Grenada - Country Profile

By PAHO/OPS, 17 September, 2024

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 Grenada was 107 451 inhabitants; by 2024 this figure had risen to 117 207, representing a 9.1% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 12.2% of the total population, an increase of 3.7 percentage points compared to the year 2000. In 2024, there were 99.5 women per 100 men and 63. 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 68.3% of the total population of the country in 2024 ( 80 076 people). When we add these figures to the potentially passive population ( 22 787 under 15 years of age and 14 346 over 65 years of age), the result is a dependency ratio of 46.4 potentially passive people per 100 potentially active people. This ratio was 70.7 in 2000.

Life expectancy at birth in 2024 was 75.4 years, lower than the average for the Region of the Americas and 2.4 years higher that in 2000 (73).

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

The literacy rate was 98.6% in 2014 (98.6% for men and 98.6% for women).

During the period 2002-2022, the country improved its score on the Human Development Index, with an increase of 4.9% (from a score of 0.756 to a score of 0.793); 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 2.22% of gross domestic product (GDP) (Figure 3) and 6.99% of total public expenditure, while out-of-pocket spending on health accounted for 53.68% of total health expenditure.

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

Digital coverage

In 2021, 77.8% of the population had an internet connection, representing a considerable increase from 2000, when 4.1% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2021, infant mortality in Grenada increased from 14.3 to 18.9 deaths per 1000 live births, a decrease of 32.2% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 7.5% to 9.3% between 2002 and 2018.

Regarding the immunization strategy, measles vaccination coverage was 76.0% in 2022, a decrease of 16 percentage points from 2000.

Figure 4. Infant mortality per 1000 live births, 1995–2021

The maternal mortality ratio in 2020 was estimated at 21.1 deaths per 100 000 live births, representing a 49.8% 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 1.5 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 46.9% decrease, from 53.9 live births per 1000 women aged 15 to 19 years in 2000 to 28.6 in 2024. In 2022, 100.0% of births were attended by skilled birth personnel. Between 2016 and 2020 the percentage of pregnant people who received antenatal care increased from 60% to 76%.

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

Communicable diseases

In 2022, there were 1 new cases of tuberculosis per 100 000 population in Grenada. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 0.8 (0.0 in women and 1.6 in men).

In 2022, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 23.1 per 100 000 population. The age-adjusted mortality rate for HIV was 2.8 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 61.6%.

Noncommunicable diseases and risk factors

In Grenada, the prevalence of overweight and obesity among people aged 15 and older was 59.9% in 2022.

Also in 2016, 28.7% 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 24.3%, a decrease of 0.6 percentage points compared to 2000 (24.9%). The prevalence of diabetes mellitus, which stood at 7.5% in 2000, increased to 11.1% in 2014.

Mortality

In 2019, the adjusted rate of potentially avoidable premature mortality in Grenada was 312,2 deaths per 100 000 population, an increase of 2,8% from a rate of 303,8 in 2000. This meant that, in 2019, the rate in the country was 37,7% 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 138,7 per 100 000 population in 2019, which is 1,2% higher than the regional average rate; and the rate for treatable causes was 173,5 per 100 000 population, below the regional average of 89,6.

The overall age-adjusted mortality rate was 7,6 per 1000 population in 2019, a decrease of 8,8% compared to 2000 (8,3 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 88,3 per 100 000 population (95,2 per 100 000 in men and 80,5 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 618,7 per 100 000 population (731,7 per 100 000 in men and 523,6 per 100 000 in women). The rate of age-adjusted mortality from external causes was 48,5 per 100 000 population (74,6 per 100 000 in men and 22,1 per 100 000 in women), including road traffic accidents (7,8 per 100 000 population), homicides (6,4 per 100 000 population), and suicides (0.6 per 100 000 population). In 2000, the percentage distribution of causes was 80,5% for noncommunicable diseases, 14,4% for communicable diseases, and 5,1% for external causes; in 2019, the percentages were 82,8%, 11,3%, and 5,9%, respectively (Figure 6).

Figure 6. Proportional mortality in Grenada, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 80,4 per 100 000 men; lung cancer, 15,3 per 100 000; and colorectal cancer, 16,2 per 100 000. In women, these values were 36,7 deaths per 100 000 for breast cancer, 7,9 per 100 000 for lung cancer, and 13,7 per 100 000 for colorectal cancer.

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

The health situation and the COVID-19 pandemic

In Grenada in 2020, there were a total of 128 cases of COVID-19, representing 1 027,5 per million population. In 2021, there were 6 053 identified cases. In 2020, there were no deaths directly caused by COVID-19 in people diagnosed with the disease; in 2021, 200 deaths were reported, or 1 606 per million. In 2020, Grenada ranked 47th in the Region of the Americas in terms of the number of deaths from COVID-19, and 11th in 2021 (Figure 7).

According to estimates by the World Health Organization, there was a total of 225–253 excess deaths per 100 000 population in 2020; a total of 14 deaths were estimated in 2021, for an excess mortality rate of 12 per 100 000.

As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 38,6% of the country's population. As of 2 July 2022 (latest available data), 34% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and four 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

In 2019, the Government of Grenada released its long-term strategic plan (2020–2035), focusing heavily on sustainability and resilience, and placing a healthy population as national outcome number one and at the center of sustainable development. Equitable access to health care is detailed as one part of a wider move to strengthen the social safety net for all citizens, and this represents an adoption of the global move toward universal health coverage. A strengthened community health infrastructure is planned to bolster programs for preventive health, for encouraging healthy lifestyles among children – a response to the increasing burden of childhood obesity – and health programs across the life course. Introduction of a national health insurance scheme to fund specific health outcomes will help prioritize those most at need. Strengthened surveillance and monitoring will provide evidence on health sector priorities and for health communication. The health in all policies framework is planned to ensure that the health and well-being of the Grenadian people remain at the forefront of development in each sector. Therefore, scaling up universal health coverage in Grenada, incorporating national health insurance, and strengthening community-based health care are key priorities to increase the proportion of the population that access care. Strengthening community health services is also a priority for addressing chronic noncommunicable diseases. These strategic actions are also required to ensure prepaid services, provide a wider range of services, and improve the quality-of-service delivery. The Basic Needs Trust Fund Programme is the flagship poverty reduction program of the Government. The overarching objective of this program is to reduce poverty and vulnerability by enhancing access to basic social and economic infrastructures and human resource development services.

Challenges related to population health

The Grenada population is aging, and the pace of this aging is predicted to increase. In 1980, the proportion of Granada’s population aged 65 and older was 7.2%. This proportion increased to an estimated 9.8% by 2020 and is predicted to more than double to 21.2% by 2060). This future increase of 11.4 percentage points represents a rapid rise in older adults, and remains above the regional averages for the Caribbean of 10.7 percentage points, but below the average for the Americas of 13.7 percentage points. There has been important progress in reducing the burden of neonatal disorders, lower respiratory infections, and HIV/AIDS, all down by one-third since 2000. These successes contribute to a disease burden increasingly dominated by noncommunicable diseases. Cardiovascular diseases, diabetes, and cancers in 2019 were the top three causes of death and disability, collectively accounting for almost half of all healthy life lost. Including all other noncommunicable diseases raises this burden to over 80% of all healthy life lost. Diabetes is a national concern. The burden of diabetes has increased by more than one-third since 2000, is driven by nationally high rates of obesity and physical inactivity and requires lifelong comprehensive care that is onerous for those living with the condition and for healthcare financing. Solutions to the prevention and control of noncommunicable diseases require multisectoral cooperation.

COVID-19 pandemic response

Grenada experienced three extended COVID-19 outbreak surges between April 2020 and May 2022, with over 200 confirmed deaths by May 2022, concentrated in the first of these outbreaks (September–October 2021). The COVID-19 outbreak hit Grenada hard: although infections were low through the first 12 months of the outbreak, the economic contraction was severe, with GDP dropping by an estimated 12% in 2020 due to the standstill in tourism. The World Bank approved a COVID-19 crisis response program in 2020, aimed at mitigating short-term health, social, and economic impacts, and supporting the Government to build financial resilience during the recovery phase. An ongoing COVID-19 policy is the further scale-up and implementation of the vaccination program in cooperation with international partners.

References

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

2. 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.

3. National Plan Secretariat, Ministry of Finance, Planning, Economic, and Physical Development. National Sustainable Development Plan, 2020–2035: Better. Ever Stronger. Together. National Plan Secretariat, Ministry of Finance, Planning, Economic, and Physical Development; 2019.

4. 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/.

5. Institute for Health Metrics and Evaluation. Grenada profile. Seattle: IHME, University of Washington: 2021 [cited 16 September 2022]. Available from http://www.healthdata.org/grenada.

6. World Bank. Grenada - COVID-19 crisis response and fiscal management development policy credit. Washington, DC: World Bank Group; 2020. Available from: http://documents.worldbank.org/curated/en/910171608519629297/Grenada-COVID-19-Crisis-Response.