FOCUSING on rural environments presents unique challenges for health care access.
In many developing countries, there are often shortages of medical personnel in rural areas, as well as transportation and distance barriers to care and an increasing economic destabilisation of rural health care services.
According to the World Health Organisation (WHO), since the mid-20th century, physicians have favoured urban and suburban practice locations over rural areas.
Physicians often need lucrative practices to repay high education debts and they have been trained to use costly new technologies in diagnosis and treatment.
Rural practice locations typically generate lower income for the physician and have fewer and older technology resources than urban and suburban locations.
Modern medical school graduates are rarely well prepared to practice in rural environments. Consequently, rural communities suffer chronic physician shortages.
WHO further points out that physicians are not most visible in primary prevention, diagnosis, and treatment.
Public health systems and an array of alternative primary care providers often fill in the gaps. Primary care may be provided by nurse practitioners, physician assistants, or home-health nurses. Practice locations include publicly or charitably subsidised comprehensive primary-care centres or categorical service clinics (e.g., prenatal care, family planning, immunisations) situated in central locations, mobile clinics, and in patient’s homes.
Specialty physician services (such as psychiatry or dermatology) may also be available through intermittent clinics in local facilities, such as health departments, churches, or schools.
In Guyana’s case, providing rural care has the additional challenge of logistics because of geography and tough terrain which has to be encountered in reaching many rural communities.
However, the government, apart from overhauling the overall health care system, has placed special focus on rural health care and that is why in almost every single community there is a health facility. But it has not only built these facilities; it has been working assiduously to ensure that they are manned by trained medical personnel and the Cuban scholarship programme is helping tremendously in this respect.
In addition, the Ministry of Health has instituted a training programme for Community Health Workers. This was most commendable and an idea with a vision because these workers are from within the community they serve and therefore would be familiar with local peculiarities and the residents.
The establishment of the diagnostic centres in several regions is another excellent step to further improve both the accessibility and quality of health care in rural communities.
This is in keeping with the special focus on rural health care of the governments between 1957 and 1964 when `Cottage Hospitals’ were established across the country, a process which began when the Ministry of Health was under the stewardship of the late President Janet Jagan.
The Campbellville Health Centre is being refurbished as part of the programme to improve such facilities countrywide as these are seen as the “essence of primary health care”, according to Minister within the Ministry of Health, Dr. Bheri Ramsaran.