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 Suriname was 478 999 in habitants; by 2021 this figure had risen to 612 985, representing a 28% increase. Regarding the country's demographic profile, in 2021 people over 65 years of age accounted for 7,3% of the total population, an increase of 2,4 percentage points compared to the year 2000. In 2021, there were 100,7 women per 100 men and 27,4 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 66,3% of the total population of the country in 2021 (406 116 people). When these figures are added to the potentially passive population (162 329 under 15 years of age and 44 541 over 65 years of age), the result is a dependency ratio of 50,9 potentially passive people per 100 potentially active people. This ratio was 60,5 in 2000.
Life expectancy has progressively increased with respect to the year 2000. This trend is expected to continue, as is the proportion of the population over 65 years of age. Life expectancy at birth was 71.9 years in 2021—lower than the average for the Region of the Americas and 6 years higher than in 2000.
Figure 1. Population pyramids of Suriname, years 2000 and 2021
Between 2004 and 2012, the average number of years of schooling in Suriname increased by 17,6%, reaching an average of 9.1 years in the latest year for which information is available. The unemployment rate in 2021 was 10,1% for the total population. Disaggregated by sex, the rate was 13,9% for women and 7,5% for men. The literacy rate was 96,4% in 2021 (95,3% for men and 97,5% for women).
During the period 2010–2021, the country improved its score on the Human Development Index, with an increase of 1% from a score of 0,723 to a score of 0,730; during the same period, the index rose 15% internationally and 11% in Latin America (Figure 2).
Figure 2. Human Development Index in the Region of the Americas, 2021
In 2019, public expenditure on health accounted for 7% of gross domestic product (GDP) (Figure 3) and 15,7% of total public expenditure, while out-of-pocket spending on health accounted for 16,1% of total health expenditure.
Figure 3. Public expenditure on health as a percentage of gross domestic product in the Region of the Americas, 2019
In 2020, 70% of Surinamese had an Internet connection, representing a considerable increase from 2000, when 2,5% of the population had an Internet connection.
Maternal and child health
Although the country has shown a decrease in maternal, infant, and under-five mortality since 2000, its values are still high. In this regard, it is expected that the country, together with the Pan American Health Organization (PAHO), will continue to make progress in implementing strategies and programs such as the National Maternal and Neonatal Health Strategy 2021–2025.
Between 2000 and 2017, infant mortality in Suriname decreased from 20,2 to 14 deaths per 1000 live births, a decrease of 30.7% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 11.4% to 13.9% between 2000 and 2010, while exclusive breastfeeding in the child population up to 6 months of age was 9,2%, compared with 2,2% in 2006. Regarding the immunization strategy, measles vaccination coverage was 79% in 2021, an increase of eight percentage points over 2000 (71%). The maternal mortality ratio for 2017 was estimated at 120 deaths per 100 000 live births, a reduction of 45.7% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated that women have an average of 2,3 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 31,4% decrease, from 80,5 live births per 1000 women aged 15–19 years in 2000 to 55,2 in 2022. In 2015, 90% of births were attended by skilled birth personnel.
Figure 4. Infant mortality per 1000 live births, 1995–2020
Figure 5. Maternal mortality per 100 000 live births, 2000–2017
In the last 10 years, Suriname has achieved important goals toward malaria elimination, with the possibility of eradicating it by 2025. It is expected that the country will continue to take action to control tuberculosis and human immunodeficiency virus (HIV).
In 2020, there were 18 new cases of tuberculosis per 100 000 population in Suriname. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 2,9 (0,6 in women and 5,5 in men).
In 2020, the estimated HIV infection incidence rate (new diagnoses) was 70,6 per 100 000 population. The age-adjusted mortality rate for HIV was 23,5 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 43,68%.
There were no cases of human rabies in the country in 2020.
Noncommunicable diseases and risk factors
Noncommunicable diseases represent an important burden of disease. Part of PAHO’s technical collaboration involves actions for the control and prevention of cardiovascular risk factors.
In Suriname, the prevalence of overweight and obesity among people aged 15 and older was 58,9% in 2016.
Also in 2016, 88,9% 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 22,4%, a decrease of 4 percentage points compared to 2000 (26,4%). The prevalence of diabetes mellitus, which stood at 9,5% in 2000, increased to 12,3% in 2014.
In 2019, the adjusted rate of potentially avoidable premature mortality in Suriname was 392,4 deaths per 100 000 population, a decrease of 15,9% from a rate of 466,7 in 2000. This meant that, in 2019, the rate in the country was 73,1% higher 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 206,5 per 100 000 population in 2019, which is 50.6% higher than the regional average rate; and the rate for treatable causes was 185,9 per 100 000 population, above the regional average of 89.6.
The overall age-adjusted mortality rate was 8,4 per 1000 population in 2019, a decrease of 1,2% compared to 2000 (8.5 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 95,5 per 100 000 population (120,3 per 100 000 in men and 74,4 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 660,5 per 100 000 population (814,8 per 100 000 in men and 543,1 per 100 000 in women). The rate of age-adjusted mortality from external causes was 76,1 per 100 000 population (114,5 per 100 000 in men and 40,3 per 100 000 in women), including road traffic accidents (15,5 per 100 000 population), homicides (5,8 per 100 000 population), and suicides (25,9 per 100 000 population). In 2000, the percentage distribution of causes was 65,9% for noncommunicable diseases, 20,5% for communicable diseases, and 13,6% for external causes; in 2019, the percentages were 78,6%, 11,8%, and 9,6%, respectively (Figure 6).
Figure 6. Proportional mortality in Suriname, 2000 and 2019
Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 39,6 per 100 000 men; lung cancer, 23,2 per 100 000; and colorectal cancer, 16,9 per 100 000. In women, these values were 18,5 deaths per 100 000 for breast cancer, 11,5 per 100 000 for lung cancer, 11,1 per 100 000 for colorectal cancer, and 8.7 per 100 000 for cervix uteri.
The health situation and the COVID-19 pandemic
In 2020, Suriname ranked 29th in the Region of the Americas in terms of the number of deaths from COVID-19, and 7th in 2021, with a cumulative 1 940,6 deaths per million population over the two years (Figure 7).
According to estimates by the World Health Organization, there were not excess deaths in 2020, or -47,1 per 100 000 population; a total of 1 013 deaths were estimated in 2021, for an excess mortality rate of 165,3 per 100 000.
As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 45.6% of the country's population. As of 2 July 2022 (latest available data), 40,2% of the population had completed the vaccination schedule. The vaccination campaign began on 23 February 2021, and four types of COVID-19 vaccine have been used to date.
The PAHO office collaborated technically with the country during the COVID-19 pandemic in the development of protocols and guidelines, and in the preparation of health services for diagnosis and clinical management.
Figure 7. Cumulative COVID-19 deaths in the Region of the Americas, to 31 December 2022
Measures to achieve universal health coverage
The National Development Plan for Suriname (2017–2021) identified two high-level health policy priorities: the broad prevention and reduction of disease and mortality, and the availability and accessibility of quality health care for the entire population – an adoption of the global move towards universal health coverage. The Suriname Ministry of Health has developed a healthcare vision of guaranteed access to quality care. Through this vision, the reduction of disease and mortality is driven by multisectoral integration, and universal health coverage development by ensuring universal and sustainable accessibility to health care with measurable quality. Limited resources have been recognized with an action plan for healthcare efficiency gains. Contributing to this is the development of information systems for health as well as the digital transformation of the sector to improve evidence for decision-making.
Measures to reduce inequalities in health
At the national level, there has been a review of the health insurance scheme and the services offered. Provision of health services to populations in vulnerable situations in the rural interior by the Medical Mission Primary Health Care Services continues. There is advocacy for the disaggregation of health data by ethnicity, which will aid the identification of inequities, as a recent study highlighted ongoing inequalities in healthcare access, particularly for the rural interior of Suriname, compared to urban and coastal regions. This in part reflects a fragmented healthcare system. A special health service provides primary care for the population in the interior (Medische Zending) and in the urban coastal area (RGD). Through the Bureau of Public Health, public health projects and programs are being implemented, including monitoring of health trends. Also under way is a project to implement telehealth in primary health care to improve access to specialist consultations for the interior.
In addressing the social determinants of health, health inequities, and the sustainable health agenda for the Americas, the Government of Suriname has embraced a Health in All Policies approach. An intersectoral body of participants from all major sectors of the government, nongovernmental organizations, and the private sector have formulated key policy measures. Several ministries, including Regional Development, Agriculture, and Economic Affairs, have included budget lines for intersectoral cooperation on health issues.
Challenges related to population health
Before the onset of COVID-19, Suriname had made important progress in reducing the burden of infectious diseases, and these public health successes have introduced an era of demographic transition, with declining fertility and longer lives. Suriname is aging and the pace of this aging is predicted to increase. In 1980, the proportion of Suriname's population aged 65 and older was 4.4%. It had risen to 7.1% by 2020 and is predicted to rise to 16.6% by 2060. These successive 40-year increases of 2.7 and 9.5 percentage points are lower than the regional average for the Americas of 4.6 and 13.7 percentage points, and for the Caribbean of 4.7 and 10.7 percentage points. This transition is reflected in a disease burden shift towards noncommunicable diseases. Cardiovascular diseases, diabetes, and cancers all increased in importance between 2000 and 2019, and in 2019 were the top three causes of death and disability, collectively accounting for 36.9% of all healthy life lost. Despite the reduced importance of many communicable diseases, neonatal disorders still accounted for 7.0% of all healthy life lost in 2019 and remained the fourth most important disease burden. Depression, anxiety, and self-harm (7.3% of all healthy life lost) have increased in importance since 2000. Road injuries (3.0% of all healthy life lost) have decreased in importance, but not by enough to meet the global Sustainable Development Goal target of halving the number of deaths and injuries from road traffic crashes by 2030. Solutions to each of these challenges require multisectoral cooperation.
COVID-19 pandemic response
External pressures, notably the financial crisis of 2009 and the COVID-19 pandemic in 2020–21, have adversely affected the economic stability of the Small Island Developing States of the Caribbean. The ongoing COVID-19 pandemic in particular has affected all countries, although the wealthiest economies of Asia, Europe, and North America provided extensive social support to workers and the general population, injecting 9.8 trillion dollars into their economies (from a global total of $11.7 trillion). This level of support was not possible among the Small Island Developing States of the Caribbean, which had fewer resources to counteract the health and economic burden of the pandemic. Suriname experienced five major COVID-19 outbreak surges between April 2020 and May 2022, with most of the 1339 confirmed deaths by May 2022 concentrated in the last three outbreak periods. The major ongoing COVID-19 policy is the further scale-up and implementation of the vaccination program in cooperation with international partners. Other activities include strengthening health technologies and epidemiology capacity as well as maintenance of the diagnostic capabilities.