The report also notes that The Bahamas, despite having one of the highest per capita incomes in the region, continues to face persistent inequities in access to care and health outcomes.

It argues that addressing these issues will require sustained coordination across government, the private sector, and international partners, along with a greater focus on prevention, primary care, and system efficiency.

PAHO said the strategy was developed through consultations with national stakeholders and is intended to guide technical cooperation over the next six years.

While it does not prescribe specific policy decisions, it provides a framework for tackling what it describes as the country’s most pressing health challenges and for improving outcomes across the population.