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C ommo nwe a l t h memb e r c o u n t r i e s 1,000 live births to 19 and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 29 deaths per 1,000 live births and in 2012 measles immunisation at 98 per cent. These figures have remained static since 2011, suggesting that the country is unlikely to meet the under-five mortality target. Tuvalu’s high rate of measles immunisation is promising, suggesting that it has a good chance of achieving 100 per cent immunisation 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. There is no data available on this figure for the last few years. Part of the goal stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007–12 this figure stood at 98 per cent, so this target is close to being achieved. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. There has been a significant reduction in the estimated incidence of TB since 1990, however, 2011–12 saw a marked increase in the incidence of the disease. Estimated mortality (when mortality data excludes cases comorbid with HIV) from the disease has dropped slightly overall in the period 2007–13, although there was great fluctuation over this time. Tuvalu is unlikely to achieve MDG 6. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage All health care in Tuvalu is covered by the government. Total health expenditure constituted 15.4 per cent of GDP in 2012, equivalent to US$577 per capita. The Tuvalu Medical Treatment Scheme ensures that people who have conditions beyond the scope of Tuvalu’s health services are treated in Fiji or New Zealand. Tuvalu began to reform its health care system in 2008 with the development of a new health master plan to guide the work of the Ministry of Health for the next decade. The Strategic Health Plan 2009–19 aims at ensuring the highest attainable standard of health for all people of Tuvalu by ensuring legislative and budgetary support for efficient and effective health services; providing highquality and cost-effective management of health services; improving the quality and cost effectiveness of curative medical services; and focusing on primary health care. The plan also emphasises the improvement of services for mother and child health in the areas of immunisation, childhood illness, nutrition, breastfeeding and reproductive health. Reducing TB is another aim. Tuvalu 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: Nine per cent of the population is aged 60 or older. Like other Pacific nations, the elderly in Tuvalu have traditionally been cared for by younger generations of their extended family. However, migration to Funafuti and overseas has left some older people isolated with no family left locally to care for them. The Red Cross runs a programme on Funafuti that sees volunteers visiting older people at home to check on their well-being. The elderly have also been identified as a priority for help in the event of a natural disaster. Further information Ministry of Health: www.tuvaluislands.com/gov_addresses.htm Commonwealth Health Online: www.commonwealthhealth.org/health/pacific/tuvalu 284 Commonwealth Health Partnerships 2015


Commonwealth Health Partnerships 2015
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