MaldivesUrban population

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2019 Health SDG Proﬁ le: Maldives

Out-of-pocket expenditure⁴ In most cases, high percentage of out-of-pocket

expenditure out of the total health expenditure is associated with low financial protection.

Maldives

Urban population²

40.2%

Life expectancy at birth

Life expectancy⁵ measures how long people will live and is an indication of overall mortality of a country's population. Lost healthy life expectancy (HALE) represents equivalent year(s) of full health lost through years lived with morbidity and disability. Although females live longer, lost HALE is longer as well, on average 2.7 years or 36.0% more than males.

Population (000s)¹

531

Poverty³

1.5%

GDP per capita³ (Current US$)

10233.6

Current health expenditure as share of GDP⁴ 10.6%

0 20 40 60 80 100

Age (years) Male

Female

HALE Lost HALE

Monitoring the health SDG goal: Indicators of overall progress

(ppp < $1.90 a day)

5.7%

The goal of universal health coverage (UHC) is that all people and communities receive the health care they need, without suffering financial hardship. Monitoring UHC requires measuring health service coverage and financial protection (SDG target 3.8).

Universal health coverage: At the centre of the health goal

HEALTH SERVICES COVERAGE

The summary measure of essential health services coverage, service coverage index of 16 indicators in four main areas: (1) reproductive, maternal, newborn and child health; (2) infectious diseases; (3) noncommunicable diseases; (4) service capacity, access and health security.

FINANCIAL PROTECTION

Financial protection is measured through two indicators:

(1) impoverishment, and (2) catastrophic health expenditure.

Impoverishment: 0% people* are being pushed into poverty (at $1.90 level) because of out-of-pocket health spending¹⁵.

Catastrophic expenditure on health: 10.3% of people spent more than 10% of their household's total expenditure on health care¹⁵.

*Impoverishment data are not reported at PPP $1.90 level Family planning

coverage⁶ Pregnancy and

delivery care⁶ Child immunization

coverage⁷ (DTP3) Care seeking behaviour suspected pneumonia⁶ 0

50 100

Coverage (%)

99

30

88 75

Reproductive, maternal, newborn and child health Latest available data (2010-2017)

Tuberculosis (effective) treatment

Coverage⁸

HIV antiretroviral

therapy coverage⁹ Insecticide-treated bednets/IRS coverage for malaria prevention

Access to basic sanitation¹⁰ (%) 0

50 100

Coverage (%)

66

19

96 Infectious diseases

Prevalence of normal fasting glucose level¹¹

Prevalence of normal blood pressure¹¹

Cervical cancer

screening Tobacco non-use¹² 0

50 100

Coverage (%)

98 76 80

Noncommunicable diseases

Density of hospital beds¹¹, expressed as % of global threshold, 18/10

000

Heath worker density¹³, expressed as % of

global threshold, 44.5/10 000

Access to essential

medicines Health security: IHR compliance¹⁴ 0

50 100

Coverage (%)

100 100

44 Service capacity, access and health security

UHC services coverage index of essential health services To provide a summary measure of

coverage, an index of national service coverage is computed by averaging service coverage values across the 16 tracer indicators. The UHC coverage index ranges from 0% to 100%, with 100% implying full coverage across a

range of services. 2010 2019

0 50 100

Coverage (%)

61 68

UHC services coverage index

Out-of-pocket expenditure, as % of the health expenditure (2016)

Public spending on health⁴ is determined by the capacity of the government to raise revenues and the level of priority it attaches to the health sector.

This profile provides an overview of the current status of progress towards the 13 targets under the

Sustainable Development Goal #3 (SDG3): Ensure healthy lives and promote well-being for all at all ages.

All SDG3 indicators plus other selected health-related indicators are presented using global health estimates or country comparable reported values if available.

When nationally reported indicators from other sources are available, these are included in the references.

19.1%

77.2 79.9

5.7%

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2019 Health SDG Proﬁ le: Maldives

Variation by education

Equity status and trends: Variation by income, geographical location and education*

*There are many dimensions of equity, including but not limited to examples based on income, geographical location, and education presented here but also age, sex, race, and others. SDG 17.18 emphasizes the need for disaggregated data to facilitate better measurement of inequalities.

SDG 3: Health targets

Maternal and child mortality (SDG target 3.1, 3.2)

Births attended by skilled health personnel⁶⋅¹⁶

2009 2016

0 50 100

Percentage (%) ^99.5^94.8

Maternal mortality ratio¹⁹

2000 2005 2010 2015

0 150 300 450

MMR (per 100 000 live births)

163.00

68.00

1990 2000 2005 2010 2015 2016 2017 0

25 50 75 100

CMR (per 1000 live births)

8.0 5.0 94.0

43.0

Child mortality²⁰

Neonatal mortality rate Under-five mortality rate

Health service delivery

NCD risk factors

2000 2005 2010 2015

0 50 100

Success rate

97

83 TB treatment success rate for new cases¹⁸

2000 2005 2010 2015

0 50 100

Percentage (%) ^99.0^98.0

Coverage of DTP3 immunization⁷

Cervical cancer screening

Female Male

2000 2005 2010 2015

0 10 20

Percentage (%)

1.2 4.0

3.1

7.3 Prevalence of obesity among adults¹⁸

(18+ years of age)

2009 2016

0 50 100

Percentage (%) _79.6 ^84.0^87.5 80.4

Antenatal care coverage⁶⋅¹⁶ (4+ visits)

Rural Urban

2009 2016

0 50 100

Percentage (%) ^99.1^100.0^99.3_88.6

Proportion of births attended by skilled birth attendant⁶⋅¹⁶

Quintile 1 (poorest) Quintile 5 (richest)

Variation by geographical location

2009 2016

0 50 100

Percentage (%)

62.6 73.0

Children < 5 yrs with diarrhoea receiving ORT and continued feeding⁶⋅¹⁶

Variation by income

2000 2005 2010 2015

0 25 50

Percentage (%)

22.3 23.1

14.9 17.0

Prevalence of raised blood pressure among adults¹⁸ (18+ years of age)

Female Male

2011 0

25 50 75 100

Percentage (%)

36.0

4.4 Prevalence of tobbaco use¹²

Female Male

Current data are insufficient for analysis

2009 2016

0 50 100

Percentage (%)

15.520.2

15.6

23.0 21.7

19.9 Prevalence of stunting among children under-five

by mother's education level⁶⋅¹⁶

None Primary Secondary +

2010 2011 2012 2013 2014 2015 0

2 4

Per person per year

2.0 2.2

OPD utilization¹⁷ (per person per year)

Bed occupancy rate (BOR)

Current data are insufficient for analysis

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2019 Health SDG Proﬁ le: Maldives TB incidence rate²¹

20132014 201520162017 0

150 300 450

TB incidence (per 100,000 pop.)

41 44 53 49 39

Communicable diseases (SDG target 3.3)

Indicators SDG

target Year Maldives Regional estimate Probability of dying from any of CVD,cancer,

diabetes,CRD between age 30 and age 70²² 3.4.1 2016 13.4 23.1 Noncommunicable diseases and injuries

Malaria incidence is calculated for confirmed cases. Only small number of imported cases have been reported.

Indicators Year Maldives Regional estimate Hepatitis B surface

antigen prevalance among children under 5 years²² (%)

2015 0.19

Number of people requiring

interventions against neglected tropical²²

2017 1,004

0.26

73,300,000

2009 2016

0 50 100 150 200

Adolescent birth rate

10.0 10.0

Adolescent birth rate (per 1000 women aged 15 to 19 years)⁶⋅¹⁶

Proportion of married or in-union women of reproductive age who have their need for family

planning satisfied with modern methods⁶ (%) 3.7.1 2016 29.8 71.4 Sexual and reproductive health

Female Male

2000 2005 2010 2015

0 250 500 750 1000

Total NCD mortality rate (per 100 000 pop.)

462.7

732.2

356.0

684.0 Total NCD mortality¹⁸

2008 2010 2012 2014 2016 0

5 10

Deaths per 100 000 population

3.5

1.2 Reported road traffic deaths²³

(per 100 000 population)

Adolescent birth rate⁶ (per 1000 women aged

15 to19 years) 3.7.2 2016 10 33.0

Age-standardized mortality rate attributed to household and ambient air pollution²²

(per 100 000 population) 3.9.1 2016 25.6 165.8

Mortality due to environmental pollution

Note: A dash (-) implies relevant data are not available

Total net official development assistance to medical research and basic health per capita²²

(US $) 3.b.2 2017 1.42

Proportion of health facilities that have a core set of relevant essential medicines available

and affordable on a sustainable basis 3.b.3 2017 -

0.6

-

Health worker density¹³ (per 10 000 population) 3.c.1 2016 50 - Health workforce

Suicide mortality rate²² (per 100 000

population) 3.4.2 2016 2.3

Total alcohol per capita (age 15+ years)

consumption²² 3.5.2 2016 2.7

Road traffic mortality rate²² (per 100 000

population) 3.6.1 2016 0.9

13.2 4.5 20.7

International Health Regulations Core Capacity

Index¹⁴ 3.d.1 2018 44 56

National and global health risks

Mortality rate attributed to exposure to unsafe

WASH services²² (per 100 000 population) 3.9.2 2016 0.3 Mortality rate from unintentional poisoning²²

(per 100 000 population) 3.9.3 2016 0

15.4 1.8

Prevalence of tobacco use among persons

aged 15 years and older¹³ (%) - Female 3.a.1 2011 4.4 Prevalence of tobacco use among persons

aged 15 years and older¹³ (%) - Male 3.a.1 2011 36

- - Tobacco use

DTP3 immunization coverage among 1-year-

olds⁷ 3.b.1 2017 99

MCV2 immunization coverage by the nationally

recommended age²² 3.b.1 2017 99

PCV3 immunization coverage among 1-year

olds²² 3.b.1 2017 -

88 77 12 Essential medicines and vaccines

New HIV infections

Current data are insufficient to determine trend

Malaria Incidence

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2019 Health SDG Proﬁ le: Maldives

References

1.World population prospects: the 2019 revision. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2019 (https://population.un.org/wpp/, accessed 29 June 2019).

2. World urbanization prospects: 2018 revision. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2018 (https://population.un.org/wpp/, accessed 29 June 2019).

3.World Bank. (https://data.worldbank.org/, accessed 28 May 2019)

4.Global health expenditure database. Geneva: World Health Organization; June 2019

5.Global health estimates 2016: Life expectancy, 2000–2016. Geneva: World Health Organization; 2018 (https://www.who.int/gho/mortality_burden_disease/life_tables/en/, accessed 29 June 2019).

6. Maldives Demographic and Health Survey (DHS 2016-2017). Male, Maldives and Rockville, Maryland, USA: MOH and ICF.

7. WHO/UNICEF estimates of national immunization coverage. (http://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=BGD, accessed 29 June 2019) 8. Global tuberculosis report 2018. Geneva: World Health Organization; 2018 (https://www.who.int/tb/publications/global_report/en/, accessed 15 March 2019).

9. UNAIDS/AIDSINFO [Online database]. (http://aidsinfo.unaids.org/, accessed 29 June 2019) 10. WHO/UNICEF Joint Monitoring Programme estimate 2015.

11. Tracking universal health coverage: 2017 global monitoring report

12. Maldives (2011) Tobacco Factsheet 2018. New Delhi: World Health Organization/SEARO; 2018

(https://apps.who.int/iris/bitstream/handle/10665/272674/wntd_2018_maldives_fs.pdf?sequence=1&isAllowed=y, accessed 29 June 2019) 13. HRH profiles 2018

14. International Health Regulations (2005) Monitoring Framework, GHO data. Geneva: World Health Organization (https://www.who.int/gho/ihr/en/, accessed 21 March 2019).

15, SEARO staff estimates from (Maldives) Household Income and Expenditure Survey 2016

16. Maldives Demographic and Health Survey (DHS) 2009. Male, Maldives and Rockville, Maryland, USA: MOH and ICF.

17. Calculated. Maldives Health Statistics

18. WHO Global Health Observatory (GHO) (https://www.who.int/gho/en/ - accessed 29 June 2019)

19. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva; 2015

(https://apps.who.int/iris/bitstream/handle/10665/194254/9789241565141_eng.pdf;jsessionid=56B6C12830EA6EA8CD0F30A8433E8FC3?sequence=1, accessed 28 May 2019). See for maternal mortality. Country reported value 2014=41, 2015=72, 2016=44. Data Source: Maldives vital registry system (VRS)

20. Levels & trends in child mortality: report 2017: estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York (NY), Geneva and Washington (DC): UNICEF, World Health Organization, World Bank, United Nation; 2017 (http://www.childinfo.org/, accessed 28 May 2019). See for under-five mortality. Country reported value. 2013=9, 2014=10, 2015=11, 2016=9. Data Source: Maldives vital registry system (VRS)

21. WHO Global Tuberculosis database [online]. ( https://www.who.int/tb/country/data/download/en/, accessed 29 June 2019).

22. . World Health Statistics 2019.

(https://apps.who.int/iris/bitstream/handle/10665/324835/9789241565707-eng.pdf?ua=1, accessed 28 May 2019) 23. Country reported.

Other health-related SDGs

Annual mean concentrations of fine particulate

matter (PM2.5) in urban areas²² (µg/m3) 11.6 2016 7.6 57.3 Ambient air pollution

Mortality rate due to homicide²² (per 100 000

population) 16.1.1 2016 3.4 4.1

Homicide and conflicts

Birth registration coverage⁶ 16.9.1 2016 98.8 -

Birth registration

Note: A dash (-) implies relevant data are not availableCompleteness of cause-of-death data²² (%) 17.19.2 2017 91 10 Cause-of-death data

Indicators SDG

target Year Maldives Regional estimate Domestic general government health expenditure

as percentage of general government

expenditure⁴ (%) 1.a 2016 20.2 6.7

General government health expenditure

2000 2005 2010 2015 2016 2017 0

50 100

Percentage (%)

>95

32 65

84

93 94

Population with primary reliance on clean fuels¹⁸ (%)

2009 2016

0 50 100

Percentage (%)

92.5 98.8

Birth registration coverage⁶⋅¹⁶ (%)

Proportion of ever-partnered women and girls aged 15 yrs and older subjected to physical, sexual or psychological violence by a current or former intimate partner in previous 12 months

5.2 2017 - -

Intimate Partner Violence

Amount of water- and sanitation-related official development assistance that is part of a government-coordinated spending plan²²

(constant 2016 US$ millions) 6.a 2017 3.19 1484.41

Proportion of population using safely managed

drinking-water services 6.1 2015 -

Proportion of population using safely managed

sanitation services 6.2 2015 -

- - Drinking water services and sanitation

Children under 5 years who are stunted⁶ 2.2.1 2016 15.3 Children under 5 years who are wasted⁶ 2.2.2 2016 9 Children under 5 years who are overweight⁶ 2.2.3 2016 5.7

33.015.2 3.4 Child nutrition

Proportion of population with primary reliance on

clean fuel²² (%) 7.1 2017 >95 45

Clean household energy

Prevalence of stunting among children under-five⁶⋅¹⁶

2009 2016

0 50 100

Percentage (%)

18.9 15.3