Health

A comparison of Guyana’s health care system to Jamaica’s
Anadia Olyfveldt (1034493)

University of Guyana
Date of completion: 12/22/2019
Health is a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity.1 To achieve this state of complete physical mental and social wellbeing,
health care services are utilized. Health care refers to the provision of medical services to
prevent, diagnose, and treat health problems. It is important to note that Health is central to
human happiness and well-being. It also makes an important contribution to economic progress,
as healthy populations live longer, are more productive, and save more. 2 According to the Talcott
Parsons, the functionalist perspective emphasizes that good health and effective medical care are
essential for a society’s ability to function. Ill health impairs our ability to perform our roles in
society, and if too many people are unhealthy, society’s functioning and stability suffer. 3 Guyana
has developed health care services to keep society functioning as per normal. Health and medical
care in Guyana are provided by both public and private suppliers. The public health care system
is highly decentralized and is administered through the Regional Democratic Councils and
Regional Health Authorities, with ministerial oversight vested in the Ministry of Local
Government and Regional Development.4 The purpose of this paper is to compare Guyana’s
Health care to another country. The comparable jurisdiction would be Jamaica, whose health
care system is synonymous to Guyana’s because they both consist of public and private
suppliers. Therefore, this paper will succinctly compare these two countries’ health care systems
based on organization, financing and health status of the country.
As it relates to the organization of the health care system in Guyana, the responsibility for the
health care of the population rests with the Minister of Health. However, in 1986, the
responsibility for the delivery of health services was devolved to the Regional Democratic
Councils who received funding through the Ministry of Local Government. The Ministry of
Health retained responsibility for the vertical health programs in the entire country, including
vector control, rehabilitation services, dental care, mental health programes, Hansen’s disease,
AIDS, and alcohol and drug abuse. The Ministry also formulates policy, sets standards and
1
World Health Organization “WHO Constitution” Retrieved from: https://www.who.int/about/who-we-
are/constitution
2
World Health Organization “Health and development” Retrieved from: https://www.who.int/hdp/en/
3
Barkan, Steve “A Primer on Social Problems” 2012 pg 644
4
Commonwealth Health Online “Health Systems in Guyana”
www.commonwealthhealth.org/americas/guyana/health_systems_in_guyana/
1
monitors and evaluates the health sector. The emerging model is that of decentralization to semi-
autonomous bodies, with the Ministry of Health relinquishing its role in service delivery. 5
The health sector is subsequently organized into Public and Private Institutions. The main public
institutions that participate in the health sector are the Ministries of Health and Local
Government. They are headed by a Minister who is the political head of the Ministry and is a
member of the Cabinet. The Ministries receive funding from the Central Government. The
donor community and other sources also contribute to the Ministry of Health. The human and
technological resources of the health departments of the Regional Democratic Councils, Ministry
of Local Government are for the most part provided by the Ministry of Health. There are five
levels of care ranging from health posts to health centres, district hospitals, regional hospitals,
and the national referral hospital. Within a region, at least 4 levels are found. Although the
levels of care are well-defined, in practice they do not function in that manner as patients often
bypass the health centre and district hospital levels to attend the regional hospitals and the
national referral hospital. The technical head of the services at the regional level is the Regional
Health Officer whose role is to ensure the linkages among the various levels.6
The private sector and private companies own 10 hospitals as well as diagnostic facilities,
clinics, and dispensaries. The private health services provide about half of all curative services
which tends to meet the health needs of Guyanese people. Most of these services are provided in
the capital city and other urban centres. The principal sources of financing in the private sector
are through fees from individual patients. The Ministry of Health has legislation for private
hospitals which is, the Private Hospitals Act. This makes provision for the licensing of Private
Hospitals. 7
5
Pan American Health Organization (2001) “Health Systems and services profile of Guyana” Retrieved from:
http://www.paho.org/hq/dmdocuments/2010/Health_System_Profile-Guyana_2001.pdf
6
7
2
In the same vein, the health systems in Jamaica is organized in the brackets of the Public and
Private sector. According to research done by Pan America Organization, the public sector is
comprised of a network of 23 public hospitals and approximately 350 primary health care clinics
dispersed around the country. The public hospitals have a limited number of resources to meet
the growing population of Jamaica. For example, the public hospitals report a bed capacity of
4,500 - 5,000. A Comprehensive Service Review and other studies have indicated that the
current system is too large and inefficient. There are approximately 8 private hospitals with a
capacity of about 300 beds.8
Because of the central role of the public sector and size of the country, there is a relatively high
degree of informal familiarity between the public and private sector health systems. Many health
professionals work in both sectors and most started their careers in the public sector. This is a
similar occurrence in Guyana. The private sector is loosely regulated. Little, if any, organized
information is maintained on the organization, operations and other characteristics of the private
health sector. Historically, the predominant organizational model for the health services has been
the traditional physician-led model. The Ministry of Finance and Planning is the primary
financier of health services, other than out-of-pocket payments by consumers. Responsibility for
the management and delivery of services has been delegated to the decentralized Regional
Health Authorities (RHAs). The Ministry is considering public-private partnerships and out-
sourcing of selected services. 9
Like Guyana, the health system in Guyana is subsequently divided into Public and Private
Institutions. The Ministry of Health is the primary public institution involved in the health sector.
A law was passed in 1998 to authorize the establishment of four regional health authorities to
deliver health services in the 14 parishes. The principal sources of financing are the government
8
Pan American Health Organization (2001) “Health Systems and services profile of Jamaica” Retrieved from:
https://www.paho.org/hq/dmdocuments/2010/Health_System_Profile-Jamaica_2001.pdf
9
3
budget and international donor support. The government relies on local human resources for the
delivery of services. Technology and supplies are largely imported. 10
Unlike Guyana, the private sector is loosely regulated in Jamaica. However, most of the
ambulatory and primary care is delivered in the private sector. The private hospital sector only
handles about 5 percent of the total hospital services. The public hospitals handle the most
complicated and costly cases. Most of the drugs are acquired in the private sector. Evidently,
these two countries stand to be similar in the organization of the health systems.11
Secondly, The World Health Organization has identified financing systems as one of the six
building blocks of health (WHO, 2007). The public hospitals in Guyana are primarily financed
by the government, but contributions from donor countries also play a part. The public health
sector generates only insignificant revenues. On the contrary, there is no form of public financing
of private health insurance. No tax breaks are given to individuals when they purchase health
insurance policies; all the funds are from grants. The principal sources of external financing
were UN agencies, Inter-American Development Bank, United Nations Development Fund,
USAID and German Technical Cooperation. The Ministry of Finance prepares data on health
expenditure. The national per capita expenditure on health was US$24.8 in 1997 and US$25.3 in
1998. In 1999, health expenditure amounted to 6.51% of total government expenditure. If debt
payments are excluded, the percentage was 8.51%.12
In Jamaica, The Ministry of Health has a finance and budget department that is responsible for
managing financial resources for the public sector. With decentralization, the RHAs have a
greater role in resource management and have added to the fragmentation of information that
currently exists.
10
11
12
4
Ultimately, the health status of a country determines its development. According to the latest
WHO data published in 2018, life expectancy in Guyana is; Male 63.6, female 69.0 and the total
life expectancy is 66.2 which gives Guyana a World Life Expectancy ranking of 135. 13 Guyana’s
life expectancy may be this low because of lack of nutrition, lack of knowledge and information
about healthy lifestyles, communicable and non-communicable diseases. Contradistinctive to
this, according to the latest WHO data published in 2018 life expectancy in Jamaica is: Male
73.6, Female 78.5 and the total life expectancy are 76.0 which gives Jamaica a World Life
Expectancy ranking of 59.14 Evidently, persons in Jamaica are expected to live longer than their
counterparts in Guyana. Reasons proffered for such may include better health care than Guyana
and a much more nutritious population.
Another determinant of the health status of a country is its maternal mortality rate. This is the
annual number of female deaths per 100,000 live births from any cause related to or aggravated
by pregnancy or its management (excluding accidental or incidental causes). The maternal
mortality ratio includes deaths during pregnancy, childbirth, or within 42 days of termination of
pregnancy, irrespective of the duration and site of the pregnancy, for a specified year. The rate
has been recorded as 667 deaths/100,000 live births in 2017.15 Based on these statistics, it can be
noted that Jamaica has a better health status than Guyana.
It is, therefore, the plausible deduction that health is a vital component of any society because it
aids in the proper functioning of that society. Guyana and Jamaican can be compared to the lines
of their health systems. Practically, both countries’ health system is organized into the public and
private sector which subsequently has public and private institutions respectively. The public
hospitals are monitored and managed by the Ministry of Health. It is also financed by the
Government. However, private hospitals receive finance from their patients. However, the health
13
World Health Rankings (2018) “Jamaica: Life Expectancy” Retrieved from:
https://www.worldlifeexpectancy.com/guyana-life-expectancy
14
World Health Rankings (2018) “Jamaica: Life Expectancy” Retrieved from:
https://www.worldlifeexpectancy.com/jamaica-life-expectancy
15
Index Mundi (2017) “Guyana Maternal Mortality Rate” Retrieved from:
https://www.indexmundi.com/guyana/maternal_mortality_rate.html
5
status in each country is starkly different. In Guyana, the life expectancy rate is lower and its
maternal mortality rate is much higher than Jamaica. A deduction can be taken from this to
conclude that Jamaica has a better health status than Guyana.
References
6
 World Health Organization “WHO Constitution” Retrieved from

https://www.who.int/about/who-we-are/constitution
 World Health Organization “Health and development” Retrieved from

https://www.who.int/hdp/en/
 Barkan, Steve “A Primer on Social Problems” 2012 pg 644
 Commonwealth Health Online “Health Systems in Guyana” Retrieved from:

www.commonwealthhealth.org/americas/guyana/health_systems_in_guyana/
 Pan American Health Organization (2001) “Health Systems and services profile of
Guyana” Retrieved from:
 Pan American Health Organization (2001) “Health Systems and services profile of
Jamaica” Retrieved from:
 World Health Rankings (2018) “Jamaica: Life Expectancy” Retrieved from:

https://www.worldlifeexpectancy.com/guyana-life-expectancy
 World Health Rankings (2018) “Jamaica: Life Expectancy” Retrieved from:

https://www.worldlifeexpectancy.com/jamaica-life-expectancy
 Index Mundi (2017) “Guyana Maternal Mortality Rate” Retrieved from:

https://www.indexmundi.com/guyana/maternal_mortality_rate.html

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A comparison of Guyana’s health care system to Jamaica’s

Anadia Olyfveldt (1034493)

 World Health Organization “WHO Constitution” Retrieved from

 World Health Organization “Health and development” Retrieved from

 Barkan, Steve “A Primer on Social Problems” 2012 pg 644

 Commonwealth Health Online “Health Systems in Guyana” Retrieved from:

 World Health Rankings (2018) “Jamaica: Life Expectancy” Retrieved from:

 World Health Rankings (2018) “Jamaica: Life Expectancy” Retrieved from:

 Index Mundi (2017) “Guyana Maternal Mortality Rate” Retrieved from:

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