Households in Antigua and Barbuda are paying a smaller share of their healthcare costs out-of-pocket than most of the Caribbean, but still above the global average, according to new regional data.

Figures compiled by CARISTATS show that out-of-pocket (OOP) spending — direct payments for services not covered by public healthcare or insurance — accounts for 20.8% of total health expenditure in Antigua and Barbuda. This places the country among the lowest in the Caribbean, though still higher than the global average of 17.3%.

Across the wider CARICOM region, households typically shoulder a significantly greater burden. In most member states, OOP spending exceeds a quarter of total health costs, reflecting gaps in insurance coverage and reliance on private healthcare providers.

The highest levels are recorded in Haiti, where households pay 52.4% of healthcare costs directly. Barbados follows at 49.5%, alongside Grenada at 48.5%. Analysts note that Barbados’ figure is particularly striking given its status as a high-income country with a universal public health system, suggesting that many patients still turn to private care and pay cash.

By contrast, Antigua and Barbuda’s relatively lower share places it closer to countries such as Jamaica (20.2%) and Suriname (19.7%), which are also near the global benchmark.

The data, drawn from the World Health Organization Global Health Expenditure Database and published via the World Bank, suggest that how healthcare systems are financed and organised plays a greater role in determining household costs than national income levels alone.

Researchers say the findings underline ongoing challenges across the Caribbean, where limited insurance coverage and uneven access to public services continue to push costs onto individuals, even in countries performing relatively well by regional standards.