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PAHO Basic Health Indicator Data Base This is a multidimensional query tool that offers a collection of 108 indicators from 1995 to 2005. The system presents data and indicators on:
- demography
- socioeconomic
- mortality by cause indicators
- morbidity and risk factors
- access, resources and health services coverage.
Selected indicators are disaggregated into age groups, sex and/or urban/rural region. Generated tables can be exported and printed.
The data presented is updated annually with the latest country information.
GENERAL SITUATION AND TRENDS French Guiana occupies around 91,000 km2
of Northern South America , neighboring with Suriname and Brazil . Its capital
city is Cayenne. The jungle covers the majority of the territory and only
5% of the territory is populated.
Economy:
The European Space Center in Kourou has contributed to the economic development
of the department and in 1997, space activities accounted for 50.5% of French
Guiana 's economic activity. Unemployment stands at 25%.
Demography:
Over the past decade, the population grew 37% to 156,790 inhabitants in 1999.
This figure is probably underestimated. The fertility rate of 119.4 per 1,000
women aged 15-49 is the highest of all the FODs. The population has very diverse
origins. Immigrants make up nearly 40 % of the total population. The population
is young (in 1999, 50.2% is under 25 years of age). The average population
density is 2 inhabitants/km2. More than 9 out of 10 people live
on the coast and 78% in urban areas. In 1997, life expectancy at birth was
72.4 years for men and 78.7 for women.
Mortality:
During the period 1996-1998, the average infant mortality rate was 10.3 per
1,000 live births. In 1997, the crude mortality rate was 3.8 per 1,000 live
births. A 1998 study showed that the four leading broad groups of causes were
external causes of injury and poisoning, diseases of the circulatory system,
neoplasms and infectious or parasitic diseases. For morbidity, the main causes
were traumatic injuries, poisoning, digestive disorders, infectious and parasitic
diseases, and diseases of the circulatory system. Mortality and morbidity
are due to causes typically associated with developed countries and those
more specific to developing countries. There are considerable disparities
between the various socioeconomic levels and geographical zones.
Health policies and plans Since 1946, French Guiana, Guadeloupe, and Martinique
have formed part of the French Overseas Departments (FODs). Their political
and administrative organization coincides with the rest of France . As ultraperipheral
regions of the European Union, they receive program funds designed to assist
developing European regions. The health policies of the FODs are fashioned
along the lines of the national policy of the Ministry of Labor and Social
Affairs of France (MES). Regional priorities are set during a conference of
health professionals and decision-makers and representatives of institutions
and users.
Health system: The
French State is responsible for general public health, but the competencies
specifically pertaining to health are divided between the State level and
the local administrative units, which draw up and implement local health policies,
undertake health surveillance, and participate in policy development for public
and private hospitals, human resources development, and the organization of
networks of health professionals. The population benefits from a universal
health insurance plan that forms part of the social security system, which
enables the State to cover the cost of medical care for even the poorest sectors
of the population. The system is funded by compulsory contributions, which
are deducted from wages and salaries. Public and private medical care establishments
are key players in the health system, giving unrestricted access to a variety
of primary and secondary medical services. Hospital policy is governed by
Regional Hospital Agencies, whose mission is to define and implement policy
on the provision of hospital care, administer regional budgets, allocate resources,
and oversee the activities of public and private establishments.
Organization of regulatory actions:
A 1998 law created the French Agency for the Safety of Health Products and
the French Food Safety Agency. That law also created the Institute for Health
Surveillance to supervise and monitor the overall state of health of the population,
and the National Committee for Health Safety.
Health sector financing: The
social entities at the national level play an important role in financing
the social protection, given that local contributions are insufficient to
cover costs of the health services.
External technical cooperation: The
FODs must take complementary measures in certain areas of health planning
(for common diseases for example). The departments also maintain a relationship
with PAHO, mainly through the Caribbean Program Coordination. Some health
establishments coordinate cooperation activities directly with the neighboring
states.
SPECIFIC HEALTH PROBLEMS Analysis by population group Children:In
1999, the perinatal mortality rate was 18.9 per 1,000 live births. Prematurity
is one of the leading neonatal risk factors (13.8% of children are born prematurely).
The infant mortality rate was at 11.1 per 1,000 live births in 1998. Conditions
originating in the perinatal period were the leading causes of death (29%),
followed by congenital anomalies (21%) and external causes of injuries and
poisoning (16.1%). The only infectious disease leading to death in this age
group was AIDS. The leading causes of death in children 1-4 in 1998 were external
causes, diseases of the respiratory system and neoplasms.
Schoolchildren and adolescents: The
most common diseases are dental conditions, visual disorders and osteoarticular
conditions. A 1997 survey of schoolchildren averaging 15 years of age showed
that their main concerns were over sexuality, violence, drug addiction, and
sexually transmitted infections, particularly AIDS. In the 5-14 years age
group, the leading cause of death was external causes (injuries), which caused
8 of 11 deaths registered in 1998. Other causes were neoplasms, pneumonia
and diseases of the digestive system.
Adults: In
1998, the leading causes of death among people 15-64 were external causes
of injury and poisoning (40.7 % of all deaths, mainly traffic accidents),
neoplasms (16.1%), infectious and parasitic diseases (15.4%, mainly AIDS)
and diseases of the circulatory system (11.7%). The maternal mortality rate
during the period 1993-1997 was 79.3 per 100,000 live births, an increase
from 64.6 in the 1987-1990 period . On average, pregnant women had six prenatal
visits in 1999, but 15.6% had fewer than four. Drug addiction primarily affects
25-35-year-olds. In 1994, 233 of every 100,000 inhabitants were called in
for questioning regarding the use of narcotics, mainly for cocaine use (90%).
Elderly:In
1998, diseases of the circulatory system (mainly cerebrovascular disease,
heart failure and hypertension) and external causes of injuries and poisoning
were the leading causes of death in people 65 and over. Chronic diseases most
often found in this age group are severe hypertension, cancer and diabetes.
The ratio of beds available for older adults is 86.5 per 1,000 population.
Family health: The
head of household is a single parent in 32% of homes (75 % are mothers).
Disabled: In
the under-20 age group, 232 people receive special education subsidies (3.7
per 1,000). In the 20-59 years age group, 1,034 people receive a disability
subsidy (15 per 1,000). There are very few places that take in mentally and
physically disabled adults.
Analysis by type of health problem Natural disasters:
In April 2000, some 10 people died as a result of a landslide cause by the collapse
of Cabassou hill, near Cayenne.
Vector-borne diseases:
Malaria is endemic in French Guiana . The annual incidence oscillates between
100 and 300 cases per 1,000 population . Over 90% of the cases correspond to
zones with a high risk of transmission located along rivers and affect less
than 10% of the population. Dengue is endemic and epidemic in French Guiana
; it is transmitted more in the coastal area, where the main towns are located.
In 2000, 186 cases of dengue were serologically confirmed and four cases of
hemorrhagic dengue were observed. In 1998, an isolated case of yellow fever
was detected in an Amerindian woman.
Diseases preventable by immunization:In the
last few years, no cases of poliomyelitis, diphtheria, or tetanus have been
reported. There is no surveillance system for measles or rubella. The most
recent vaccination coverage survey, conducted in 2000, found that BCG coverage
among 1-year-olds in the coastal zone was 83% and in municipalities in the
interior it ranged from 40 to 67%. DPT3 coverage at 1 year of age was 68%.
Coverage with MMR at 24 months was 69%. Yellow fever vaccination coverage
ranged from 78% to 93% (22,000 vaccines administered in 2000).
Intestinal infectious diseases:
The last reported case of cholera was in 1994. In 2000, three cases of typhoid
fever (Salmonella typhi) were reported. Intestinal infectious diseases are
the leading reasons for visits to health centers in the interior of French
Guiana for children under 5. Between 1991 and 1997, the mortality rate was
60 deaths per 100,000 children in this age group.
Chronic communicable diseases: The
incidence of tuberculosis in 2000 was 39 cases per 100,000 population . The
age group most affected is 20-59 years; approximately two-thirds of patients
were foreigners. Seventy-one percent had the pulmonary form of the disease.
Leprosy has been endemic in French Guiana since the 18th century.
Every year, some 10 new cases are detected and the annual incidence is currently
5.7 per 100,000 population.
Acute respiratory infections:Deaths
from respiratory conditions are largely due to pneumonia and bronchopneumonia.
These deaths have increased 23% since 1990. In 2000, there were 127 cases
of influenza.
Zoonoses: Animal
rabies transmitted by the vampire bat Desmodus rotundus is a problem in French
Guiana . No case of human rabies has been reported.
HIV/AIDS: As
of 2000, 794 cases of AIDS had been diagnosed in French Guiana since the beginning
of the epidemic. The male-female ratio (1.65:1) has remained stable throughout
the epidemic. In 1999, the incidence rate was 34.4 cases per 100,000 population
. Cases of pediatric AIDS have dropped considerably since the start of the
epidemic. The heterosexual mode of HIV transmission predominates. There are
still weaknesses in the department's AIDS prevention activities. Medical
care for people who have contracted HIV is satisfactory.
Nutritional and metabolic diseases: Protein-energy
malnutrition is found in some isolated areas of the department.
Diseases of the circulatory system: In
1991, 300 cases of chronic diseases of the circulatory system were recorded,
most of them arterial hypertension, stroke, cardiac insufficiency and sequelae
of myocardial infarction.
Malignant neoplasms: The
leading neoplasms responsible for adult deaths were, in decreasing order,
malignant neoplasms of the respiratory system, the upper respiratory system,
and the digestive system. Two of three cancer deaths occur in persons over
65 years of age and mainly in men.
Accidents and violence: Every
year there is a considerable number of traffic accidents in French Guiana
. Fatal accidents occur mainly in the 25-44 years age group (45%), which tends
to use cars, while serious injuries mainly occur in users of two-wheeled vehicles
(51%). In 1998, suicides were the third leading external cause of death among
15-44-year-old.
Oral health:A
school-based study revealed a 22% prevalence of cavities among students.
Emerging and re-emerging diseases: Since
1996, there has been one case of meningococcal meningitis per year (serotype
B or C). Since 1996, the incidence of Q fever has also increased (about 37
cases per 100,000 population in Cayenne and its environs). Some cases of infection
by Venezuelan equine encephalitis complex virus were also detected in 2000.
RESPONSE OF THE HEALTH SYSTEM Epidemiological surveillance and public
health laboratories: Notification of HIV,
hepatitis B, or tetanus infection is mandatory. Diseases subject to surveillance
and special measures are dengue, enteric diseases, fevers without apparent
cause, and measles. A sentinel network supports this surveillance. There are
10 laboratories in French Guiana , one blood bank and a reference laboratory
at the Pasteur Institute.
Potable water: The
Directorate of Health and Social Development is responsible for the quality
of piped water. In 1999, 86% of the population had access to running potable
water. In urban areas, the bacteriologic quality of water is good, but for
a few physiochemical problems. In rural areas, water treatment is incomplete.
Municipalities are legally responsible for non-communal sanitation. Due to
soil quality and failure to maintain the facilities, purification is unsatisfactory.
Solid waste services: Hazardous
waste is disposed in incinerators in public hospitals, at the Pasteur Institute
and in a private clinic in Cayenne . Two garbage dumps operate as sanitary
landfills in Cayenne . In the rest of the country garbage dumps are not under
any control.
Food safety: In
1999, a food safety unit was created for the department, to control for food
imports, processing of animal products, commercial restaurants and markets,
and to handle cases of food poisoning.
Health care services: The
health system is based on: the public and private hospital sector; urban medicine;
health centers; and disease prevention and vaccination centers. There are three
public hospitals in French Guiana and three small private clinics. There are
also 21 centers and health posts. There are also specialized disease prevention
centers in Cayenne and three entities specialized in drug addiction care. Drugs
are imported (by sea due to high airfreight costs) mostly from continental France
. In emergency, they can be supplied by Martinique or Guadeloupe. There is no
local reagents distributor. Problems of transport generally hamper the distribution
of drugs and biomedical products.
Human resources: Some
medical specialties are not sufficiently represented, like psychiatry, infectious
diseases or diabetes care, or not sufficiently organized, like perinatology.
Some specialties, like heart surgery, neurosurgery and pediatric surgery,
are not represented. The private sector is concentrated fundamentally in coastal
cities. A nursing school that operates in Cayenne prepares and certifies some
20 nursing professionals a year, an insufficient number. Financial difficulties
prevent compliance with the requirement to provide continuous training for
paramedical staff.
Health research and technology: The main
research programs focus on immunology and cutaneous leishmaniasis, HTLV-1,
HIV molecular epidemiology, participation in a multicenter study on plasmodia
and studies related to insecticide resistance by vector mosquitoes.
External technical cooperation and financing:
A cooperation project was prepared with Suriname
to consolidate epidemiological surveillance, communicable disease monitoring
and prevention, and strengthening of central laboratory diagnostic capacity.
In 2000, the Pasteur Institute of French Guiana prepared a program on hepatitis
C in conjunction with Haiti.
