HEALTH SYSTEMS IN BRUNEI

DARUSSALAM

Brunei’s public spending on health was 2.1 %of GDP in 2011, which is equivalent to US$993 per capita. In the most recent survey, conducted between 1997 and 2010, there were 136 doctors, and 702 nurses and midwives per 100,000 people. There is universal maternal health care in the country and in 2012, 99 per cent of one-year-olds were immunised with one dose of measles (2011).

The most recent survey available, conducted in 2010, reported that Brunei had ten pharmaceutical personnel per 100,000 people.

CHILD AND MATERNAL HEALTH

The rate of infant mortality in Brunei Darussalam was seven deaths out of 1,000 live births in 2012, with an under-five mortality rate of eight deaths out 1,000 live births. As shown in there has been a sustained decrease in Brunei’s under-five mortality rate since 1990.

. In 2010 the three most prominent known causes of death for children below the age of five years were congenital anomalies (29%), prematurity (25%) and injuries (11%). Other contributory causes were neonatal sepsis (4%) and pneumonia (5%). In 2010 Brunei had a maternal mortality rate of 24 deaths per 100,000 live births (estimate by UN agencies/World Bank

COMMUNICABLE DISEASES

Communicable diseases along with maternal, perinatal and nutritional conditions in Brunei accounted for an estimated ten per cent of all mortality in 2008. A government paper on HIV/AIDS reported that there were 49 people in the country living with HIV at the end of 2011.

The country is free from malaria. Estimated incidences of tuberculosis (TB) have seen a very slight overall increase in the period 1990-2012, peaking in 2000. Estimated mortality (when mortality data excludes cases co-morbid with HIV) from TB has remained the same over this period. In 2009 there were two reported cases of measles and in 2010 there were three reported cases of leprosy

NON-COMMUNICABLE DISEASES

on-communicable diseases (NCDs) in Brunei accounted for an estimated 82 %majority of all mortality in 2008. The most prevalent NCDs in Brunei are cardiovascular diseases, which accounted for 33 %of total deaths across all age groups in 2008. Cancers, diabetes and non-communicable variants of respiratory diseases contributed 16 %11 %and 8%to total mortality respectively (2008).

MENTAL HEALTH

The most commonly diagnosed mental illnesses in Brunei Darussalam are depression, personality disorder and anxiety.

• Notably, reports state that cases of eating disorders and suicide are rare. Psychiatric disorders related to alcohol use are uncommon, although not unheard of, due to prohibition. According to the government, around 11,000 people were registered with the country’s Mental Health Services in 2012. Neuropsychiatric disorders contributed an estimated 18.9 % of the global burden of disease in 2008.

CURRENT HEALTH ISSUES AND PROGRESS

Brunei Darussalam is currently working towards achievement of the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms Millennium Development Goal 4 (MDG 4), Brunei should reduce under-five deaths per 1,000 live births to four, and increase measles immunisation to 100 % by 2015. In 2012 under-five mortality stood at 8 deaths per 1,000 live births and measles immunisation at 99%

With continued good progress, the country is likely to achieve MDG 4 by 2015.

The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by three quarters between 1990 and 2015. When applying this target to Brunei, the maternal mortality rate should fall to seven cases per 100,000 live births. In 2010 Brunei had 24 maternal deaths per 100,000 live births (an estimate from UN agencies/World Bank),

indicating that changes must be made if this target is to be achieved. Part of the goal also stipulates that 100 % of births must be attended by a skilled health professional. In the period 2007-11 this figure stood at 100 %, so this target has already been achieved

Estimated TB incidences and mortality (when mortality data excludes cases co-morbid with HIV) have remained roughly the same since 1990. There is insufficient data from international agencies to confirm the country’s progress on this goal for HIV/AIDS. This suggests that significant improvements are needed to target TB prevention and enhance treatment if this goal is to be achieved.

MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Malaria has already been eradicated in the country.

Estimated TB incidences and mortality (when mortality data excludes cases co-morbid with HIV) have remained roughly the same since 1990. There is insufficient data from international agencies to confirm the country’s progress on this goal for HIV/AIDS. This suggests that significant improvements are needed to target TB prevention and enhance treatment if this goal is to be achieved.

The most recent MDG progress report for Brunei was released in 2010. Since this time, no further reports have been released by the government of Brunei or its donors which indicate what measures are being taken in the country to achieve these goals. In 2008 Brunei announced plans to implement a new strategic development plan, entitled Wawasan Brunei 2035 Beyond the Millennium Development Goals and High Human Development; however, there is no specific reference to health care development mentioned in the plan.