Until World War II, medical facilities in rural areas were inadequate. The extension of workers' compensation to agricultural workers in 1947 and the subsequent establishment of the medical services on the sugar estates did much to improve rural health care. The World Bank estimated that 89 percent of the population had access to health care in the late 1980s. Some children under twelve had been immunized against measles (52 percent), and diphtheria, pertussis, and tetanus (DPT) (67 percent), figures that are about average for the region. Health expenditures by the government were 3.7 percent of all expenditures in 1984.

In 1988 there were 21 hospitals, 47 health clinics, and 115 rural health centers in Guyana. The country counted 2,933 hospital beds for a bed to population ratio of approximately one to 280. Guyana's seven private hospitals and the largest public hospitals are in Georgetown.

Statistics for 1988 showed 164 physicians in Guyana, which made for a physician-to-patient ratio of one to 5,000. About 90 percent of the physicians were in public service. Most physicians in the private sector were also holding government jobs. Approximately half of the country's physicians were expatriates from communist countries, such as Cuba and the Democratic People's Republic of Korea (North Korea), who were assigned to work in Guyana as part of bilateral agreements. These foreign professionals experienced significant language and cultural difficulties in dealing with patients.

Guyana's 789 nurses made for a nurse-to-patient ratio of one to 1,014 in 1988. There were an additional 875 nursing assistants and 409 trained midwives. Because of the shortage of nurses, many health care functions that in developed countries would be performed by nursing personnel were assigned to nursing students. Thirty-eight pharmacists were licensed to operate.

A national insurance program was established in 1969. It covers most workers and self-employed people for disability, sickness, and maternity. The program is administered by the National Insurance Board. Workers with permanent total disabilities are paid their full salary those with temporary disabilities get at least 60 percent of their salary. Employees with illnesses can receive 60 percent of their salary for up to six months. Women can take maternity leave for up to thirteen weeks with 60 percent of their salary. Guyana also has a pensions system that provides a basis of 30 percent of earnings starting at age sixty-five. Employers and employees alike pay into all of these insurance funds, which are administered by the National Insurance Board. Social security and welfare accounted for 2.7 percent of government expenditures in 1984.

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Current information on Guyanese society is difficult to obtain, especially in book form. Some of the most useful books about Guyana that have appeared since independence include Henry B. Jeffrey and Colin Baber's Guyana: Politics, Economics and Society, which focuses on the political system but also contains several interesting analyses a 1000 and observations on Guyanese social structure and ethnicity, and on the impact of government policies on education and religion and A Political and Social History of Guyana, 1945-1983, by Thomas J. Spinner, Jr., which offers a detailed discussion of the social and economic forces operating in Guyana during the turbulent 1950s and through independence, including most of the Burnham period.

Andrew Sanders's The Powerless People: An Analysis of the Amerindian People of the Corentyne River is about the ethnic identity and values of a small population of coastal Amerindians living along the Suriname border. Although the topic sounds somewhat narrow, the analysis offers much on how ethnicity is experienced and handled throughout Guyanese society. The book includes a clear discussion of the various approaches to the study of Guyanese ethnicity taken by social scientists since the 1950s.

Perhaps the most famous book published about Guyana since independence is Walter Rodney's posthumous A History of the Guyanese Working People, 1881-1905, published in 1981. Less than a decade after its publication, this book had become a classic in the literature on Caribbean societies. Rodney's careful analysis of the forces shaping Guyanese society at the end of the nineteenth century provides a basis for understanding the conflicts of modern Guyana.

The works of two anthropologists, Raymond T. Smith and Leo A. Despres, are very helpful in understanding Guyanese society between the World War II and independence. Smith's British Guiana is regarded by many as the best book on Guyanese society in the colonial period. Other works by Smith have focused on kinship structure, especially among Afro-Guyanese. Smith's The Negro Family in British Guiana: Family Structure and Social Status in the Villages is a classic of Caribbean anthropology. In the late 1980s, he published a further analysis of his field data in Kinship and Class in the West Indies: A Genealogical Study of Jamaica and Guyana. Cultural Pluralism and Nationalist Politics in Guyana, by Leo Despres, is concerned with understanding the nature of ethnicity in Guyana. Despres sees Guyana as an example of a "plural society" composed of separate cultural communities. His analysis is based on fieldwork in AfroGuyanese and Indo-Guyanese villages.

It is impossible to understand Guyanese society in the second half of the twentieth century without an acquaintance with the economic history of the country. Two works published in the 1970s are very helpful in this regard. Alan H. Adamson's Sugar Without Slaves: The Political Economy of British Guiana, 1838-1904 looks at the indentured labor system in the nineteenth century. Jay R. Mandle's The Plantation Economy: Population and Economic Change in Guyana 1838-1960 is concerned with British Guiana from the end of slavery to the closing years of the colonial period.

A number of books on specialized topics were published in the 1980s. Education for Development or Underdevelopment?, by M.K. Bacchus, provides an analysis of changes in the Guyanese education system since World War II. Peter Rivière's Individual and Society in Guiana is a review of anthropological knowledge about the Amerindian cultures of the Guianas. The book focuses on kinship and political systems at the village level. (For further information and complete citations, see Bibliography.)

Data as of January 1992