WHO Country Cooperation Strategy Republic of Maldives 2013–2017

Abstract

The health status of the people of Maldives has improved in the past few decades. In 1977, the life expectancy at birth was 46.5 years as compared with about 74 years in 2011. In 1990, 34 live-born babies in every 1000 live births in Maldives died before reaching the age of one year. In 2011, the comparative infant mortality rate figure was 9, with the majority of infant deaths occurring in the neonatal period. The maternal mortality ratio declined from about 500 per 100000 live births in 1990 to 56 per 100000 live births in 2011. Notable achievements have been made in the control of communicable diseases; however, some challenges persist. Dengue, scrub typhus and toxoplasmosis have surfaced due to environmental and climate changes. Diarrhea and acute respiratory infections (ARI) continue to cause significant morbidity among children and adults. Tuberculosis, although controlled, has a high risk of spreading in Malé due to overcrowding and poor housing conditions. Noncommunicable diseases (NCDs) accounted for more than 70% of all deaths and disease burden. Lifestyle risk factors are prevalent in the country. The disparity between the atolls and Malé has increased over the past 10 years. Maldives is undergoing socioeconomic and political transition. In this transition, the country is facing extraordinary challenges in consolidating its initial progress within its decentralization programme. Building capacity and strengthening the newly formed institutions, professionalizing the civil service, ensuring equity, and establishing and promoting good governance – all remain key challenges for the country. With the newly formed local government structure in place, the government’s agenda on decentralization requires local communities, spearheaded by the councils, to undertake a number of new roles and responsibilities. Considering this transformation, it is imperative to lay out the framework for smooth and efficient functioning of the local government system. Within the reform context, the Health Master Plan 2006–2015 was reviewed in 2012. The review redirected the policies and strategies of the plan, based on national development priorities, the emerging needs and the lessons learnt. It formulated four principles of the government’s health policy, particularly addressing health as a human right, equitable access to quality health-care services, solidarity for health in all national policies and policy development based on facts and scientific evidence. A focus on the Millennium Development Goals (MDGs) was kept throughout the process as the timeline for the Health Master Plan is congruent with that of the MDGs. In addition, the Health Sector Roadmap 2012–2013, addressing current challenges and indicating strategic approaches related to the building blocks of the health system, has been drafted.