Whenever I think of healthcare, three things readily come to mind – affordability, access and quality. As a young person in Jamaica, accessing healthcare comes with its challenges. Many young persons, irrespective of their status, struggle with accessing affordable and quality health services, particularly relating to sexual and reproductive health (SHR) services and information.
But as I learned, these challenges are not unique to Jamaican youth. A month ago, as a youth delegate on behalf of UNICEF, I attended the Global Conference on Primary Health Care (PHC) in Astana, Kazakhstan, held to renew a commitment to primary healthcare to achieve universal health coverage and the Sustainable Development Goals. More than 90 young people, representing over 50 countries, came together to share their experiences and challenges.
Across the world, in Asia, Africa, Europe, the Caribbean and Latin America, the experiences of youth as users of PHC include barriers such as:
- affordability of healthcare services;
- cost of treatment and medication (including contraceptives);
- accessing quality and confidential care; and
- the location of health facilities and the costs associated with transportation.
Jamaica joins world’s largest U-Report poll
Ahead of the conference, countries around the world, including Jamaica, participated in the world’s largest ever U-Report poll, to which 400,000 youths responded! Here in Jamaica, 49 per cent of U-Reporters who responded said that their main consideration when deciding on seeking medical treatment was the cost. Twenty-nine per cent said quality of treatment; and a small, but noteworthy, seven per cent said confidentiality/privacy. Distance and friendly and respectful staff came just after at six per cent.
When asked what they do when they are ill, an alarming 22 per cent said they ‘look for info online’ and 20 per cent responded that they ‘take medicine at home’. However, 27 per cent opted to ‘go to see a regular doctor’.
I was supposed to get stitches, but the nurse refused to deliver treatment because I was HIV positive.
These results raised many concerns. Though healthcare in Jamaica is free, it is limited and remains inaccessible for some young people because of the distance from home to health centres; the cost to travel to and from; and the nature of the treatment they are receiving. This also raises concerns about whether healthcare workers are offering youth-friendly services and protecting the privacy of young persons.
Access to healthcare is even more complicated for young people who belong to key and marginalized groups – those who are disabled, LGBT, living with HIV and living in rural areas. A lack of access will of course contribute to youths making decisions that could damage their health. In a subsequent U-Report poll, 35 per cent said that they did not use a condom when they first had sex.
Leaving nobody behind
Distrust both among those seeking treatment and those supposed to treat them is also an issue. “I was supposed to get stitches, but the nurse refused to deliver treatment because I was HIV positive,” a young person living with HIV said at a focus group held by Jamaica Youth Advocacy Network (JYAN).
One of the major themes arising from the PHC conference was that no-one should be left behind. Commitments to ensuring universal PHC must be targeted and involve many stakeholders – the government, the private sector and especially youth, who must be at the centre of their healthcare needs.