C ommo nwe a l t h memb e r c o u n t r i e s The number of deaths from malaria fell by approximately 94 per cent in the period 2003–11. In the period 1990–2013 there were considerable fluctuations in estimated incidence of tuberculosis (TB), with the figure considerably lower in 2013 than it was in 1990; estimated mortality (when mortality data excludes cases comorbid with HIV) from TB dropped significantly from 13 deaths per 100,000 people in 2007 to 6.3 in 2013. Diagnoses of mental illness in Vanuatu are often related to physical illnesses and the manner in which they can affect mental health. There is also evidence of common mental disorders, such as depression, personality disorder and anxiety, most of which have gone untreated in the past. A significant number of people have also been treated for ‘brief psychotic disorders’ commonly associated with religious experiences. Also present are mental health conditions relating to psychoactive substance misuse. Health systems: In 2012 government expenditure on health was 3.1 per cent of GDP, equivalent to US$100 per capita. In the most recent survey, conducted between 1997 and 2010, there were 12 doctors, and 170 nurses and midwives per 100,000 people. Additionally, in the period 2007–12, 74 per cent of births were attended by qualified health staff and in 2013, 52 per cent of oneyear olds were immunised with one dose of measles. In 2012, 91 per cent of people were using an improved drinking water source and 58 per cent had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that Vanuatu has one pharmaceutical professional per 100,000 people. The Ministry of Health is responsible for the four provincial hospitals and two referral hospitals in Vanuatu; the two major referral hospitals are located in Port Vila (Central Hospital) and Luganville (Northern District Hospital). Port Vila’s Central Hospital suffered substantial damage in March 2015 when Cyclone Pam hit the islands. There are a number of health centres and clinics around the islands providing preventative medicine and inpatient, outpatient and primary care. There are around 100 active dispensaries. The Ministry of Health heads the four tiers of public health facilities (hospitals, health centres, dispensaries and aid posts). Support from non-governmental organisations (NGOs) and community-based services supplement government-provided services. The private health sector in Vanuatu is a recent development and private health insurance is primarily utilised by expatriates, with services mainly available in towns. Under-five mortality 35 30 25 20 15 1990 1995 2000 2005 2010 2015 Under-five mortality per 1,000 live births 2015 MDG 4 target 80 70 60 296 Commonwealth Health Partnerships 2015 10 Life expectancy 1980 1990 2000 2013 Life expectancy Life expectancy in years 50 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 250 200 150 100 50 0
Commonwealth Health Partnerships 2015
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