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Commonwealth Health Partnerships 2015

C ommo nwe a l t h memb e r c o u n t r i e s 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 Samoa 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 ten and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 18 deaths per 1,000 live births and measles immunisation at 99 per cent. While the level of immunisation has not yet reached 100 per cent, the country had no recorded cases of measles in 2008. The under-five mortality target is unlikely to have been met 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, making Samoa’s target a maternal mortality ratio of 65 per 100,000 live births. In 2013 Samoa had an adjusted maternal mortality ratio of 58 deaths per 100,000 live births (estimated at 100 deaths per 100,000 live births by UN agencies/World Bank in 2010), so it has already met this target. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2009 this figure stood at 81 per cent, so this target may be met when the 2015 data is analysed. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. The prevalence of HIV/AIDS is low. There has been a gradual reduction in estimated incidence of and estimated mortality (when mortality data excludes cases comorbid with HIV) from TB since 1990. Consequently, progress has clearly been made and Samoa may well achieve 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 Samoa (12 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 6.8 per cent of GDP in 2012, of which 88 per cent (US$217 per capita) was covered by the government. Samoa’s Health Sector Plan 2008–18 states as its mission: ‘To regulate and provide quality, accountable and sustainable health services through people working in partnership.’ Its aims include improving access to publicly funded health care facilities for all Samoans, with clear guidelines on accessibility and affordability. The role of non-governmental, religious, civil society and community organisations in the health sector is gaining increased government recognition. The Ministry of Health is currently looking at how to manage performance measurement, partnership approaches, formal contractual arrangements, cost structures and incentives with partner organisations, particularly with a view to increasing coverage to vulnerable and underserved communities. Samoa 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 9,000 people in Samoa are over the age of 65 – five per cent of the total population (2013). At the age of 60 a person living in Samoa can be expected to live for an additional 19 years, on average (2013). Samoa’s Senior Citizens Benefit dates back to 1990. Today, monthly pension credits are paid by the state at a rate of US$59 per person (2007–12) on a universal basis. There are a number of non-governmental and community-based organisations that provide health services for the elderly. Mapuifagalele Old People’s Home in Apia, for example, is run by the Catholic Church of Samoa and provides accommodation for elderly people whose families are unable to care for them. The Home also works with the National Health Service and private GPs to provide medical care for older citizens in their own homes. Mapuifagalele is Samoa’s only old people’s home and when it first opened in 1975 it was the first old people’s home in western Polynesia. Further information Ministry of Health: www.health.gov.ws Commonwealth Health Online: www.commonwealthhealth.org/health/pacific/samoa 254 Commonwealth Health Partnerships 2015 Population over 65 5%


Commonwealth Health Partnerships 2015
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