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Commonwealth Health Partnerships 2015

C ommo nwe a l t h memb e r c o u n t r i e s Notably, reports state that cases of eating disorders and suicide are rare. Psychiatric disorders related to alcohol use are uncommon, although not unheard of, due to prohibition. Health systems: In 2012 government expenditure on health was 2.1 per cent of GDP, equivalent to US$862 per capita. In the most recent survey, conducted between 1997 and 2011, there were 150 doctors, and 773 nurses and midwives per 100,000 people. There is universal maternal health care in the country and in 2013, 99 per cent of one-year-olds were immunised with one dose of measles. The most recent survey available, conducted in 2010, reports that Brunei has ten pharmaceutical personnel per 100,000 people. Health care in Brunei is fully subsidised by the government and there are ten hospitals as well as health clinics, travelling clinics and a flying doctor service. The petroleum and natural gas industry has its own separate Occupational Health Service and the armed forces also have their own medical service, so workers in these sectors are not covered by the Ministry of Health’s Occupational Health Division. Brunei’s pharmaceutical industry benefits from the wealth of raw materials provided by the country’s rainforests, which have allowed it to focus on the niche halal pharmaceutical market. The country nonetheless imports most of its pharmaceutical requirements. The most recent act relating to mental health in Brunei Darussalam is the Mental Health Order, enacted in November of 2014 and replacing the Lunacy Act of 1929. Key concepts outlined in the act highlight the vital need for continuity of care and implementation of a monitoring system to ensure patient welfare. Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. To achieve MDG 4, Brunei Darussalam should have reduced underfive deaths per 1,000 live births to four and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2012 under-five mortality stood at ten deaths per 1,000 live births and measles immunisation at 99 per cent. While universal measles immunisation has almost been achieved, under-five mortality will need to have halved for the country to achieve MDG 4. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. The maternal mortality ratio for Brunei, therefore, should fall to seven cases per 100,000 live births. In 2013 Brunei had an adjusted ratio of 27 maternal deaths per 100,000 live births (an estimate from UN agencies/World Bank), Under-five mortality 1990 1995 2000 2005 2010 2015 Under-five mortality per 1,000 live births 15 12 80 75 156 Commonwealth Health Partnerships 2015 9 Mortality by cause of death (% of all deaths), 2012 Communicable diseases, Injuries maternal, perinatal and nutritional conditions Non-communicable diseases Tuberculosis: Incidence and mortality 1990 2000 2010 Mortality excluding cases comorbid with HIV (per100,000 people) Incidence of tuberculosis (per 100,000 people) – including cases comorbid with HIV 120 100 80 60 40 20 0 Life expectancy 1980 1990 2000 2013 Life expectancy Life expectancy in years 70


Commonwealth Health Partnerships 2015
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