By Roslyn A Douglas, MA
Founder of Central Health-Grenada
Statistics released by the Ministry of Health indicate that more Grenadian men than women are dying from chronic illnesses such as cancer, heart disease and diabetes. As such, men’s health has become a major concern and a priority for the Ministry of Health.
Efforts ranging from evaluating surveys, conducting training sessions for healthcare professionals and community-focused health education sessions began last year, with plans to continue throughout 2014.
Director of Primary Health Care, Dr Francis Martin summarised an analysis of the causes of death in Grenada over a 10 year period, which revealed men are dying more than women from many of the chronic illnesses. “We have looked at the data, the mortality data over the past 10 years and put those data together in one graph. And what those data together in one graph shows is that [out of] the 10 leading causes of death in Grenada, the most in terms of share quantity is cancers. Cancers are the leading cause of death in Grenada, and on the heels of that are cerebrovascular diseases. So you are talking about strokes, heart attacks and what have you. Pulmonary disease is next and metabolic disease which is like complications of diabetes, comes in fourth.”
Although cancers are the number one cause of death in the 10 year analysis, overall in many of the other diseases, Grenadian men are dying more than women, “So the cancers, the cardiovascular diseases like strokes and heart attack and so on and the diabetes and respiratory problem are leading at the top. And of those leading at the top men are actually leading ladies in those as well, except in the case of some metabolic diseases that has to do with ovarian issues, hormonal issues, and thyroid issues,” said Dr Martin.
To determine the cause of the number of male deaths, the Ministry of Heath reviewed surveys and studies conducted on men regarding their health. The results showed that lack of accessibility, concerns about confidentiality and lack of targeted education were reasons why some men do not seek health care.
“One of the things men said was, because the health centres only open for a certain amount of hours during the day, the time at which they are at work, they are not able to access care. And so what we have done in terms of the Primary Health Care, one of the first things we did was to extend the opening hours of the major health centers, and so men now can access care after 4pm. Since the extended hours were implemented, feedback shows that the health centers are being utilised more in the evening than in the day; which is wonderful news. If this is a sign of what’s to come, then this is an exciting time for Primary Health Care in our country,” said Dr Martin.
Another indicator that surfaced as a reason why men appear apathetic towards their health is lack of education. “The second thing that men indicated was they felt as though the main thrust of the health care programmes were not put together and directed towards men. It was more so towards women and children,” said Dr Martin.
He went onto say that over the past few decades, health systems in the Eastern Caribbean and other parts of the world focus on women and children. These efforts have resulted in reducing maternal and mortality rates, however at the same time focus on men has fallen behind.
“So because of that, one of the pillars of our Primary Health Care programme is what we called community outreach, where we can focus on vulnerable groups. We have already started one of those is called the Men’s Health Outreach. We actually advertise [and] mobilise some men for one afternoon and we go out and do screenings, blood pressure, blood sugar, blood testing for prostate and all sorts of things.” Martin enthusiastically added, “So in the next few months and certainly within the next few years to my mind that is the kind of strategic position we will be taking. Trying to find the vulnerable groups and putting together programmes specifically for those groups.”
In a separate interview, although there are a number of health clinics around the island, Permanent Secretary for the Ministry of Health Aaron Francois stated another reason why men do not seek medical assistance is due to concern about a breach in confidentiality. “What we found out is that in a lot of the cases, men are very reluctant to attend or to visit health practitioners, whether it is a medical centre, or a doctor. Men tend to wait very late, when their situation becomes desperate, to visit the doctor.”
PS Francois went on to say in extreme cases some men chose to go to a clinic that is not even within their own community. “You would find, assuming a man goes to one of our centres and based on the situation, based on what the complaint is, [that] he would not want the issue to be divulged to the wider community. So you would find that a man would leave his [local] centre and go to another centre for attendance.”
To address this issue PS Francois said that the Ministry of Health has communicated this concern to practitioners with the intent to make the environment more comfortable for men.