Challenges

• Guyana has inadequate health professionals, an estimated 8 doctors and 10 nurses per 10,000 people, much lower than the regional average. Maldistribution and skills gaps exacerbate this problem with approximately 70% of nurses working in the capital, Georgetown.  

• The government of Guyana is constructing 15 new regional hospitals, to fully staff these hospitals PAHO and the Ministry of Health estimate that an additional 4,000 nurses will be needed.  

• Training the required number of nurses using the traditional approach is a major challenge for the Government to effectively implement its hospital expansion program.  

• The three national nursing schools in Guyana admit approximately 200 new students annually and all nursing training also takes place in Georgetown with implications for deployment and retention in rural areas after graduation.  

• To address this challenge, PAHO partnered with the Ribeirao Preto School of Nursing, Brazil to reform nursing education in Guyana, introducing a hybrid training model.  

Toward a Solution

Nursing Education Reform in Guyana 

• This new nursing training program aims to rapidly increase the number of nurses in Guyana. The program allows nurses to be trained in their home regions and increases the numbers that can be trained without compromising the quality of the training.  

• The initiative involved a tripartite partnership between PAHO/WHO, the University of Sao Paulo in Brazil, and the Ministry of Health, Guyana. PAHO facilitated a technical collaboration between the Health Sciences Education Department of the Ministry of Health, Guyana and the  PAHO/WHO Collaborating Centre for Nursing Research Development at the University of Sao Paulo, Riberao Preto College of Nursing in Brazil to design and implement a new nursing training model. The partnership also attracted additional resources from the Canadian Government.  

• The program adopted a hybrid approach, combining online theoretical courses with modules delivered through the Coursera platform. Hands-on practical training and in-person clinical rotations have been done through practical simulation and skills development labs established in the different regions of Guyana. 

• Initially, a strategic analysis of the existing nursing training program in the country was conducted which highlighted several challenges in the traditional training program including inadequate intake capacity, educational and skills gaps among tutors, inadequate educational resources and teaching aids, and lack of standardized teaching protocols. 

• The technical support involved adapting courses for an online platform, standardizing training contents, training of tutors, and delivering the training through a hybrid model of online and in person programs. The simulation centers established across the country allow students to complete the practical components of their courses in the regions.  

Promising Results: 

• Between 2023-2024, more than 1,800 nursing students were enrolled in the hybrid program, exceeding the previous yearly enrollments  almost ten- fold. Currently, the program has a total of 1,422 students enrolled across the two years.  

• This new approach to nursing education provides a promising medium to long term solution to the nursing shortage in Guyana, with an estimated 800 new nursing professionals expected to graduate in 2026. This represents an exponential increase from the previous 200 new nurses that graduated annually under the previous conventional training format. It also represents progress towards accomplishing SDG target 3c.  

Added Benefits of the New Initiative:   

• The hybrid format makes the enrolment of students into the program more equitable by allowing rural students to enroll with the flexibility to pursue their education from wherever they live which has important implications for retention of these nurses in the long-term. Increased enrolment from rural areas into the training program is particularly important in addressing the significant maldistribution of health workers in Guyana.  

• Placing the simulation centers in the regions and decentralizing the clinical rotation to hospitals in the regions as opposed to the capital city allowed for students to do practical training in or near the communities where they live. The program helps students to appreciate the problems of the communities they will serve upon graduation.  

Transformative Partnerships:  

• The initiative transformed the way nursing education is conducted in Guyana by blending the power of technology, south-to-south collaboration, and innovation. Using the benefit that technology to share knowledge and experience generated elsewhere more accessible. 

• The hybrid model also allowed for standardization of training materials and course content ensuring all students are exposed to the same educational content, and undergo the same standardized skills training and assessments. This is fundamental shift in the way nursing training takes place traditionally in Guyana, improving the quality of preservice training of nurses.  

Sustainability Considerations:  

• In addition to increasing the availability of nurses in the country, the program is expected to improve equitable distribution, as well as the retention of nurses.   

• The new training model offers the potential for expansion to the training of other cadres of health professionals. The regional training platforms and simulation centers are already being utilized to train nursing assistants across Guyana. 

• This initiative between the University of Sao Paulo, Brazil and the Ministry of Health, Guyana demonstrates how collaboration and knowledge sharing of best practices provides the potential to improve equity in health and the strengthening health systems in countries in the South.