TAILIEUCHUNG - Maldives

Similarly, a debate over the degree to which the objectives of primary health care can be translated into effective programmes resulted in the emergence of ‘‘selective primary health care’’ (7). This new strategy, which targeted the control of diseases identified as the most important contributors to increasedmortality, was intended to bemore focused and more feasible. A number of specific, more vertical programmes (so named because of the self- contained way they appear on organizational charts and, more importantly, in budget lines of health ministries) were promoted to channel relatively meagre resources into areas in which demonstrable success could be achieved in the medium-term. Furthermore, the emphasis was clearly put on programmes that would contribute to. | Maldives MDG Goal 4 and 5 indicators Under-five mortality rate males 38 females 42 per 1 000 live births Infant mortality rate per 1 000 live births Proportion of 1 year-old children immunized for measles 97 MMR 160 per 100 000 live births Births by a skilled attendant O. Data source Basic Indicators Health Situation in South-East Asia World Health Organization South-East Asia Region 2004. Maldives is a small island nation with a population in 2000 of approximately 270 101 scattered among 200 islands dispersed over a large geographical area. The country has made considerable advances over the last decades in terms of health status reflected in increasing life expectancy rates for both sexes and decreasing maternal and infant mortality rates. Life expectancy at birth increased from 63 for women and 64 for men in 1990 to 71 for women and 70 for men in 2003. Providing health services to such a dispersed population is one of the major challenges facing the government. In particular ensure timely referral for specialist and emergency care posses special difficulties for health planners. The barriers to accessing health care services in the rural islands such as lack of everyday and regular transport and lack of personnel and facilities have created significant rural and urban differences. In addition to access to health care malnutrition remains the other major concern for the health status of mothers newborns and children. The health policy of the Maldives states that the enjoyment of the highest attainable level of health is a basic right of every citizen. Therefore the government places great emphasis on the accessibility and affordability of health care services and the health of women and other vulnerable groups. An important part of the long term national efforts to improve maternal and child health is increasing awareness of the opportunities for practicing family planning. The effects of this effort can be seen in the dramatic decrease in the crude .

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