Antigua and Barbuda

The Caribbean islands of Antigua and Barbuda have been having economic difficulties after a decline in tourism that began in 2000. Commitment to public health has suffered, even though the government announced in 1994 that it was committed to guaranteeing health as a human right and launched a multiyear program designed to improve access to healthcare. With a per capita income of $10,900, Antigua and Barbuda rank 85 out of 233 countries in world income. Some 82 percent of the labor force are engaged in service industries, mostly tourism, and unemployment now stands at 11 percent. The unofficial poverty rate is 12 percent, and the bulk of those living below the poverty line are mothers with dependent children. Important data on many social indicators are unavailable, making analysis of general health somewhat difficult.

[Page 149]While only 3.8 percent of the labor force is involved in agriculture, this sector is extremely important to the overall health of islanders because local farmers sell chiefly to the domestic market. Agriculture on the islands is vulnerable to the hurricanes and tropical storms that occur between July and October and to periodic droughts. Most islanders (85.8 percent) over the age of 15 are able to read and write. The United Nations Development Programme (UNDP) Development Reports rank Antigua and Barbuda 59th of 177 countries on overall quality-of-life issues.

While 95 percent of the urban population has access to safe drinking water, that number drops to 89 percent in rural areas. Likewise, 94 percent of the rural population has access to improved sanitation compared to 98 percent of urban residents. The government spends 4.5 percent of its Gross Domestic Product (GDP) on healthcare, and allots $443 (international dollars) per capita for healthcare expenditures. Government spending accounts for 70.6 percent of total health expenditures, but none of that is directed toward providing social security. Almost 30 percent of healthcare costs are derived from private sources, and virtually all of those are out-of-pocket expenditures. Access to health professionals on Antigua and Barbuda is somewhat limited because there are only 0.17 physicians and 3.28 nurses per 10,000/population on the islands.

Antigua and Barbuda's population of 69,108 experiences a life expectancy of 72.16 years, earning the islands a ranking of 118th in world life expectancy. At 2.24 children per female, the fertility rate is also in the mid-range. Approximately 53 percent of island females use some method of birth control. All births are attended by skilled personnel, and all women receive prenatal care. The maternal mortality rate is 65 deaths per 100,000 live births.

The infant mortality rate on the islands is 18.86 deaths per 1,000 live births, and male infants (22.71) are particularly vulnerable compared to females (14.82). The under-5 mortality rate is 12 deaths per 1,000 live births. Eight percent of island infants are underweight at birth. Around 10 percent of children under the age of 5 are malnourished, and 4 percent are severely underweight. Some 10 percent of the un-der-5 population suffer from wasting diseases, and 7 percent of this age group experience growth stunting. The government subsidizes 100 percent of the required vaccines for small children. As a result, 91 percent of all children are immunized against diphtheria, pertussis, and tetanus (DPT1), and 97 percent receive the DPT3, polio, measles, hepatitis B, and Haemophilus influenzae type B (Hib3) vaccines.

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