The Ministry of Health in Guyana (MOH), in collaboration with its partner Mount Sinai Health System, developed a comprehensive screening programme for school-age children. This initiative was created to provide a package of essential health services for the young child and adolescent according to the standards of care of the Ministry. This is in alignment with the Government of Guyana’s wider plan of expanding Primary Health Care and strengthening the healthcare system to provide world-class services. The main aim of the comprehensive school screening programme is to advance the preventative care health agenda while maximizing the health outcomes for this population.
Programme Launch and Target Population
This programme was successfully launched in collaboration with the Ministry of Education and the Arnold Institute for Global Health in the last quarter of 2023. The target population of focus is all school-aged children and adolescents that are in the education system, which amounts to approximately 210,000 individuals in Nursery, Primary and Secondary schools. The age group which corresponds to the schools are between 3 years to 17 years, a large subset of the total population of Guyana.
Implementation and Services Provided
The programme commenced with screening for the Nursery Level I and II in 2023 and extended to Primary in 2024, with the expected continuation of the secondary schools by the end of 2025. The coverage achieved to date is 67% (17,754) of the nursery population and 61% (51,994) of the primary population. This programme is implemented regionally by a team of healthcare providers that includes a General Medical Officer/ Medex, nurses, community health workers, dentists, optometrists and clerical staff. The screening is available in the schools as a collaborative effort with the teachers and senior staff of each school.
The services provided include a physical examination that allows the healthcare worker to evaluate if there are pathologies of the heart, lungs and other major systems. It also allows for the evaluation of the hearing and sight of the child. Additionally, early identification of speech impediments, motor skills and deformities in the musculoskeletal system. As the level of education increases, there are changes in the screening that is done. Specifically, the older child in primary school will have a mental health screening done. The secondary student has additional screening done for puberty because there are physiological changes that are a part of normal development at this age.
Importance of Early Detection and Primary Prevention
Primary prevention, which is demonstrated by the comprehensive school screening programme, is one of the foundational pillars of primary health care. In Guyana, primary health care is the backbone of the healthcare system. The early interventions of primary health care in Guyana were focused mainly on providing services for the early childhood years, women during the reproductive years and adults who are diagnosed with non-communicable diseases. On review of the services, what was noted is that there was a paucity of screening services for children 5 years old and above until adulthood, unless it is an emergency. This created a situation of a lack of data on the health status and the associated risk factors affecting the health of the 5 to 18 population.
Early identification of diseases and associated risk factors in the young child and adolescent is important and allows for early intervention, in some instances, lifesaving interventions. Growth and development, whether physical, mental or social, are intrinsically linked; any deviation from the normal tends to affect the other parameters. Therefore, the opportunity to provide timely care from a prevention or intervention standpoint is critical to the overall health outcome.
Promoting Lifelong Health and Addressing NCDs
It is important to note that this programme, as a secondary aim, hopes to foster healthy habits in children and adolescents, which we expect will impact their lifestyle choices as adults. Guyana, like many other countries, is challenged by the alarming increase in the population that suffers from Non-Communicable Diseases (NCDs). A comprehensive response to non-communicable diseases requires early screening, treatment and rehabilitation. Comprehensive school health programme is a platform that provides an entry point into making an impact on the public health crisis of non-communicable diseases.
Guyana’s Comprehensive School Screening Programme marks a pivotal shift in the nation’s approach to preventive healthcare. This initiative not only addresses immediate health needs but also lays the foundation for a healthier adult population in the future. The programme’s emphasis on early detection, timely intervention, and the promotion of lifelong healthy habits demonstrates a proactive, data-driven strategy to strengthen primary health care and combat the growing burden of non-communicable diseases. As the programme continues to expand across all levels of the education system, it represents a transformative step toward achieving equitable, holistic health care for every child and adolescent in Guyana, irrespective of their geographic location.
