and measles immunisation at 94 per cent. While the measles target is coming close to being achieved, Fiji is unlikely to have achieved the under-five mortality element of this goal when the 2015 data is analysed. 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. Maternal mortality in Fiji, therefore, should fall to eight cases per 100,000 live births. In 2013 Fiji had an adjusted maternal mortality ratio of 59 deaths per 100,000 live births, having increased significantly from 23 deaths per 100,000 live births in 2011. The maternal mortality target is very unlikely to be met. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. By 2012 this target had been met. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Fiji’s prevalence of HIV is low and remained consistent at 0.1 per cent in the period 1990–2012. Progress towards MDG 6 has been promising, with an absence of malaria and decline in estimated incidence of TB. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Only about a third of health care in Fiji (35 per cent) 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 four per cent of GDP in 2012, of which 65 per cent (US$115 per capita) was covered by the government. The number of health centres, clinics and nursing stations across the islands means that basic medical treatment is accessible for most people. However, patients may need to travel to the larger urban centres for more comprehensive treatment. The Ministry of Health’s Strategic Plan for 2011–15 has three strategic goals: providing adequate primary and preventive services; providing accessible clinical and rehabilitation services; and strengthening health systems. The WHO Country Co-operation Strategy for Fiji adds to this the need to develop and implement plans to prevent communicable diseases, such as STIs, HIV and TB, and meet targets for vaccination programmes. Another priority identified in the strategy is strengthening maternal, adolescent and child health programmes. F i j i Fiji’s Bill of Rights includes the right to access to health care, sanitation, food security and safe water. Fiji 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’. Care of the elderly: Approximately 48,000 people in Fiji are over the age of 65 – five per cent of the population (2013). At the age of 60 a person living in Fiji can be expected to live for an additional 17 years on average. The social pension scheme was introduced in 2013. Monthly pension credits are paid by the state at a rate of US$16 per person (2007–12) on a pensions-tested basis. Overall, public pension spending is equivalent to 0.5 per cent of the country’s total economic output (2005). Population over 65 Fijian culture is particularly geared towards care of the elderly, with in-house and in-community care provided by family, extended family and neighbours being the norm for older people. There are also three government-owned senior citizens homes and three private ones. Fiji has a National Policy on Ageing (2011–15) and a National Council for Older Persons. The Bill of Rights includes the right to housing and social security schemes. Elderly people get concessions on bus fares. Further information Ministry of Health: www.health.gov.fj Commonwealth Health Online: www.commonwealthhealth.org/health/pacific/fiji Commonwealth Health Partnerships 2015 173 5%
Commonwealth Health Partnerships 2015
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