Health in the Americas 2022

COUNTRY PROFILE

Guyana

The Health in the Americas+ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. 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 Guyana was 759 051 inhabitants; by 2023 this figure had risen to 813 834, representing a 7.2% increase. Regarding the country’s demographic profile, in 2023 people over 65 years of age accounted for 6.5% of the total population, an increase of 2.7 percentage points compared to the year 2000. In 2023, there were 104.1 women per 100 men and 22.7 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 65.1% of the total population of the country in 2023 (529 617 people). When we add these figures to the potentially passive population (231 590 under 15 years of age and 52 628 over 65 years of age), the result is a dependency ratio of 53.7 potentially passive people per 100 potentially active people. This ratio was 67.6 in 2000.

Life expectancy at birth in 2023 was 69.8 years, lower than the average for the Region of the Americas and 5.3 years higher that in 2000.

Figure 1. Population pyramids, years 2000 and 2023

The average number of years of schooling in Guyana is 12.2 years in the latest year for which information is available. Women have on average 12.4 years and men have 12.1 years of schooling. The unemployment rate in 2022 was 12.4%. Disaggregated by sex, the rate was 14.4% for women and 11.0% for men. The literacy rate was 97.8% in 2021. In men, this figure was 98.1%; in women, 97.5%. The literacy rate was 92.1% in 2021 (92.2% for men and 91.9% for women). In addition, 11.8% of the population was below the national poverty line in 2019, above the regional average of 3%. 

During the period 2000-2021, the country improved its score on the Human Development Index, with an increase of 23.7% (from a score of 0.577 to a score of 0.714); during the same period, the index rose 13.5% internationally and 9.4% in Latin America (Figure 2).

Figure 2. Human Development Index in the Region of the Americas, 2021

In 2020, public expenditure on health accounted for 4.02% of gross domestic product (GDP) (Figure 3) and 13.09% of total public expenditure, while out-of-pocket spending on health accounted for 23.48% of total health expenditure.

Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2020

Digital coverage

In 2021, 84.8% of the population had an internet connection, representing a considerable increase from 2000, when 0.6% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2019, infant mortality in Guyana increased from 21.9 to 23.0 deaths per 1000 live births, an increase of 5% (Figure 4). The percentage of low-weight births (less than 2500 g) decreased from 13.4% to 7.8% between 2000 and 2018, while exclusive breastfeeding in the child population up to 6 months of age was 21.4% in 2014, compared with 10.6% in 2000.

Regarding the immunization strategy, measles vaccination coverage was 100.0% in 2022, an increase of 14 percentage points from 2000.

The maternal mortality ratio for 2020 was estimated at 111.9 deaths per 100 000 live births, a reduction of 41.1% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated that in 2023 women had an average of 2.3 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 38.3% decrease, from 102.3 live births per 1000 women aged 15 to 19 years in 2000 to 63.1 in 2023. In 2018, 95.1% of births were attended by skilled birth personnel. Between 2009 and 2018, the percentage of pregnant people who received antenatal care remained similar: 95.7% in 2009 and 96% in 2018.

Figure 4. Infant mortality per 1000 live births, 1995–2020
Figure 5. Maternal mortality per 100 000 live births, 2000–2020

Communicable diseases

In 2021, there were 51 new cases of tuberculosis per 100 000 population in Guyana. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 18.8 (8.9 in women and 29.3 in men).

In 2021, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 11.3 per 100 000 population. The age-adjusted mortality rate for HIV was 34.9 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 20.8%.

Noncommunicable diseases and risk factors

In Guyana in 2023, the prevalence of tobacco use among people aged 15 and older was 10.5%. In the same age group, the prevalence of overweight and obesity was 49.4% in 2016.

Also in 2016, 15.8% 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 23.1%, like 2000 (23%). The prevalence of diabetes mellitus, which stood at 7.3% in 2000, increased to 10.9% in 2014.

Mortality

In 2019, the adjusted rate of potentially avoidable premature mortality in Guyana was 614.6 deaths per 100 000 population, a decrease of 13.2% from a rate of 708 in 2000. Among potentially avoidable premature mortality, the rate for preventable causes was 326.9 per 100 000 population in 2019, which is 138.4% higher than the regional average rate; and the rate for treatable causes was 287.7 per 100 000 population, below the regional average of 89.6.

The overall age-adjusted mortality rate was 11.3 per 1000 population in 2019, a decrease of 12.7% compared to 2000 (12.9 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 190 per 100 000 population (224.3 per 100 000 in men and 156.2 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 797.8 per 100 000 population (896.9 per 100 000 in men and 710.5 per 100 000 in women). The rate of age-adjusted mortality from external causes was 136 per 100 000 population (218.8 per 100 000 in men and 53.3 per 100 000 in women), including road traffic accidents (22.4 per 100 000 population), homicides (25.5 per 100 000 population), and suicides (40.8 per 100 000 population). In 2000, the percentage distribution of causes was 60.3% for noncommunicable diseases, 27.1% for communicable diseases, and 12.7% for external causes; in 2019, the percentages were 69.6%, 17.4%, and 12.9%, respectively (Figure 6).

Figure 6. Proportional mortality in Guyana, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 41.1 per 100 000 men; lung cancer, 6.4 per 100 000; and colorectal cancer, 7.8 per 100 000. In women, these values were 25.6 deaths per 100 000 for breast cancer, 3.3 per 100 000 for lung cancer, and 8.7 per 100 000 for colorectal cancer.

The health situation and the COVID-19 pandemic

In Guyana in 2020, there were a total of 6 319 cases of COVID-19, representing 7 864 per million population. In 2021, there were 33 076 identified cases, equivalent to 41 165 per million population. In 2020, there were 164 deaths directly caused by COVID-19 in people diagnosed with the disease, or 204 per million population; in 2021, 888 deaths were reported, or 1 105 per million. In 2020, Guyana ranked 28th in the Region of the Americas in terms of the number of deaths from COVID-19, and 21th in 2021, with a cumulative 1 309 deaths per million population over the two years (Figure 7). According to estimates by the World Health Organization, there was a total of 393 excess deaths in 2020, or 50 per 100 000 population; a total of 2418 deaths were estimated in 2021, for an excess mortality rate of 306 per 100 000.

As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 60.3% of the country's population. As of 20 April 2022 (latest available data), 46% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and seven types of COVID-19 vaccine have been used to date.

Figure 7. Cumulative COVID-19 deaths in the Region of the Americas, to 31 December 2022

Prospects

Measures to achieve universal health coverage

The Green State Development Strategy, Vision 2040 places sustainable, low-carbon, and resilient use of natural resources at the heart of the country's future development. Within this context and consistent with Sustainable Development Goal 3, the Vision 2040 development agenda promotes healthy lives and well-being for all Guyana's citizens, and the development of universal health access – an adoption of the global move toward universal health coverage. The strategy describes 16 health system priorities (with underpinning policies), which can be grouped into four broad themes: (1) the development of primary health care as the foundation of Guyana's health care service; (2) the development of universal health coverage includes focusing on currently underserved indigenous peoples and other populations in situations of vulnerability, strengthening health system referrals and health financing to enhance equitable access, and improving national capacity to run an integrated universal health coverage system; (3) health system strengthening through improved disease surveillance, monitoring healthcare quality and results, and a focus on human resources in health; and (4) collaborations across government – a move toward recognizing the need for health in all policies, and multisectoral collaborations, particularly in the areas of public sanitation and neighborhood environmental quality.

Challenges related to population health

Guyana has a relatively young population but is aging, and the pace of this aging is predicted to increase. In 1980, the proportion of Guyana's population aged 65 and older was 3.8%. This proportion increased to an estimated 6.2% by 2021. This increase represents a rapid rise in older adults, but remains below the regional average for the Caribbean of 10.7 percentage points, and for the Americas of 13.7 percentage points. Guyana has made important progress in reducing the burden of many infectious diseases, including intestinal (enteric) infections, HIV/AIDS and other sexually transmitted infections, and notably malaria. The disease burden is shifting toward noncommunicable disease. Cardiovascular diseases, diabetes, and cancers in 2019 were the top three causes of death and disability, collectively accounting for over one-third of all healthy life lost. The health system has made important improvements over the past decades, but challenges remain. Neonatal and maternal disorders and respiratory infections (such as influenza, pneumonia, and tuberculosis) remain important causes of healthy life lost and reflect Guyana's continuing double burden of noncommunicable diseases and infectious diseases. Suicides remain close to three times the global and regional averages. Solutions for reducing these challenges require multisectoral cooperation.

COVID-19 pandemic response

Regional and global external pressures are recognized as a major risk to the ongoing healthcare reform. Climate change is a notable example from the National Report, and the financial crisis of 2009 and the COVID-19 pandemic in 2020-2021 have adversely affected the economic stability across the Small Island Developing States of the Caribbean. In response to the onset of COVID-19, the Government of Guyana outlined a Preparedness and Response Plan and activated the Health Emergency Operations Centre to oversee coordination and implementation of the plan and support intersectoral coordination. Support from the World Bank and others has contributed to COVID-19 health system strengthening, for example, to adapt to the acute healthcare demands of the outbreak, to facilitate procurement of equipment and medicines, to build sustainability in hard-to-reach settings, to train laboratory professionals, and to decentralize the COVID-19 response for the particular benefit of vulnerable populations. The National Health Multi-Hazard Emergency Management Plan has been updated to include the need for stronger national surveillance and response systems. A major ongoing COVID-19 policy is the further scale-up and implementation of the vaccination program in cooperation with international partners.

Measures to reduce inequalities in health

A concern raised in Vision 2040 was of inadequate health facilities and services in hinterland and coastal communities, such as a shortage of doctors and other trained specialists, shortages of medicines, and health centers that were not well equipped. These inequities have driven the current emphasis on primary care, universal health coverage, and health system strengthening. Health Vision 2030 aligns with Vision 2040 and is the National Strategic Plan for Health to take Guyana through the coming decade. It focuses on health care coverage using primary healthcare and health financing as enablers of universal health coverage. It also targets social determinants of disease to address ongoing health inequalities, recognizing that healthcare delivery may vary according to community context. Additionally, the Ministry of Health will be developing public-private partnerships to enhance healthcare coverage and access. Already a memorandum of understanding has been established to enable private partners to provide care for a range of chronic conditions and infertility.

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.