Maldives, with a population of about 305,027, is the smallest country in Asia, both population and area wise. Its first health plan was developed in 1981. Since the early 1980′s, health care is delivered in the Maldives through a primary health care approach. The health policy in Maldives is laid out in such a way to increase life expectancy and quality of life. To achieve these, the government is developing the country’s health structure to attain the reduction of disability, suffering, death, and disease.
The government is accommodating the basic right to health and education, involvement of people at community level, concept of regional development etc. in the health structure to get to the aims set out in the health policy. The health of Maldivians is inevitably connected to their environment and therefore the government has given tremendous importance to the preservation of environment. As the Maldives is an island nation where the islands are separated by the sea, geography remains a barrier to health care access.
|Geographical isolation: a barrier to health care access|
In Maldives, the health care delivery system, which was previously a four-tiered delivery system, is reorganized into a five-tiered referral system, which was established in 2001. The structure of this referral system includes a central level and subsequently regional, atoll, sub-atoll and Island levels. IGMH or Indira Gandhi Memorial Hospital serves at the central level. The regional level includes regional hospitals. In a similar manner, the atoll level includes atoll hospitals, the sub-atoll level atoll health centers and the island level health posts and family health sections, respectively.
|In-patient department of IGMH|
IGMH provides both general and specialty health care services to the whole country and is assigned as the tertiary level referral hospital. IGMH is a 275 bed hospital, which is the leading health care delivery center that provides advanced diagnostic testing, major surgeries and other health facilities, to the public. Its establishment was funded by the government of India. ADK is a private hospital situated in Male’, the capital city, which also provides tertiary level health services to the public.
Since the early 1980′s Maldives has made significant achievements in the field of health care. Due to the establishment of hospitals and health centers in the island and atoll level, availability of family health care workers and midwives etc. in almost all the inhabited islands, Maldivians now have better access to health care facilities. Conduction of effective health programs, health education and promotion and increased access to better health care facilities have helped in the control of several communicable and non-communicable diseases in the Maldives.
|Island health centre|
In Maldives, health promotion and education is made a part of all public health programs. Health education and promotion has especially been emphasized on specific areas such as safe maternity, childhood immunization, family planning and reproductive health, nutrition and healthy life styles, prevention of substance abuse, non-communicable diseases, thalassemia, children and women’s safety etc. Health promotion and education is part of the curricula in the courses conducted by the Faculty of Health Sciences of Maldives National University.
|Weighing a child at a health care facility|
Effective immunization programs are being conducted in the Maldives. Maldives has achieved high levels of immunization coverage throughout all parts of the country. As a result of these successful vaccination programs, most childhood infectious diseases have been eradicated. The Maldivian government gives high priority to providing immunization for children and against vaccine-preventable diseases such as Diphtheria, measles, poliomyelitis, BCG and hepatitis B. Pregnant women are also immunized against tetanus.
|Immunization against poliomyelitis|