COUNTRY : REPUBLIC OF THE MALDIVES

PUBLIC HEALTH PROJECT 2014

Allocations and Expenditure of Government Budget on Health Sector, 2004 – 2013

Year Total GDP at constant basic prices (in million Rf)

Total GDP at current basic prices (in million Rf)

Public health expenditure (% of total GDP)

GDP growth rates

Health expenditure as % of national budget

2004 13,767.80 13,678.00 3.1 7.5 11.3

2005 12,489.00 12,704.00 4.1 8.6 8.7

2006 14,936.00 16,683.00 4.1 16.8 9.7

2007 16,512.00 19,737.00 4.0 27.2 9.4

2008 18,526.00 24,213.00 5.5 62.3 12.8

2009 17,853.00 25,403.40 5.6 14.2 12.6

2010 19,113.20 27,316.50 3.7 1.3 9.0

2011 20,351.00 31,583.70 1.3 1.0 3.1

2012 20,621.80 32,469.40 NA 1.0 NA

2013 21,387.60 35,341.00 NA 2.1 NA

Source: Department of National Planning, 2014

SYSTEM OF MEDICAL INSURANCE• Medical insurance in Maldives include both:- universal health scheme from the government for all nationals

- the private insurance. UNIVERSAL HEALTH SCHEME• Called Aasandha program• Universal social health insurance scheme (a public-private

partnership) 60%-40% with Allied insurance company of the Maldives.

• The program gives free universal access to the scheme of the entire population, with annual individual financial limits.

• The service begins in 1st January 2012. • Currently, has a sizable coverage• Available from all government institutes and some private sector. • More information: www.aasandha.mv

Sources of Health Funds

Amount MVR % Amount USD Per Capita USD

Ministry of Finance and Treasury

1 209 222 934 43.7 78 419 127 245

Other Public 8 200 557 0.3 531 813 2

Household Funds 1 365 372 621 49.4 88 545 566 277

NGOs and Community Health

4 910 654 0.2 318 460 1

Employers Funds 87 965 070 3.2 5 704 609 18

Donors 90 901 454 3.3 5 895 036 18

Total 2 766 573 290 100 179 414 610 561

Source: Health Ministry of Maldives.

Structure of Ministry of Health and Gender

1) KULHUDHUFUSHI RH

REGIONAL HOSPITALS

2) UNGOOFARU RH

3) MULI RH

4)GAN RH

5)THINADHOORH

6)HITHADHOORH

ATOLLHOSPITALS

2

3

3

2

1

1

1

POP2006 CENCUS

41672

20483

25662

119454

43539

13442

19275

GOVERNMENT PRIVATE

INPATIENT OUTPATIENT INPATIENT OUTPATIENT

CAPITAL 2 2 1 38ISLAND 226 226 0 8

GOVERNMENT ONE Tertiary Hospital (IGMH) in Male’ the capital. ONE Hospital for employees and family of army forces. SIX Regional Hospitals which is one regional hospital for every 3 Atolls. 13 Atoll hospitals 116 Health Centers 20 health postsPRIVATE SECTOR 1 tertiary private hospital (ADK), and 45 private clinics.

Number and types of medical institutions of outpatient and inpatient care.

Atoll hospitalsRegional hospitals

Health postsHealth service centre

RURAL ATOLLS

CAPITAL CITY

MALDIVES NATIONAL UNIVERSITY• The faculty of health sciences of Maldives national

university provides education courses in the following fields.

• Bachelor of nursing• Bachelor of health sciences and management• Bachelor of health sciences in primary health care• Advanced diploma in critical care• Advanced diploma in midwifery• Advanced diploma in public health• Diploma in medical laboratory technology• Diploma in primary health care• Diploma in pharmacy• Diploma in nursing

• Medical Staff and distribution according to population

• According to 2011 statistics,60% of nurses and 80% of doctors in maldives are expatriates.

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Indices of provisions of the population with Hospital bed per 10000 person.

• IGMH: 9 Beds.• ADK: 2 Beds.

Frequency of Hospitalization per 1000 person• In year 2013 - IGMH: 38 person

- ADK: 10 person

The Average duration of the patient stay in the hospital

IGMH: 5 days ADK: 5days

Hospital lethality and other indicators of hospital

activity• IGMH: 212 person/ year. • ADK: 140 person/ year.

• Besides the 2 tertiary hospitals, a number of private clinics are present in the city. They must be registered at the MoH in order to give service to the public. These clinics all provide out patient based medical care, giving out approximately 30-60 appointments per specialists. Most of these clinics are not covered under the government health scheme, thus the service is in paid form by the patient themselves.

Organization of medical care to women• Family care workers and midwives are the caregivers in the islands• At atoll hospitals and regional hospitals, medical officers and gynecologists are

accessible• Regional hospitals have availability for delivery, gynecological consultations and

operations• Modern facilities including a contemporary emergency care for pregnant women,

specialists doctors are available in the city.

System of family planning• A policy to implement programs in

family planning in Maldives was adopted in 1986.

• Most of the family planning outlets are in the public sector.

• Private pharmacies are registered to provide contraceptives prescribed by private physicians.

• Besides good prenatal maternal care, protection of the fetus refers to permission of abortion. Generally, Maldives is a country with the main population consisting of Muslims, so abortion is not permitted.

• However, grounds on which abortion is permitted:

Conditions PermissabilityTo save the life of the woman Yes

To preserve physical health Yes

To preserve mental health No

Rape or incest No

Fetal impairment No

Economic or social reasons No

Available on request No

System of prenatal protection of fetus

• The percentage of births delivered by a gynaecologist decreases with age of the mother at birth and increases with the mother’s level of education and wealth status.

• The percentage of births delivered by a gynaecologist decreases with increasing birth order and is higher in urban areas than in rural areas