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| *Travel Tips>>>Maldives Travel Tips |
Any information about Doctors status and profession in Maldives(male)? |
Travel Info any racism or religiuos hatred, low salary to doctos anything??? Travel Tips TRENDS IN POLICY DEVELOPMENT In the Maldives health is considered a basic right of every citizen and the government emphasizes the goal of health for all based on the primary health care approach. The island nature of the country poses a major challenge to providing equitable access to health care. To overcome this geographical barrier, Maldives established a four-tiered health care delivery system. Now, with the expansion of health care services, it is being re-organized into a five-tier referral system, beginning 2001. The potential doubling of the population every 20 years was considered a matter of grave concern, and the government has been working to reduce the rate of population growth through more active promotion of population control and educational programmes. Special importance is also given to the preservation of the environment, the concept of regional development, the central role of human beings and their quality of life, the basic right to health and education, the involvement of the people at community level, and the role of women in development. Given that health is a basic human right, the health policy of the government aims to further increase life expectancy by reducing preventable deaths, disease, suffering and disability, and to improve the quality of life. The health sector鈥檚 vision is reflected in the National Vision 2020 statement that reads: 鈥淭he people will have greater awareness of and commitment to healthy lifestyles. Good quality medical care will be available to all citizens in the area in which they live, and they will have easy access to a health insurance scheme that will enable them to meet their medical expenses.鈥?Necessary measures will be taken to provide and maintain public health needs and services within the overall framework of a sustainable health system. SECTION 2: TRENDS IN SOCIOECONOMIC DEVELOPMENT 2.1 Economic trends The Maldivian economy is characterized by its narrow base. It is based on fisheries and tourism, which account for more than 30% of the GDP and are the major sources of foreign exchange and government revenue. Health expenditure as a proportion of the national budget increased from 8.7% in 1998 to 10.9% in 2000. 2.2 Demographic trends The population of Maldives was 270,101 in 2000. Between 1995 and 2000 the average annual population growth rate was 1.96%. Despite a declining population growth rate during the decade 1990-2000, it is still high and alarmingly significant given the size of the country and the available resources. The total fertility rate (TFR) continued at 5.4 during 1990-95, but has since reduced to 2.8 in 2000. The country is in the second stage of demographic transition. The crude death rate (CDR) declined from 6 per 1000 population in 1990 to 4 in 2000, and the crude birth rate (CBR) from 41 to 20 during the same period. The singulate mean age at marriage in 2000 was 24 and 18.9 years for males and females respectively. In 2000 the population below 15 years was 40.7% and above 65 years of age 3.7%, resulting in a high dependency ratio. In the same year, the average life expectancy at birth for males was estimated at 70.7 years and for females 72.2 years. 2.3 Social trends The emphasis on education during the past 10 years was considerable. Primary school enrolment is over 98% and secondary school enrolment 44%. The literacy rate in the 10-45 years age group was 98.94 (1999). The proportion of females in the labour force increased from 27% to 34% during 1995- 2000. Although there is no discrimination in the employment of women, in certain situations, such as for executive level jobs, men clearly have the advantage. Labour conditions continue to be Human resources for health An acute dearth of skilled personnel is a major constraint for sustainable health development in Maldives. In 2000 there were 226 doctors in the country giving a ratio of 8.4 per 10,000 population. However, more than three quarters of the doctors are expatriate. The number of registered nurses was 358 and other nurses 204 (2000). At the community level there were 825 locally trained health workers in 2000, including health assistants, nurse aides, auxiliary nurse midwives (ANMs), community health workers (CHWs), family health workers (FHWs) and traditional birth attendants (TBAs). There were 106 pharmacists (including pharmacy assistants) in 2000. Over 90% of health professionals are employed in the public sector (81% of all doctors and 91% of nurses). Government has given high priority to HRH development in allocating resources, both its own as well as external, for in- country and training abroad. The out put was highest in the training of medical doctors and diploma level nurses, and lowest in the training of CHWs, paramedical and management personnel. The vertical training program for these categories failed to produce sufficient personnel to sustain the health status achieved during last two decades. Priority categories for human resource development have been doctors, CHWs, nurses, paramedical and management personnel. There have been policy changes vis-脿-vis in-country training in order to meet the shortage of community health workers (CHW). In 2001 about 23 candidates were sent to Sri Lanka for training in community health. The CHW curriculum has been revised. The emphasis is now towards training of preventive, management and paramedical support staff. However, due to financial resource shortages the actual training conducted in these categories has been limited. Main sources of finance were WHO, UNFPA and Government budget. A large share of the WHO budget was spent for training of health personnel. 4.2 Financial resources for health Health expenditure increased in the 1990s while revenue generated by this sector continued to remain low. The system of free government health care, which conferred many benefits, was under serious strain, particularly following the addition to the government health infrastructure of an externally funded hospital in Male (Indira Gandhi Memorial Hospital - IGMH). Options that were promoted to meet this situation included private sector and NGO participation, increased cost sharing with island communities, and the introduction of user fees at the IGMH and regional hospitals. In the private sector, health care primarily covers outpatient and diagnostic services. In 1996 the first private hospital with 40 beds was opened in Male. The government depends heavily on external funding for capital investment and human resource development in the health sector. The government health expenditure as a proportion of the total government expenditure increased from 10% in 1995 to 10.2% in 2000. The per capita expenditure on health was $89 in 2000 |
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