Independent proposal for public review. Evidence date: 4 November 2026. Pilot sizes, targets and institutional roles are proposed. Baselines, institutional acceptance, quotations, specialist review and funding require confirmation before implementation.
2040 citizen vision
People receive timely primary care, dependable follow-up and safe referrals close to where they live.
Proposed pilot and beneficiaries
Ten participating primary-care facilities using existing ministry programmes; select a coastal and remote mix after capacity and records review.
Rationale and evidence
PAHO reports an established HEARTS programme [S6]. The proposal strengthens operational continuity and referral tracking within authorised clinical protocols.
Delivery approach
- Audit appointment flow, stock availability, follow-up records and referral pathways with facility teams.
- Introduce simple recall and referral-completion tracking through approved systems, with assisted access for patients.
- Agree stock replenishment triggers, staff cover and transport escalation for the selected service pathways.
First 90 days from authorised start
Days 1–30: ministry approval and data/privacy assessment. Days 31–60: measure service gaps and agree operational improvements. Days 61–90: implement approved tracking and staff routines.
Months 4–12
Evaluate continuity, referral completion and patient experience. Clinical outcome definitions and treatment decisions remain with the authorised clinical team.
Proposed accountability and competencies
Proposed lead: Ministry of Health and regional health services. Partners: facility teams and relevant technical partners. Skills: primary-care operations, pharmacy logistics, clinical governance and health information management.
Resources, funding and recurrent costs
Quote staff training/backfill, secure records, communication, essential stock logistics, referral transport and evaluation. Recurrent staffing and medicines must fit authorised health budgets.
Feasibility and expansion gate
Require clinical oversight, patient confidentiality, approved care pathways and staff capacity. Publish aggregate service results; patient records remain restricted.
Measurement and proposed pilot thresholds
Baseline status: pending local verification for every measure. Confirm definitions, sample, reporting owner and realistic thresholds before implementation. All percentage-point changes use the same defined cohort; relative reductions are calculated against the verified baseline.
| Type / measure |
Definition |
Proposed target |
Data owner / cadence |
| Result · Referrals completed in agreed window |
Verified completed referrals ÷ referrals due ×100, by clinical pathway. |
Proposed: +15 percentage points. |
Regional referral lead; monthly |
| Result · Planned follow-up completed |
Patients completing follow-up within clinician-agreed window ÷ patients due ×100. |
Proposed: +10 percentage points. |
Facility clinical lead; monthly |
| Activity · Essential-item stock availability |
Selected item-days available ÷ selected item-days required ×100. |
Proposed: 95%. |
Pharmacy/logistics lead; monthly |
| Activity · Facility improvement actions closed |
Verified actions closed ÷ actions due ×100. |
Proposed: 90%. |
Facility manager; monthly |
Complementary initiative
Risk-Based Safety and Environmental Compliance: coordinate workplace inspections, water/waste sampling and corrective-action closure in one selected industrial cluster, using existing regulator mandates and qualified inspectors.
Proposed 2030 milestone
By 2030, participating facilities maintain funded continuity arrangements and publish comparable aggregate service performance.
Evidence confidence and required verification
Medium for alignment; local clinical/service baselines and full specialist review pending.
Evidence and sources
[S3] [S3] World Bank: Guyana country overview, accessed 4 November 2026
Identifies human capital, jobs and climate resilience priorities and existing education, transport, energy and flood programmes.
[S6] [S6] PAHO: Guyana HEARTS quality improvement workshop, 22 June 2026
Search-accessible report confirms an existing primary-care improvement programme. Full-page retrieval returned an access restriction; local facility performance remains unverified.
The earlier roadmap research informs this proposal. Read the portfolio roadmap and review standard.
Funding status: Uncommitted. Proposed institutional roles require acceptance. Next editorial review: 4 February 2027, or earlier when material evidence changes.
