Statement of Problem

“What are the factors that affect residents of the Angoy’s Avenue Community from accessing
Public health care services and how does this affect their health.”
 Introduction
Guyana’s health care system is one that has been noted for being universal and easily accessible
by all citizens. Though it is important to note that no health care system is without its faults,
Guyana’s system over the years has been plagued with criticisms as it relates to their
accountability and efficiency.
The purpose of this research is directly linked to the objectives. Hence the researchers wish to
determine the following: what is access to good health care; the benefits of accessing good
healthcare; the factors affecting persons from accessing good health care; and how not accessing
good health care affects persons’ health. The researchers through this study would like to shed
light on the situation so awareness can be raised and proper measures could be put in place to
deal with the issue.
The research will be carried out in the Angoy’s Avenue community to assess the factors that
affect residents there from accessing health care services and how this affects their health.
According to an article by Kaieteur News, September 27, 2015, this community is noted for its
high rate of impoverishment and poor infrastructure over the years. These situations have
somewhat heightened residents’ inability to access good health care and have thus led to a
significant number of health problems involving death.
This research will benefit primarily the Ministry of Health along with the hospital and clinics in
the New Amsterdam area. One main role of the public health institution in Guyana is to build
healthier communities; that is a force that will drive national development. Through the
information gathered in this research the health institution will be more able to understand the
needs of the residents in the Angoy’s Avenue community. They will also be better able to equip
clinics and other health institutions with good quality health care facilities and personnel and
most importantly put systems in place to help those vulnerable individuals to better access health
care, whether it be pre, during and or post care.
Secondarily, this research will benefit persons in the wider community, more so teachers and
students. This will enable them to become more aware of the seriousness of the health issues
plaguing the community. They will also be able to work towards preventing the prevalence of
certain ills in society by doing regular check-ups. As well as in the case of students, education on
the issue and health in itself will help them to build knowledge, skills and positive attitudes.

Technical terms
Access - the timely use of professional health services to achieve the best health outcomes; the
process whereby people actually use services—utilization serving as a proxy for access; the
health insurance coverage or the eligibility of a person to receive health care services if they
were to fall ill; the ability to receive health care service when needed; the individual’s perception
of whether or not they can get the services they want.
Accountability - taking responsibility for one’s actions; always ensuring that you are competent
to do the activity you've been asked to perform.
Alleviate - to cause the lessening or disappearance of a patient's problem.
Competent - the application and demonstration of appropriate knowledge, skills, behaviours, and
judgment in a clinical setting.
Decentralised - the transfer of control of an activity or organization to several local offices or
authorities rather than one single one.
Debilitate – to make someone very weak and infirm.
Metropolitan - a region consisting of a densely populated urban core and its less-populated
surrounding territories, sharing industry, infrastructure, and housing.
Mortality- the state of being subject to death; death, especially on a large scale; the number of
deaths in a given area or period, or from a particular cause.
Preventative - a medicine or other treatment designed to prevent disease or ill health.
Remote- a place that is situated far from the main centres of population; distant; isolated.
Sub-specialty - area of study or a specific interest in which a person has become an expert;
something that meets particular tastes and needs.
 Objectives
1. To define access to good health care.

2. To determine the benefits of accessing good healthcare.

3. To determine the factors affecting persons from accessing good health care.

4. To determine how not accessing good health care affects persons’ health.
 Literature Review
According to the Agency for Healthcare Research, 2018, One of the main factors that influence
health today is health care access. The concept can be defined in many ways. Access to good
healthcare most commonly means having “the timely use of personal health services to achieve
the best health outcomes”. It consists of four components: coverage; services- having a usual
source of care, usually associated with persons receiving recommended screening and prevention
services; timeliness- ability to provide health care promptly when the need is recognized;
workforce- capable, qualified, culturally competent providers.
With that in mind, it is important to note that the public health care system in Guyana as outlined
by Commonwealth Health online, 2019, is highly decentralised and is administered through the
Regional Democratic Councils and Regional Health Authorities. Public health care is primarily
financed by the government, but contributions from the donor community also play a part. The
Ministry of Health plays a central role in advising and co-ordinating public health care
organisations, ensuring that public health services are developing in line with the government’s
National Health Plan.
Guyana ranks poorly in regard to basic health indicators, though it was highly regarded by the
World Health Organisation. Many citizens have complained of its lack of accountability and
efficiency in health care services across the nation’s public health care institutions.
When this is compared to one of our CARICOM sisters, Trinidad and Tobago, it shows how
much Guyana has to measure up to. Mzali, S. (2020) in his article affirmed this- many of the
health indicators for Trinidad & Tobago are similar to those of developed countries. Well over
90% of the population has access to clean drinking water and proper sanitation. Regarding
childbirth – one of the key health benchmarks for emerging markets – nearly all expectant
mothers make at least four doctor visits before giving birth, and virtually all births in the country
are attended by health professionals. The percentage of infants who are immunised against
poliomyelitis and other diseases like diphtheria, pertussis and tetanus, are roughly the same as
those in the US.
Inability to access good health care therefore is a major issue. This is because access to good
health care is beneficial to a person's overall physical, social, and mental health status and quality
of life. Primary care is the most basic and, along with emergency and public health services, the
most vital service needed in rural communities. Cohen, A. (2005) relates that primary care access
can allow for preventative services, including early disease detection. It can also lower cancer,
heart disease and the mortality rates of other illnesses and improve health behaviours; ultimately
leading to a more productive labour force. Studies have also shown that access to good health
care also improves longevity; boosting an individual’s chances
Many factors lead to individuals’ inability to access good health care. Hall, D. (2019) said in her
report that the effective coverage of health expenses may be low if a country lacks the trained
health care professional, facilities, equipment or medications necessary to address a particular
condition (resource availability gap). Even if resources are available, people may not have access
if these resources are not located in sufficient proximity to the people who need them (physical
availability gap). Similarly, access can be limited if the individuals who need the services have to
pay for it, whether through enrolment in a health insurance plan or out of pocket and lacks the
mean to do so (affordability gap). Travel to reach a primary care provider may be costly and
burdensome for patients living in remote rural areas, with subspecialty care often being even
further away. These patients may substitute local primary care providers for subspecialists or
they may decide to postpone or forego care.
According to the 2014 RUPRI Health Panel report, Access to Rural Health Care - A Literature
Review and New Synthesis, when accessing professional health care services proves to be costly
or difficult, most persons would develop natural remedies or look to the internet to research ways
to alleviate their symptoms. As a result, persons are likely to defer treatment until illness
acquires greater severity. Then the consequences are that the illness becomes more debilitating
and the cost of treatment is higher than it could have been otherwise. The patient suffers, and at
the same time the financing problem for health care is aggravated. When using homemade
natural remedies, the risks associated are detrimental to health because the sickness can evolve to
cause more damage to the individual. This can lead to hospitalization or in severe cases death. In
addition, barriers that affect the persons from accessing healthcare result in unmet healthcare
needs, including a lack of preventive and screening services and treatment of illnesses.
A vital community is dependent on the health of its population. While access to medical care
does not guarantee good health, access to healthcare is critical for a population's well-being and
optimal health.
In light of this knowledge, it has been noted that there are many challenges faced by individuals
with regards to good health care which lead to disparities. With the united force of NGOs and the
Government, these issues can be remedied and Guyana can start achieving the health goals that
were set out.
 Data Collection Sources
In order to carry out this study the researchers used both primary and secondary data collection
sources.
Primary sources
A questionnaire is a research instrument consisting of a series of questions for the purpose of
gathering information from respondents. The questionnaire was chosen to gather data for this
research because of its many advantages: a large number of people can be reached relatively,
easily and economically. Furthermore, the target respondents are able to remain anonymous as
the questionnaire does not require them to identify themselves by name.
Twenty-five questionnaires were distributed to residents of the Angoy's Avenue community who
were within the age range of fifteen (15) to seventy-five (75) by random selection, on 12th
January, 2020 at 9:00 am. The questionnaire contained both opened and closed ended questions.
The researchers received filled questionnaires from the target population in about 20- 45 minutes
after the residents completed the survey
The use of the questionnaire helped the researchers to become aware of the specific ways the
residents are affected. This is so since, the survey was carried directly to the subjects and were
not influenced by researcher bias or any ‘middle man interpretation’. Hence the researchers were
able to capture the complete picture of the problem by gaining direct insight on the underlying
health issues that plague the community.
Secondary sources
Secondary sources give credible and reliable background information about the problem being
investigated from learnt individuals who would have carried out varying surveys and
observations. Some secondary sources that were used include: websites and newspaper articles.
One such source was an online report titled, ‘The RUPRI Health Panel report’. It noted that when
accessing professional health care services prove to be costly or difficult, most persons would
develop natural remedies or look to the internet to research ways to alleviate their symptoms.
This in many cases, worsens the illness.
The use of the secondary sources helped the researchers to gain a clearer understanding of the
problem by providing a backdrop for the data gathered from the questionnaire. With this source
the researchers were able to gather previous work from learnt individuals who have varying
view-points. This provided a basis for comparison of the data gathered meanwhile aiding the
researchers to look at the research problem from new angles. Also, this helped them to realise
that the viewpoints of many learnt individuals on issues that affect the poor and needy are far
from what the victims give voice to.
The combination of primary and secondary methods identified also allowed for greater validity
and reliability of interpretations, analysis and conclusions.
Questionnaire
1. Sex
Male Female
2. Age
15-35 36- 45 46- 65 66- 75
3. What is your ethnicity?

African East Indian Amerindian Mixed

4. What is the nature of your occupation?

Field Factory Office Other……………

5. Is there any health facility in the community?

6. How often do you visit the hospital for treatment when you are sick or for check-ups?
Every month Every 3-6 months Every 6-12 months Other………….
7. How do you get to the hospital/ What method of transportation do you use?
Foot Bicycle Car Bus

8. Rate the quality of service provided by the health care facility

Yes No

If yes, please state the illness or disease

10. What would be some of the benefits of accessing good health care?

Prevent Complications

Improved quality of life

Detection, diagnosis and treatment of diseases in early stage

11. What factors affect you from accessing good health care?
Poor roads and lack of other infrastructure Lack of transportation
Long waiting time Lack of skilled professionals and suitable equipment
Poverty Fear Lack of education Location of Health care facility
Shortage of medication Lack of confidentiality of medical personnel

12. How does being unable to access good health care affect you?

Brings on anxiety and stress Unmet health needs Increase in severity of illness

13. How long have you been affected by the inability to access good health care?

Under 6 months 6- 11 months 1- 3 years over 3 years

14. Have you ever felt stigmatised (discriminated against) when seeking or receiving
healthcare because of (mark all that apply)?

Your physical disabilities Your sex (male/female) or gender Your health condition

Your mental health status Your ethnicity or race The community you are from

15. Do you know about any health Non-Governmental Organisations within the area?

Yes No

16. What can non- governmental organisations (NGOs) do to help the residents access better
health care?

Help residents with transportation

Conduct and or assist in medical outreaches

Assisting the government to invest in equipment

Spread awareness of health issues, making the government more informed.

17. What are the ways in which the government can improve health care in your community?
Train more health care personnel
Repair and monitor infrastructure in the community
Invest more in healthcare facilities and equipment
Conduct medical outreaches in the area