In 1990, 12.5% of the country's population had no access to health services, an increase from 11% during 1987-1989; 25% had no access to safe water and 12.5% had no access to sanitation. The infant mortality rate per 1,000 live births was 43.9 in 1985, rose to 47.0 in 1988, and dropped again to 42.9 in 1992. It is estimated that the life expectancy for women in 1992 was 67.7 years, and that of men was 62.1 years. The country's population has dropped since 1985, mainly due to international migration; net migration from 1980 to 1989 averaged -1.6% each year. The estimated population in 1991 was 739,553 inhabitants. The country also has experienced internal migration, resulting in an urban population increase from 30.9% of the total population in 1985 to 32.2% in 1992.

Specific Health Problems and Risks

In 1991, of 114 deaths due to nutritional deficiencies, 57.9% occurred among children under 1 year old, and 15.8% occurred among 1-4 year olds. Conditions such as anemia, gastroenteritis, infectious hepatitis, and typhoid fever have increased over the past years. Of pregnant women who had their hemoglobin levels checked and recorded at prenatal clinics in 1987, 70.5% had a level below 11 g/dl. In 1990, 76.4% were below that level. The increase probably reflected the economic reality of the majority of those who use the public health service. The most important causes of mortality and morbidity reported by the Health Statistics Unit in the age group 55 years old and older are chronic diseases such as cerebrovascular accidents, ischemic heart disease, and diabetes. It is estimated that 26% of the country's adult population smokes. Among Amerindians, malnutrition is the most important childhood health problem; a high level of teenage pregnancy and poor maternal health also affect the group. Malaria was the leading cause of morbidity reported in the country for 1986-1992. More than 60% of the cases are due to Plasmodium falciparum. The most affected group for both males and females was that aged 19-28 years. In 1988, there was a measles epidemic, with more than 900 cases detected. In 1992, no cases were detected. Between 1987, when the first cases of AIDS were reported in the country, and 1992, 390 AIDS cases have been reported. The trend is for cases to increase for both males and females.

Health Services and Resources

The health system was decentralized in 1985, and responsibility for most health functions fell under the country's 10 regional administrations. The Ministry of Health has remained mostly as a quality-control unit, monitoring health conditions in the country and ensuring that equal care standards are provided in the different regions; it also tackles epidemics as they occur and has maintained responsibility for dental and preventive health. There are 115 health posts staffed by community health workers that operate at the grassroots level. There are 47 health centers which should be staffed by a health visitor, a medex (a paramedical person), and nurses. There are 16 district hospitals in 8 of the country's 10 regions. The four regional hospitals are designed to provide medical, surgical, obstetric, and pediatric care. The environmental health services are extremely fragmented, with frequently overlapping functions and responsibilities. Some of those institutions are State entities, while others are fully or semi-autonomous. Food inspection, food quality control, and meat inspection were satisfactorily conducted. However, no water quality or chemical control programs were effectively implemented.

Drinking water should be purchased in bottles or boiled. Medical services and facilities throughout Guyana are inadequate. Malaria is endemic in some areas outside Georgetown.