In Guyana, becoming a nurse has long followed a traditional path. Students trained at one of three nursing schools, where teaching was largely classroom-based and relied on printed materials that were not always up to date. Clinical training depended on placements in a limited number of health facilities, often with inconsistent quality.
Opportunities to practise critical skills before entering real clinical settings were scarce. Simulation laboratories and digital learning tools were absent, and training experiences varied by institution, with little standardisation across the system.
According to the World Health Organisation’s State of the World’s Nursing 2020 Report, Guyana had just over nine nurses per 10,000 people, far below the regional density of 83. These shortages are compounded by unequal distribution, with most health workers concentrated along the coast, while hinterland regions and areas outside the coastal plain continue to face gaps in access to care.
The Ministry of Health estimates that at least 4,000 additional nurses are required to meet growing demand. For years, however, the country trained only around 200 nurses annually. In addition, outward migration — nurses leaving the country to seek employment abroad — has further reduced the available workforce, increasing the urgency to expand training, boost enrolment, and improve distribution across the country.
With support from the Pan American Health Organisation (PAHO) and the University of São Paulo’s Ribeirão Preto School of Nursing, a PAHO/WHO Collaborating Centre for Nursing Research Development in Brazil, the Ministry of Health launched a comprehensive reform of nursing education in 2022. A national steering committee was established to guide implementation and coordinate efforts between academic institutions and health authorities.
At the core of the reform is a standardised, competency-based hybrid learning model, introduced through a full review and update of the national nursing curriculum. Throughout the process, PAHO provided technical support, helping to modernise the curriculum, strengthen faculty capacities, and foster collaboration with regional academic partners.
Under the new model, theoretical instruction is delivered online, allowing students across the country to access the same high-quality content. The curriculum spans 27 courses across the three-year programme and is combined with virtual tutorials, hands-on training in simulation laboratories, and supervised clinical placements in health facilities.
“More people from hinterland areas, who would not ordinarily have the opportunity, are now able to pursue the programme within their own communities,” explained Lester Christian, nursing tutor and coordinator of the professional nursing programme for Guyana’s Ministry of Health. “It allows us to train more people and fill the gap in our country’s nursing workforce.”
Since the launch of the programme in 2023, more than 2,100 students have enrolled across two cohorts. In 2026, approximately 650 new nurses are expected to graduate, significantly strengthening the country’s workforce.
“Under the hybrid approach, it is even more important that students experience real-world scenarios in a safe environment,” Christian said, adding that “These simulations let nursing students think critically, make good clinical judgments, and become competent before entering the health system, and are a significant improvement to the quality of education we are delivering.”
To strengthen this approach, professionals from the University of São Paulo’s Ribeirão Preto School of Nursing provided hands-on training in clinical simulation.
Nursing tutors from Guyana and other Caribbean countries travelled to Brazil to learn how to design realistic scenarios based on common health conditions. In simulation laboratories, they practised managing seizures, postpartum haemorrhage, and acute respiratory conditions using lifelike techniques such as moulage to replicate wounds, bleeding, and other clinical signs.
Participants rotated roles as nurses, facilitators, and patients, followed by structured debriefings to reflect on decision-making, communication, and teamwork.
“Our goal is to refine teaching methods and equip future healthcare professionals to perform effectively in complex, interprofessional settings,” said Carla.
Back in Guyana, this approach is being implemented through a network of simulation centres established across the country. In addition to expanding the workforce, the programme is enhancing equitable access and retention by enabling greater participation from rural areas. Its flexible design is also supporting the training of other health cadres, including nursing assistants, through existing platforms.
The WHO’s State of the World’s Nursing 2025 Report shows nursing workforce density in Guyana increased to 35 per 10,000 population, reflecting a significant expansion in training capacity and workforce availability over the last five years. This upward trend suggests that recent investments in education reform and health workforce development are beginning to translate into measurable gains, strengthening the country’s ability to respond to population health needs.
“Guyana is becoming a success story in transforming nursing education and an example of best practice for the Caribbean,” said Benjamín Puertas, PAHO’s Chief of Human Resources for Health. “This model has expanded training across the country and is improving access to quality health care.”
As more nurses enter the system, the reform is also expected to strengthen the distribution and quality of the workforce, bringing more consistent, accessible care to communities across the country. Health officials hope the experience in Guyana can serve as a blueprint for other countries facing similar shortages. (PAHO)
Nurses in a simulation lab (Credit: PAHO)
