BackgroundThe Amazonian Amerindian populations living in the southern and southwestern hinterlands of Suriname (South America) have come into contact with western health care since approximately fifty years ago. In this study, secondary data were used to assess the impact of Medical Mission’s fifty-year old primary health care program on the health status of these populations.MethodsUsing data from the primary health care facilities of Medical Mission for 1965-1970, 1973-1977, 1982-1985, and 1997-2014, temporal trends in incidence and mortality of respiratory tract infections, gastroenteritis, and malaria; population composition; birth and death rates; and polyclinic consultations in these communities have been assessed over the period between 1965 and 2014.ResultsIn the period covered by this study, the incidence of respiratory tract infections and gastroenteritis declined by about 75% and 53%, respectively, while malaria incidence rose sharply from the 1980s through 2005 but subsequently declined to levels approximating elimination. Crude death rates dropped by about 70% while birth rates declined by about 50% in the 1980s and since then remained at this level. The population doubled in size and increased in all age groups, particularly in the age group of ≥59 years. The infant mortality rate declined by 50%. In addition, the average yearly number of polyclinic visits per person decreased 6- to 7-fold during this period.ConclusionsThe significant reduction of the infectious disease burden; the doubling of the population size and the growth of the proportion of elderly individuals due to the declining death rates; the declining infant mortality rates to levels comparable to the national average as well as the decline in average numbers of polyclinic consultations per person, indicate that Medical Missions health service provision achieved its goal of improving the health and survival of the indigenous people by providing free, accessible and permanent medical services. Building upon this successful experience Medical Mission could be instrumental in addressing potential contemporary life-style related health threats.

The EUFRAT model provided an estimate close to actual observed number of dengue infections. The dengue TT risk among Dutch travelling donors can be estimated using basic transmission, travel and donation information. The TT risk from Dutch donors travelling to Suriname and the Dutch Caribbean is small.

BackgroundThe literature reports that the use of healthcare services in urban areas compared to rural areas and by females compared to males is often higher. The aim of this study is to evaluate equity on geographical living area and gender for the use of primary and secondary healthcare in Suriname.MethodsWe used 5,671 records (99%) from the Suriname Health study which was designed according to World Health Organization (WHO) Steps guidelines. We evaluated the Prevalence Ratio (PR) for living area and gender in using primary (PHC) and secondary healthcare (SHC) adjusted for the perceived need for healthcare, socio-economic factors and disease factors and the effect of all factors was measured.ResultsOverall a percentage of 46.7 (95% Confidence Interval (CI) 45.1–48.4) had used primary healthcare and 12.7 (95% CI 11.6–13.8) secondary healthcare in the past 12 months. The PR for males compared to females was 0.75 (95% CI 0.70–0.81) for primary healthcare and 0.82 (95% CI 0.69–0.98) for secondary healthcare. The PR for urban and rural coastal areas compared to the rural interior was 1.52 (95 % CI 1.36–1.70) and 1.53 (95% CI 1.36–1.71), respectively. For the use of SHC, the PR for urban and rural coastal areas compared to the rural interior was 9.3 (95 % CI 5.44–15.89) and 8.58 (95% CI 4.98–14.81). The attributable effect of perceived healthcare-need to the PR of the urban and rural coastal areas was 39.64% and 37.81% compared to the rural interior for secondary healthcare. Further, 31.74% and 13.56% were due to socioeconomic factors.ConclusionAlthough we observed equity between living areas for PHC use, for SHC use we observed a disadvantaged position for the rural interior, mainly influenced by socioeconomic factors. We measured gender equity for both PHC and SHC use.

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