Barbados - Country Profile

The Health in the Americas+ country profiles are based on the interagency indicators available as of the dates referenced. In some cases, the values of the indicators may differ from the most recent data available in the country.

Environmental and social determinants of health

In 2000 the total population of Barbados was 262 063 inhabitants; by 2024 this figure had risen to 282 467, representing a 7.8% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 16.6% of the total population, an increase of 5.3 percentage points compared to the year 2000. In 2024, there were 108.6 women per 100 men and 96. older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country’s population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 66.2% of the total population of the country in 2024 (187 018 people). When we add these figures to the potentially passive population (48 701 under 15 years of age and 46 749 over 65 years of age), the result is a dependency ratio of 5 potentially passive people per 100 potentially active people. This ratio was 49.6 in 2000.

Life expectancy at birth in 2024 was 76.3 years, lower than the average for the Region of the Americas and 1.7 years higher that in 2000 (74.6).

Figure 1. Population pyramids, years 2000 and 2024

In 2000, the average number of years of schooling in Barbados reached 9 years in the latest year for which information is available.  The unemployment rate in 2023 was 8%. Disaggregated by sex, the rate was 6.9% for women and 9% for men. Disaggregated by sex, the rate was 11.5% for women and 9.3% for men. The literacy rate was 99.8% in 2014.

During the period 2000-2022, the country improved its score on the Human Development Index, with an increase of 6.4% (from a score of 0.76 to a score of 0.809); during the same period, the index rose 14.6% internationally and 11.2% in Latin America (Figure 2).

Figure 2. Human Development Index in the Region of the Americas, 2022

In 2021, public expenditure on health accounted for 4.38% of gross domestic product (GDP) (Figure 3) and 12.42% of total public expenditure, while out-of-pocket spending on health accounted for 38.92% of total health expenditure.

Figure 3. Public expenditure on health as a percentage of gross domestic product in the Region of the Americas, 2021

Digital coverage

In 2021, 85.8% of the population had an internet connection, representing a considerable increase from 2000, when 4.0% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2022, infant mortality in Barbados increased from 13.4 to 18.1 deaths per 1000 live births, a decrease of 35.1% (Figure 4). The percentage of low-weight births (less than 2500 g) remains the same at 11% between 2003 and 2022, while exclusive breastfeeding in the child population up to 6 months of age was 19.7%, the same value as in 2012.

Figure 4. Infant mortality rate per 1000 live births in Barbados, 1998-2022

Regarding the immunization strategy, measles vaccination coverage was 85% in 2022, a decrease of 9 percentage points from 2000.

The maternal mortality ratio in 2020 was estimated at 39.1 deaths per 100 000 live births, representing a 19.3% reduction compared to the estimated value in 2000 (Figure 5). In relation to fertility, it is estimated that in 2024 women had an average of 1.7 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 25.8% decrease, from 60.6 live births per 1000 women aged 15 to 19 years in 2000 to 45.0 in 2024. In 2022, 98.2% of births were attended by skilled birth personnel. Between 2011 and 2020, the percentage of pregnant people who received antenatal care increased from 89% to 90%.

Figure 5. Maternal mortality per 100 000 live births in Barbados, 2000–2020

Communicable diseases

In 2021, there were 0 new cases of tuberculosis per 100 000 population in Barbados. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 0.3 (0.2 in women and 0.3 in men).

In 2022, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 33.6 per 100 000 population. The age-adjusted mortality rate for HIV was 8.4 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 85.4%.

Noncommunicable diseases and risk factors

In Barbados in 2023, the prevalence of tobacco use among people aged 15 and older was 6.9%. In the same age group, the prevalence of overweight and obesity was 67.2% in 2022. Also in 2016, 42.9% of the population reported insufficient physical activity.

In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 24.4%, a decrease of 1.7 percentage points compared to 2000 (26.1%). The prevalence of diabetes mellitus, which stood at 9.1% in 2000, increased to 12.2% in 2014.

Mortality

In 2019, the adjusted rate of potentially avoidable premature mortality in Barbados was 198.5 deaths per 100 000 population, a decrease of 29.5% from a rate of 281.5 in 2000. This meant that, in 2019, the rate in the country was 12.4% lower than the average rate reported for the Region of the Americas as a whole. Among potentially avoidable premature mortality, the rate for preventable causes was 88.6 per 100 000 population in 2019, which is 35.4% lower than the regional average rate; and the rate for treatable causes was 109.8 per 100 000 population, above the regional average of 89.6.

The overall age-adjusted mortality rate was 6 per 1 000 population in 2019, a decrease of 8.4% compared to 2000 (6.5 deaths per 1000 population).

When deaths are categorized into three main groups, it is observed that, in 2019, the age-adjusted mortality rate from communicable diseases was 82.7 per 100 000 population (93.3 per 100 000 in men and 73.0 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 477 per 100 000 population (533.4 per 100 000 in men and 430.9 per 100 000 in women). The rate of age-adjusted mortality from external causes was 36.9 per 100 000 population (52.4 per 100 000 in men and 22.1 per 100 000 in women), including road traffic accidents (8 per 100 000 population), homicides (10.2 per 100 000 population), and suicides (0.3 per 100 000 population). In 2000, the percentage distribution of causes was 80.6% for noncommunicable diseases, 15.9% for communicable diseases, and 3.4% for external causes; in 2019, the percentages were 82.8%, 12.9%, and 4.3%, respectively (Figure 5).

Figure 5. Proportional mortality in Barbados, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 59.9 per 100 000 men; lung cancer, 16.9 per 100 000; and colorectal cancer, 23.7 per 100 000. In women, these values were 35.3 deaths per 100 000 for breast cancer, 13.0 per 100 000 for lung cancer, and 18.9 per 100 000 for colorectal cancer.

Perspectives

Barbados has made significant strides in the elimination of several infectious diseases over the years, a testament to the country’s robust healthcare infrastructure and proactive public health strategies. The island nation has achieved the elimination of poliomyelitis in 1994, followed by the elimination of measles in 2016, rubella and congenital rubella syndrome in 2015, neonatal tetanus in 2017, and smallpox as early as 1974. These achievements are underpinned by a strong immunization program and an effective disease surveillance system, which have been instrumental in preventing the resurgence of these diseases. However, Barbados is not resting on its laurels and continues to advance its elimination efforts through a comprehensive roadmap that seeks to address current and emerging health challenges.

Achievements in Disease Elimination

Barbados’ success in eliminating multiple infectious diseases can be attributed to its consistent implementation of rigorous immunization campaigns and a vigilant surveillance system. The elimination of poliomyelitis in 1994 marked the beginning of a series of public health victories for the country. This was followed by the successful elimination of measles and rubella, with the latter and congenital rubella syndrome being declared eliminated in 2015. The country has also eradicated neonatal tetanus as of 2017, and smallpox was eliminated in 1974. These milestones were achieved through a concerted effort to maintain high vaccination coverage and conduct ongoing surveillance to monitor and respond promptly to potential outbreaks. The healthcare system's ability to sustain these efforts over time demonstrates a commitment to public health that goes beyond the mere control of diseases, aiming for their complete eradication.

Current Efforts and Roadmap to 2030

Looking ahead, Barbados has laid out a well-structured roadmap to accelerate the elimination of other diseases by 2030. This plan includes several key strategies that focus on strengthening the healthcare system and enhancing disease prevention measures. A cornerstone of these efforts is the Disease Surveillance and Monitoring system, which is designed to track disease patterns, identify outbreaks swiftly, and respond effectively. This system is supported by comprehensive data collection and analysis, which are critical for informed decision-making and timely interventions.

Barbados continues to prioritize its Vaccination Programs, which are essential for maintaining the elimination status of diseases like measles and polio and for addressing new challenges such as COVID-19. The country has implemented routine childhood vaccinations and targeted immunization campaigns to ensure high coverage rates. These efforts are complemented by extensive Public Health Education initiatives aimed at raising awareness about disease prevention, the importance of vaccinations, and promoting healthy lifestyles. Public engagement through these campaigns is vital for reducing vaccine hesitancy and ensuring community support for vaccination efforts.

Moreover, Barbados is committed to Strengthening Health Infrastructure by improving healthcare facilities and services to better handle disease prevention, treatment, and management. This includes training healthcare professionals and enhancing laboratory capacities to support diagnostics and surveillance activities. Recognizing the importance of collaboration, the country is actively working with international organizations such as the World Health Organization (WHO) and the Pan American Health Organization (PAHO) to align with global health standards and receive technical and financial support for its elimination initiatives.

In addition to these measures, the country has implemented Legislative and Policy Frameworks that support disease control efforts. These include regulations on sanitation, quarantine, and health promotion, all of which are crucial for controlling and preventing the spread of diseases. Research and Innovation also play a key role in Barbados’ approach, with investments in understanding disease patterns and developing new treatments and prevention strategies. The involvement of Community Engagement ensures that health interventions are culturally appropriate and effective, making local community’s active participants in the country's public health efforts.

Challenges and Gaps

Despite these comprehensive efforts, Barbados faces several challenges in its pursuit of disease elimination. As a Small Island Developing State (SIDS), the country contends with limited human and financial resources, which can hinder its ability to sustain high-cost health interventions and procure necessary health technologies. This limitation is particularly pronounced for rare diseases that are nearing elimination but require sustained investment and resources to prevent re-emergence. Additionally, the reliance on tourism, which increases vulnerability due to the movement of people, poses a unique challenge, as does high vaccine hesitancy in certain segments of the population.

While Barbados has established a health information system, the use of data from this system is still developing, and there are ongoing challenges with interoperability between different health information systems. Enhancing the integration and utilization of these systems is essential for improving the efficiency and effectiveness of disease surveillance and response.

Addressing Health Equity

Barbados is committed to ensuring health equity through its disease elimination efforts by developing and implementing health policies and regulations that support disease control measures. These include establishing sanitation standards, enforcing quarantine regulations, and promoting health strategies that are accessible to all segments of the population. By focusing on these areas, Barbados aims to reduce disparities in health outcomes and ensure that all communities benefit from the progress made in disease elimination.

Community and Civil Society Engagement

Community engagement is a fundamental aspect of Barbados’ public health strategy. The involvement of local communities in health initiatives helps ensure that interventions are not only effective but also culturally appropriate. Examples of good practices include the implementation of community health education programs and the involvement of civil society organizations in vaccination campaigns. These initiatives help to build trust and increase the acceptance of public health measures, thereby enhancing their impact.

Coordination Mechanisms and International Collaboration

Effective coordination is crucial for the success of Barbados’ disease elimination efforts. The Ministry of Health and Wellness is the primary national body responsible for coordinating these efforts, setting health policies, and overseeing public health initiatives. National Advisory Committees provide expert guidance on disease control strategies, helping to shape policies and prioritize interventions based on the latest data and research.

Barbados also benefits from its collaboration with the Caribbean Public Health Agency (CARPHA), which supports health initiatives across the Caribbean. CARPHA provides technical assistance, coordinates disease surveillance, and offers training and resources that are critical for disease prevention and control. On a global scale, the country works closely with the World Health Organization (WHO) and the Pan American Health Organization (PAHO), which provide guidance, technical support, and align local efforts with global health standards.

Moreover, for specific diseases like HIV/AIDS, tuberculosis, and malaria, Barbados coordinates with the Global Fund, which offers financial support and resources to combat these diseases. The country also collaborates with international non-governmental organizations (NGOs) such as Médecins Sans Frontières and the Bill & Melinda Gates Foundation, which provide additional expertise, resources, and support in various health initiatives.

The sources of the interagency indicators used in this profile can be found in this table.

For the latest data on health indicators for the Region of the Americas, be sure to visit the PAHO Core Indicators portal.