Suriname - Country Profile

By PAHO/OPS, 17 September, 2022

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 Suriname was 476 643 inhabitants; by 2024 this figure had risen to 634 431, representing a 33.1% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 7.9% of the total population, an increase of 3.4 percentage points compared to the year 2000. In 2024, there were 100.2 women per 100 men and 30.8 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 66.5% of the total population of the country in 2024 ( 421 653 people). When we add these figures to the potentially passive population ( 162 663 under 15 years of age and 50 116 over 65 years of age), the result is a dependency ratio of 50.5 potentially passive people per 100 potentially active people. This ratio was 59.9 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 in 2024 was 73.8 years, lower than the average for the Region of the Americas and 9.4 years higher that in 2000 (64.4).

Figure 1. Population pyramids of Suriname, years 2000 and 2024

Between 2004 and 2018, the average number of years of schooling in Suriname increased by 7.3%, reaching an average of 8.3 years in the latest year for which information is available. The unemployment rate in 2023 was 8.0%. Disaggregated by sex, the rate was 11.3% for women and 5.7% for men. The literacy rate was 98.9% in 2021. In men, this figure was 98.7%; in women, 99.1%.

During the period 2004-2022, the country improved its score on the Human Development Index, with an increase of 3.4% (from a score of 0.667 to a score of 0.69); 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 3.33% of gross domestic product (GDP) (Figure 3) and 10.02% of total public expenditure, while out-of-pocket spending on health accounted for 24.83% of total health expenditure.

Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2021

Digital coverage

In 2021, 65.9% of the population had an internet connection, representing a considerable increase from 2000, when 2.5% of the population had an internet connection.

Health situation

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 95% in 2022, an increase of 24 percentage points from 2000.

Figure 4. Infant mortality per 1000 live births, 1995–2017

The maternal mortality ratio in 2020 was estimated at 96.5 deaths per 100 000 live births, representing a 65.3% 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 2.2 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 42.8% decrease, from 82.0 live births per 1000 women aged 15 to 19 years in 2000 to 46.9 in 2024. In 2021, 100.0% of births were attended by skilled birth personnel.

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

Communicable diseases

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 2022, there were 20 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 2022, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 96 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 43.6%. There were no cases of human rabies in the country in 2022.

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 58.1% in 2022.

Also in 2016, 44.4% 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.

Mortality

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

Cancer mortality

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 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.

Country COVID-19 Perspective

Perspective

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.⁵ The Suriname Ministry of Health has developed a healthcare vision of guaranteed access to quality care.⁶ 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.⁷ 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 2060.⁸ 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.⁹ 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.

References

1. Pan American Health Organization. Health in the Americas+. Washington, DC: PAHO; 2022. Available from: https://hia.paho.org

2. United Nations, Department of Economic and Social Affairs, Population Division. World population prospects 2019, Online Edition. Rev. 1. New York: UN; 2019 [cited 13 September 2022]. Available from: https://population.un.org/wpp/publications/.

3. United Nations, Department of Economic and Social Affairs, Population Division. World population prospects 2019, Online Edition. Rev. 1. New York: UN; 2019 [cited 13 September 2022]. Available from: https://population.un.org/wpp/publications/.

4. World Health Organization. Global excess deaths associated with COVID-19 (modelled estimates). Geneva: WHO; 2022. Available from: https://www.who.int/data/sets/global-excess-deaths-associated-with-covid-19-modelled-estimates.

5. Government of the Republic of Suriname. Policy Development Plan (2017 - 2021). Stichting Planbureau Suriname (Suriname Planning Bureau Foundation); 2017.

6. Suriname Ministry of Health/Ministerie van Volkgezondheid. Policy Plan 2021-2025: Guaranteed access to quality care.

7. Smits CCF, Toelsie JR, Eersel MGM, Krishnadath ISK. Equity in health care: an urban and rural, and gender perspective; the Suriname Health Study[J]. AIMS Public Health. 2018;5(1):1–12. Available from: 10.3934/publichealth.2018.1.1.

8. United Nations, Department of Economic and Social Affairs, Population Division. World population prospects 2019, Online Edition. Rev. 1. New York: UN; 2019 [cited 13 September 2022]. Available from: https://population.un.org/wpp/publications/.

9. Institute for Health Metrics and Evaluation . Suriname profile. Seattle: IHME, University of Washington; 2021 [cited 14 September 2022]. Available from: http://www.healthdata.org/suriname.

10. Oxfam. Shelter from the storm. The global need for universal social protection in times of COVID-19. Oxford: Oxfam International; 2020. Available from: https://www.oxfam.org/en/research/shelter-storm-global-need-universal-social-protection-times-covid-19.