Exposure to NCDs in Trinidad

Ffyona Patel, 2014 GHLI Fellow

My experience in  Trinidad has married complex health information system (HIS) ambitions  with mango chow (garlic, hot pepper, cilantro mango salad) and chicken roti (essentially a curried chicken burrito -- forgive me, Trini friends!). Here at South West Regional Health Authority (SWRHA), where about 60% of the nation’s health care is provided, all agree that an electronic HIS for NCDs is an imperative systems improvement to how primary care is provided, reported, planned, and translated into policy. However, ushering this in has required the Ministry of Health, SWRHA leadership, key departments, providers and other stakeholders to engage and commit to managing necessary changes.  Now in the formative phase of planning the HIS pilot, these requirements prove challenging.

I spoke with a Health Records staff manager who shared just how murky the “sugars” (diabetes) landscape is without timely data. With its universal health care, Trinidad patients can travel from hospital to health center to pharmacy to receive care and medications. However, largely paper-based medical records beget fragmented accounts of medical history and limited capacity to collect and aggregate epidemiological data, resulting in gross estimates of incidence and prevalence for diabetes and other NCDs. The current system also places great burden on support staff that sift through the paper records and hand count data for reporting. An electronic HIS carries promise for greater efficiency, higher quality of care, and model-worthy integration of data into planning for nationwide NCD intervention.

Between supporting the formative phase of the pilot project and the early-stage planning for the GHLI Forum for Change in Trinidad, I am grabbing my interests in strengthening health systems, strategic change management, and data-informed policy by the reins. While here, I aspire to continue sparking the small steps of leadership, management, and support staff toward realizing their big system-level change via a much needed HIS for NCDs.