Gu y a n a Population over 65 3% Commonwealth Health Partnerships 2015 183 Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. For Guyana to achieve its targets for the reduction of child mortality, which form MDG 4, Guyana should have reduced underfive deaths per 1,000 live births to 20 and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 37 deaths per 1,000 live births and measles immunisation at 99 per cent. While the measles target has nearly been met, Guyana would have to have halved its underfive mortality rate in two years to achieve this target. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. For Guyana, maternal mortality should, therefore, fall to 53 cases per 100,000 live births. In 2013 Guyana had an adjusted maternal mortality ratio of 250 deaths per 100,000 live births (this figure was estimated at 280 deaths per 100,000 by UN agencies/World Bank in 2010). This is almost five times the target figure. Guyana is, therefore, very unlikely to achieve this target by 2015. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the most recent year for which data is available (2009) this figure stood at 87 per cent, indicating that this target is also unlikely to be met. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. While HIV levels have been declining since 2001, Guyana continues to have problems with other major communicable diseases, particularly malaria and TB. The country is unlikely to meet its MDG 6 targets when the 2015 data is analysed. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Just over a third of health care in Guyana (34 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2013. Total health expenditure constituted 6.6 per cent of GDP in 2012, of which 66 per cent (US$155 per capita) was covered by the government. Public health services are mainly financed in large part by the government with contributions from the donor community. At the time of writing there was no national health insurance system in place in Guyana, although a national insurance scheme did already exist for employees in the country and was mandatory for all employed persons between the ages of 16–60, including the selfemployed. Guyana’s Health Vision 2020 provides a long-term plan to consolidate the progress made in pursuit of the health MDGs, aiming to close any remaining gaps in development. It aims to establish a post-2015 development agenda for Guyana through expanding universal health coverage, and facilitating behavioural and cultural changes through the delivery of improved health services. Guyana has signed and ratified the International Covenant on Economic, Social and Cultural Rights, which includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Around 27,000 people in Guyana are over the age of 65 – three per cent of the total population (2013). At the age of 60 a person living in Guyana can be expected to live for an additional 17 years, on average (2013). Guyana’s old age pension scheme dates back to 1944 and became universal in 1993. Monthly pension credits are paid by the state at a rate of US$65 per person (2007–12) on a universal basis. Overall, public pension spending is equivalent to 0.1 per cent of the country’s total economic output (2010). Due to the small size of the old-age pension in Guyana, many elderly people continue to be employed into their 80s or, if retired, live at home with the support of their family. Residential homes are beyond the means of many elderly citizens in Guyana as the majority are privately run. Two exceptions are The Palms, a government-subsidised residential home in Georgetown, and the Dharm Shala in Albouystown, a not-for-profit organisation run by a family and charitable donors. Further information Ministry of Health: www.health.gov.gy Commonwealth Health Online: www.commonwealthhealth.org/health/americas/guyana
Commonwealth Health Partnerships 2015
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