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Commonwealth Health Partnerships 2015

Va n u a t u Population over 65 Commonwealth Health Partnerships 2015 297 With no local pharmaceutical industry, all pharmaceutical products are imported. There is no independent drug regulatory authority with a remit to monitor the importation of drugs. The Principal Pharmacist in the Ministry of Health is the most relevant contact in these matters. Vanuatu is working with the WHO to strengthen its pharmaceutical policies and improve access to essential medicines and vaccinations. Mental health policy and a mental health plan were both most recently revised in 2009. 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. For Vanuatu to achieve its targets for the reduction of child mortality, which form MDG 4, it should have reduced under-five deaths per 1,000 live births to 11 and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 the under-five mortality rate was 17 per 1,000 live births, a slight improvement from 18 the year before. Measles immunisation currently stands at 52 per cent (2013); the 100 per cent target is hard to reach as many children live in remote, difficult-to-reach areas. 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. For Vanuatu, the maternal mortality ratio should fall to 43 deaths per 100,000 live births. In the period 2007–11 Vanuatu had an adjusted maternal ratio of 86 deaths per 100,000 live births (this figure was estimated at 110 by UN agencies/World Bank in 2010). Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007–12 this figure stood at 74 per cent. Consequently, Vanuatu is unlikely to meet this goal. In the hope of improving the country’s chances of meeting MDG 5, the Ministry of Health has taken steps to identify those women most at risk of maternal mortality, namely very young mothers (less than 15 years of age), older mothers (over 39 years) and those who have had more than four children. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. The number of deaths from malaria fell considerably in the period 2003–11. Although estimated incidence of TB has fallen in the period 1990–2010, the estimated mortality rate (when mortality data excludes cases comorbid with HIV) has remained roughly the same. The country is unlikely to meet MDG 6. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Less than an eighth of health care in Vanuatu (13 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 3.6 per cent of GDP in 2012, of which 87 per cent (US$100 per capita) was covered by the government. One of the strategic priorities in Vanuatu’s World Health Organization Country Co-operation Strategic Agenda (2013–17) is for the country to improve access to services by rolling out primary health care interventions in all provinces and building a more responsive health system that addresses human resources, good management practices, medicines and technology. In early 2014 the government endorsed a national health reform plan that aims to improve health services at all levels of delivery. This is to be implemented through improved management of health provinces, improving access to essential health services from hospitals to community-based health facilities. The progress of implementation has been slow, however, as the government does not have the financial capacity for risk pooling to provide adequate health insurance cover based on needs and equity. Vanuatu 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: Around 10,000 people in Vanuatu are over the age of 65 – four per cent of the total population (2013). At the age of 60 a person living in Vanuatu can be expected to live for an additional 18 years, on average (2013). Overall, public pension spending is equivalent to 0.3 per cent of the country’s total economic output (2005). 4% A UNDP report on hardship and poverty in Vanuatu found that men and women aged over 60 are more likely to be economically vulnerable in urban areas than in rural areas. This is mostly likely because people in rural areas tend to live in extended family groups, where older family members will be supported and cared for by younger generations. Further information Ministry of Health: www.governmentofvanuatu.gov.vu Commonwealth Health Online: www.commonwealthhealth.org/health/pacific/vanuatu


Commonwealth Health Partnerships 2015
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