Posts tagged Caribbean
When Digital Government Becomes Digital Exclusion: The Caribbean's Growing Access Crisis

Across the Caribbean, government services are rapidly moving online. Benefits applications, healthcare appointments, court filings, and payment systems now demand digital access as the default entry point. Ministries frame these changes as efficiency gains, but beneath the shiny platforms and streamlined interfaces, a quiet challenge unfolds: thousands of Caribbean citizens are being systematically locked out of essential public services because they cannot navigate the digital systems designed to serve them.

This is not a technology problem. It is an implementation problem. When governments digitise services without building the infrastructure, skills, and support systems that enable universal participation, they replace one form of exclusion with another.

Who Gets Left Behind?

The digital divide in the Caribbean cuts along predictable lines of vulnerability. Research from the Economic Commission for Latin America and the Caribbean shows that in Latin America and the Caribbean region, only 46.4% of low-income households have fixed internet connections compared to 84.6% of wealthier households. The urban-rural divide compounds this disparity further.

Trinidad and Tobago's National Digital Inclusion Survey 2021 confirms what frontline workers already know: digital development varies dramatically across geographic areas and demographic groups. The country's own digital transformation project acknowledges that "providing internet and mobile connections for vulnerable and underserved populations (i.e., rural, physically challenged, youth, and elderly) remains difficult."

Older adults face compounded barriers. They report low confidence using devices, require assistance setting up technology, and struggle with interfaces designed for digital natives. When health services moved online during COVID-19, older adults from minoritised ethnic backgrounds faced particular challenges navigating remote appointments, understanding digital platforms, and explaining symptoms without in-person interaction.

People with disabilities encounter accessibility barriers that designers often fail to anticipate. Screen readers break on poorly coded forms. Visual or motor impairments make complex navigation impossible. Cognitive differences clash with rigid, unforgiving interfaces.

Rural communities face infrastructure gaps that no amount of digital literacy training can overcome. Unreliable connectivity, expensive data packages, and limited device access create fundamental barriers before questions of skill even arise.

Migrants navigating government systems in their non-native language find digital platforms particularly unforgiving. Unlike human counter staff who can clarify misunderstandings, automated systems offer no flexibility for language barriers or cultural confusion about administrative processes.

The Hidden Costs of Online-Only Systems

When governments shift services online without maintaining alternative access points, the consequences extend far beyond inconvenience.

Benefits go unclaimed. When applying for social assistance requires online submission, those without reliable access or digital skills simply cannot apply. They miss deadlines, fail to navigate multi-step verification processes, or abandon applications when error messages provide no clear path forward. The system counts these failures as reduced demand rather than systemic exclusion.

Healthcare delays become dangerous. Online appointment booking seems efficient until you consider the person who cannot secure a slot because they lack internet access, the elderly patient who misses follow-up care because email notifications disappeared into spam folders, or the diabetic who cannot refill prescriptions through the new portal.

Informal fixers emerge. A shadow economy develops around digital access. People pay neighbours or relatives to complete online forms, creating dependencies that compromise privacy and agency. Some turn to storefront businesses charging fees to navigate government websites, introducing costs that defeat the purpose of free public services.

Dignity erodes. Being unable to independently access services your taxes support diminishes citizenship. The message received is clear: you do not count in this modernised system unless you can keep up.

The False Assumption: Phone Ownership Equals Digital Access

Policy makers often confuse device ownership with digital capability. Yes, high mobile phone penetration exists across Trinidad and Tobago, exceeding Latin American and Caribbean averages. But owning a smartphone and successfully navigating complex government portals are entirely different capabilities.

Digital literacy research consistently demonstrates that merely having access to devices does not translate to effective use. People need information navigation literacy to access the internet safely. They require culturally appropriate content in plain language. They need confidence overcoming fear of making mistakes. Research shows that digital skills shape people's digital experience, helping them overcome fear of using electronic devices and navigate digital spaces effectively.

When governments assume "everyone has a phone now" and design accordingly, they systematically exclude those whose phone skills extend to calls and WhatsApp but not to multi-factor authentication, PDF uploads, or government portal navigation.

What Inclusive Digital Government Actually Requires

Moving services online can genuinely improve access and efficiency, but only when implementation considers how citizens will actually use these systems. Caribbean governments pursuing digital transformation can learn from both successes and failures across the region and globally.

Maintain assisted digital channels. Not everyone will successfully use digital services independently. Trinidad and Tobago's digital transformation project explicitly aims to "improve efficiency and reduce transaction costs to government and citizens, while expanding the inclusiveness of the provision of such services to the elderly, the poor, persons with disabilities, women and girls and residents of rural communities." This requires trained staff who can guide users through digital processes, help desks in community locations, and phone support that does not simply redirect to websites.

Design for offline alternatives. Essential services should never exist only online. Paper forms, in-person appointments, and telephone submission options must remain available, particularly for services affecting basic rights and entitlements. Research on European digital public services shows that barriers such as limited digital skills, access to technology, and inadequate service design disproportionately affect vulnerable groups including the elderly and low-income populations.

Build digital skills as social protection. Digital literacy cannot be treated as a personal responsibility separate from service delivery. When governments require digital access for benefits, healthcare, or civic participation, they must provide structured pathways to acquiring necessary skills. Community-engaged learning approaches that bring trained facilitators into communities show promise for reducing digital divides experienced by underserved populations.

Test with actual users before launch. Caribbean governments pursuing digital transformation initiatives can incorporate user testing with vulnerable populations before rolling out new systems. What works for a ministry official with reliable internet and university education may fail completely for a rural resident with intermittent connectivity and primary school completion. Implementation science frameworks like the Consolidated Framework for Implementation Research (CFIR) emphasise assessing characteristics of individuals including their knowledge, beliefs, and self-efficacy before expecting adoption.

Create feedback mechanisms that capture exclusion. When people cannot access services, they often disappear from official view. Systems should track abandonment rates, failed attempts, and requests for assistance as signals of exclusion rather than simply measuring successful completions. This data should drive iterative improvement rather than being dismissed as user error.

The Urgency of Now

Governments are moving quickly. The UN E-Government Survey shows Latin American and Caribbean countries are highly committed to pursuing digital government strategies. Multiple regional initiatives from UN DESA, ECLAC, the World Bank, and the IDB are actively supporting Caribbean digital transformation.

But speed without inclusion creates harm. Every month that services exist only online is a month that vulnerable citizens cannot access what they need. Every poorly designed portal is another barrier to healthcare, income support, or civic participation.

Progress should be measured not by platforms launched or services digitised, but by whether all citizens can actually access what they need. When a rural grandmother can apply for her pension, when a migrant can renew their work permit, when a person with disabilities can complete a form independently, when anyone needing government services can do so with dignity, then we will have achieved digital transformation worth celebrating.

Until then, what governments are building is not modernisation. It is another way to leave people behind.

Need support implementing inclusive digital government services? Uwàmìto Consulting works with Caribbean governments and development organisations to design and implement digital transformation initiatives that genuinely serve all citizens. Our implementation science expertise helps you navigate the complex human factors that determine whether technological investments create value or create new barriers. Get in touch to discuss how we can support your inclusive digital transformation journey.

Harnessing Artificial Intelligence (AI) for Sustainable Development in the Caribbean

AI is no longer a futuristic concept; it’s a present‑day tool that can help Caribbean organizations address systemic challenges and accelerate sustainable growth. Used wisely, AI has the potential to transform operations, support communities, and contribute to resilient economies across our islands. In this post, we explore how AI can support sustainable development and highlight some early opportunities and hurdles for Caribbean leaders.

The promise of AI

AI can enhance efficiency and free up human capacity for strategic work. A recent article noted that AI tools can automate repetitive tasks and free up time for employees. For example, chatbots can handle routine customer queries while your team focuses on complex issues. Predictive algorithms can analyze data at speeds impossible for humans, enabling leaders to make better decisions. AI also makes it easier to develop innovative products and services, helping Caribbean businesses stay ahead of the curve.

The sustainable link

Environmental sustainability is a priority for our region. Emerging AI tools can monitor energy consumption, optimize logistics, and reduce carbon footprints. For instance, sensors combined with machine‑learning models help predict when equipment needs maintenance, reducing waste and energy use. The Caribbean Artificial Intelligence Policy Roadmap (spearheaded by UNESCO) emphasizes that AI adoption should align with environmental sustainability and social resilience, and calls for regional cooperation and knowledge sharing. By integrating ethical and environmentally sensitive AI tools into our operations, we can contribute to climate action while lowering costs. AI also supports public health and social programmes. Data‑driven models can identify trends in health outcomes and provide insights for targeted interventions. By improving service delivery and enhancing citizen engagement, AI can strengthen trust in public institutions and support equitable access to resources.

Barriers to consider

While AI offers tremendous promise, leaders must navigate real challenges. A skills gap remains a major obstacle; the Caribbean workforce needs specialized expertise to adopt AI technologies. Addressing this requires investment in education and training. Data privacy and security are also vital concerns; we must protect sensitive information and maintain customer trust. Ethical considerations, such as avoiding algorithmic bias, are critical.

Cost can be a barrier for small and medium‑sized organizations. However, low‑cost AI solutions are increasingly available, and partnerships with local universities or technology hubs can help reduce expenses while building capacity. The U.S. Chamber of Commerce advises governments and businesses to foster trust through transparent collaboration, streamline regulations, and invest in training. These principles provide a roadmap for responsible AI adoption in our region.

Moving forward

AI is a tool for empowerment, not replacement. As Caribbean leaders, we must embrace its potential while grounding our decisions in ethics, inclusion, and sustainability. We must try to understand before forming opinions, test the tools, get comfortable with them, and upskill. By starting with small, manageable projects such as chatbots, energy monitoring, or predictive maintenance, we can build confidence and demonstrate value. Collaboration between government, industry, academia, and even the not-for-profit sector will accelerate innovation and ensure solutions are locally relevant.

At Uwàmìto Consulting, we believe resilience is built through strategic clarity, capacity building, and operational excellence. AI can strengthen all three areas when deployed thoughtfully. Let’s lead the way by harnessing technology to serve our communities and protect our planet.

Reinvesting in Community Health Workers: An Important Strategy for Strengthening Caribbean Public Health Systems

The COVID-19 pandemic has exposed the vulnerabilities of healthcare systems worldwide, particularly in the Caribbean region. It has highlighted the need for a more resilient and responsive approach to public health, one that prioritizes primary healthcare and health prevention. As countries in the Caribbean seek to build back better, reinvesting in community health workers (CHWs) presents a vital strategy for strengthening healthcare systems and improving health outcomes.

Community health workers (CHWs) often live in the community they serve and may often receive lower levels of formal education and training than professional health care workers such as nurses and doctors. According to the World Health Organization (WHO, 2021), This human resource group has enormous potential to expand the reach of the public health system especially benefitting vulnerable populations such as rural, remote, or hard-to-reach communities and marginalized people. CHWs are often impacted by the said challenges themselves and know the language, culture, and dynamics of the communities they engage which improves the performance, efficacy, and efficiency of the health system. In the Caribbean, CHWs have played a crucial role in improving access to healthcare, particularly in rural and underserved areas (Jeet et al., 2017)

At Uwàmìto Consulting, we have witnessed firsthand the impact of investing in CHWs. Through our technical assistance and capacity-building efforts, we have supported clients in Trinidad and Tobago and Suriname to strengthen their CHW programs. In Trinidad and Tobago, we engaged stakeholders, conducted community pilots, and trained individuals to implement Risk Communication and Community Engagement (RCCE) methodologies, reaching over 2,000 people with health services. In Suriname, we provided technical assistance to develop and implement a Community-Led Monitoring (CLM) system to improve the quality and accessibility of HIV services.

The evidence supporting the effectiveness of CHWs in improving health outcomes is compelling. A systematic review by Scott et al. (2018) found that CHW interventions led to significant improvements in maternal and child health, infectious diseases, and non-communicable diseases in low- and middle-income countries. Another study by Kangovi et al. (2020) found that a CHW program in the United States reduced hospital readmissions and improved patient satisfaction.

Investing in CHWs also makes economic sense. A study by Seidman and Atun (2017) estimated that scaling up CHW programs in sub-Saharan Africa could yield a return on investment of up to 10:1, with significant savings in healthcare costs and increased economic productivity. In the Caribbean, where many countries face resource constraints and increasing healthcare costs, investing in CHWs can be a cost-effective strategy for improving health outcomes.

To fully realize the potential of CHWs in strengthening Caribbean healthcare systems, there is a need for increased investment and policy support. This includes:

  1. Providing comprehensive training and certification programs for CHWs, covering a wide range of healthcare topics and skills.

  2. Integrating CHWs into the formal healthcare system, with clear roles and responsibilities, adequate compensation, and opportunities for career advancement.

  3. Allocating sufficient resources for CHW programs, including funding for salaries, training, and equipment.

  4. Developing partnerships between CHWs, healthcare facilities, and community organizations to improve coordination and referral systems.

  5. Investing in research and evaluation to better understand the impact and effectiveness of CHW programs in the Caribbean context.

Countries in the Caribbean that already have CHW programs can benefit from a boost in investment and policy support. For countries without CHW programs, there is an opportunity to learn from the experiences of other countries and invest in this vital workforce. The COVID-19 pandemic has underscored the importance of building resilient and responsive healthcare systems, and CHWs are a critical part of the solution.

At Uwàmìto Consulting, we are committed to social development, and having a strong health system is a critical element for development in the Caribbean. Through the technical assistance, we continue to see the importance of primary health care, and more importantly, the role CHWs can play in strengthening the overall health system. We therefore call on all governments, key stakeholders, and development partners to prioritize investments in this important strategy to improve the resilience and sustainability needed to secure the future of the Caribbean.

References:

  • Kangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., and Long, J.A., 2020. Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: A randomized clinical trial. JAMA Internal Medicine, 180(10), pp.1315-1324.

  • Kraef, C., Kallestrup, P., Olsen, M.H., and Bjerregaard, P., 2020. Community health workers in the era of COVID-19: A systematic review. Tropical Medicine & International Health, 25(11), pp.1327-1336.

  • Scott, K., Beckham, S.W., Gross, M., Pariyo, G., Rao, K.D., Cometto, G., and Perry, H.B., 2018. What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Human Resources for Health, 16(1), pp.1-17.

  • Seidman, G., and Atun, R., 2017. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Human Resources for Health, 15(1), pp.1-13.

  • Jeet, G., Thakur, J.S., Prinja, S. and Singh, M., 2017. Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications. PLOS ONE, 12(7), p.e0180640. https://doi.org/10.1371/journal.pone.0180640