In 1999 Nauru’s two hospitals, the government-run Nauru General Hospital and the private Nauru Phosphate Corporation Hospital, amalgamated into the state-run Republic of Nauru Hospital (RONH), which provides free medical and dental treatment for all citizens. RONH is located in Yaren and provides basic medical care; special treatment is mainly limited to diabetes and other obesity-related diseases at the Naoero Public Health Centre, run by the Department of Public Health. Radiological services and lab work are available at RONH and there is an operating theatre, but no facilities for MRI or CT scans. Anyone with serious illnesses and injuries that cannot be treated on the island must be sent by air to Australia. There is no pharmaceutical manufacturing or independent drug regulatory authority in Nauru. The Republic of Nauru Pharmacy imports pharmaceuticals from Australia and the Netherlands, and suffers from frequent shortages in supply as well as disruptions in distribution. As part of the government’s National Sustainable Development Strategy, the Nauru NCD Action Plan was initiated in 2009 to combat high levels of diabetes and obesity by encouraging physical activity and nutritional education, and discouraging alcohol and tobacco use. Figures from 2004 show that 58 per cent of 25–64- year-olds were obese, with 23 per cent suffering from diabetes. Nauru’s WHO Country Co-operation Strategic Agenda (2013–17) Na u r u prioritises preventative measures towards obesity and diabetes through use of an improved food control system. Unhealthy lifestyle choices are linked to limited agricultural production in Nauru and high costs of importing fresh foods. No fully formed mental health policy or act existed in Nauru at the time of writing. The island is a member of the WHO Pacific Islands Mental Health Network and operates a Mental Health Toll-Free Help Line. 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 Nauru 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 44 and increased measles immunisation to 100 per cent when the 2015 data is analysed. Nauru’s under-five mortality rate for 2013 is approximately 37 deaths per 1,000 live births, so it has already surpassed that figure. In 2011, 100 per cent of one-year-olds were immunised against measles, so this goal, too, has been met. 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. However, little data is available for this statistic. In the period 2009–13 Nauru had no reported maternal mortalities. Part of this 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 97 per cent and so this target is close to being achieved. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. The contribution of communicable diseases to total mortality in Nauru is fairly low for a developing country. Tuberculosis (TB) is a possible threat to achieving the MDG 6 target, although estimated incidence of the disease fell by around a third in the period 2006–10. Malaria is not a problem in Nauru. While efforts should be concentrated on TB, it is likely Nauru will achieve the main targets set out by MDG 6. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health care Total government health expenditure in Nauru amounts to US$491 per capita (2012). The island’s hospital provides free medical and dental treatment for all citizens. The Nauru National Sustainable Development Strategy 2005–25 includes a commitment to the provision of effective clinical and preventive health services, such as those to treat, screen for and reduce NCDs as set out in the Nauru National NCD Action Plan. The strategy also commits to meeting the requirements of the conventions of the United Nations, such as the WHO Framework of Convention on Tobacco Control, the International Convention on Population Development and the Convention on the Rights of the Child. It also looks to making improvements to health information, developing human resources in the health sector and improving medicinal and equipment management systems. Australian funding has helped to create more senior management roles in the Ministry for Health, as well as more support staff in the Commonwealth Health Partnerships 2015 223 Mortality by cause of death (% of all deaths), 2008 Other NCDs Communicable, maternal, perinatal and nutritional Injuries Cardiovascular diseases Diabetes Respiratory diseases Cancer 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 8 7 6 5 4 3 2 1 0
Commonwealth Health Partnerships 2015
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