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Commonwealth Health Partnerships 2015

KEY FACTS Joined Commonwealth: 1970 Population: 105,000 (2013) GDP p.c. growth: 1.6% p.a. 1990–2013 GNI p.c.: US$4,990 (2013) UN HDI 2012 ranking: World ranking 100 Life expectancy: 73 years (2013) Under-five mortality rate (per 1,000 live births): 12 (2013) Largest contribution to mortality: Cardiovascular diseases Government health expenditure: 4.5% of GDP (2012) General information The Kingdom of Tonga, known as ‘The Friendly Islands’, lies in the central south-west Pacific, surrounded (clockwise from the west) by Fiji, Tuvalu, Kiribati, Samoa, Cook Islands and, to the south, New Zealand. The islands, which straddle the International Date Line, lie 276 Commonwealth Health Partnerships 2015 to the east of the Tonga Trench, containing some of the deepest waters of the South Pacific. The main island sub-groups are Tongatapu, Vava’u and Ha’apai. The largest island is Tongatapu. Climate: Hot and humid in January–March; cooler in April–December. Cyclones may occur November–April. Environment: The most significant environmental issues are deforestation, damage to coral reefs by excessive coral and shell harvesting, and depletion of sea turtle populations due to hunters. Population: 105,000 (2013); 24 per cent of people live in urban areas; population growth stood at 0.4 per cent p.a. between 1990 and 2013. In 2012 the birth rate was 25 per 1,000 people (37 in 1970) and life expectancy was 73 years (65 in 1970). The vast majority of the people are of Polynesian descent. Tonga suffers from heavy emigration, mostly to New Zealand, Australia and the USA. There are 50,478 Tongans living in New Zealand, more than half of whom were born there (2006 New Zealand census). Economy: Tonga is classified as an upper-middle-income economy by the World Bank. Health Child and maternal health: Infant mortality in Tonga was ten deaths per 1,000 live births in 2013, with an under-five mortality rate of 12 deaths per 1,000 live births in 2012. There has been a consistent decline in the under-five mortality rate since 1990. Although this decline is encouraging, the under-five mortality rate is not yet in line with the country’s target of eight deaths per 1,000 live births as defined by Millennium Development Goal 4 (MDG 4). In 2010 the three most prominent known causes of death for children below the age of five years were congenital anomalies (26 per cent), prematurity (24 per cent) and acute respiratory infections (nine per cent). Other contributory causes were intrapartum-related complications (eight per cent), injuries (eight per cent), neonatal sepsis (five per cent) and diarrhoea (two per cent). In 2013 Tonga had an adjusted maternal mortality ratio of 120 deaths per 100,000 live births (this figure was estimated at 110 deaths per 100,000 by UN agencies/World Bank in 2010). Burden of disease: Non-communicable diseases (NCDs) in Tonga accounted for an estimated 74 per cent of all mortality in 2008. The most prevalent NCDs in Tonga are cardiovascular diseases, which accounted for 38 per cent of total deaths across all age groups in 2008. Cancer, non-communicable variants of respiratory diseases and diabetes contributed nine per cent, seven per cent and five per cent to total mortality, respectively (2008). Communicable diseases along with maternal, perinatal and nutritional conditions accounted for an estimated 22 per cent of all mortality in 2008. In 2013 it was reported that there were two people in Tonga living with HIV. Tonga is a non-endemic country for Tonga


Commonwealth Health Partnerships 2015
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