Find Health and Medical expertise in Samoa

Samoa’s national hospital, the Tupua Tamasese Meaole Hospital, is located at Motootua, in Apia, and supported by district hospitals and health centres. Samoan tertiary care is limited and mainly provided through arrangement with New Zealand’s health care system. Publicly funded health care is delivered through the National Health Service. For medical emergencies or specialist treatment beyond the scope of Samoa’s health services, patients are usually airlifted to Australia, New Zealand or Hawaii.

All foreign nationals are required to pay for health services in Samoa, and Samoan health care facilities and doctors normally expect cash payment before carrying out any treatment. The private health care sector has expanded in recent years, but it is mostly confined to Apia, and consists of small hospitals and clinics able to offer only a limited range of medical services.

Samoa imports almost all of its pharmaceutical requirements. The country has no independent drug regulatory authority. Global pharmaceutical organisations have interests in the anti-HIV drug Prostialin, which originated from the Samoan rainforest, and some have, in turn, donated revenues to the local people.

Samoa’s Health Sector Plan 2008–18 states as its mission: ‘To regulate and provide quality, accountable and sustainable health services through people working in partnership.’ Its aims include improving access to publicly funded health care facilities for all Samoans, with clear guidelines on accessibility and affordability.

The role of non-governmental, religious, civil society and community organisations in the health sector is gaining increased government recognition. The Ministry of Health is currently looking at how to manage performance measurement, partnership approaches, formal contractual arrangements, cost structures and incentives with partner organisations, particularly with a view to increasing coverage to vulnerable and underserved communities.

Communicable and non-communicable diseases

Non-communicable diseases (NCDs) in Samoa accounted for an estimated 70% of all mortality in 2008. The most prevalent NCDs in Samoa are cardiovascular diseases, which accounted for 37% of total deaths across all age groups in 2008. Non-communicable variants of respiratory diseases, cancer and diabetes contributed 7%, 6% and 5% to total mortality, respectively (2008).

Communicable diseases, along with maternal, perinatal and nutritional conditions in Samoa, accounted for an estimated 25% of all mortality in 2008. A government paper on HIV/AIDS reported a cumulative 23 HIV cases (12 of which resulted in death) in the period 1984–2013. Samoa is a non-endemic country for malaria. There has been an overall reduction in estimated incidence of and estimated mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis (TB) in the period 1990–2012. In 2013 the estimated incidence of TB in the country was 18 per 100,000 people and estimated mortality (when mortality data excludes cases comorbid with HIV) was 3.2 per 100,000 people.

The most commonly diagnosed mental illnesses in Samoa are bipolar disorder and drug-induced psychosis. Diagnosed cases of depression are also on the increase. Causes of depression are cited as increased urbanisation and migration causing the break-up of traditional support structures, and the increasing stresses of economic hardship. The country’s mental health act was passed in 2006.

Government expenditure

In 2013 government expenditure on health was 6.7% of GDP. In the most recent survey, conducted between 1997 and 2010, there were 48 doctors, and 185 nurses and midwives per 100,000 people. Additionally, in 2009, 81% of births were attended by qualified health staff and in 2013, 99% of one-year-olds were immunised with a dose of measles. In 2014, 99% of people had access to adequate sanitation facilities and 92% had access to an improved source of water.

Less than an eighth of health care in Samoa (12%) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 6.8% of GDP in 2012, of which 88% (US$217 per capita) was covered by the government.

Samoa is not a signatory to the International Covenant on Economic, Social and Cultural Rights, the covenant that commits signees to the ensuring ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’.