The Healthcare Scenario of Maldives

Healthcare Scenario of Maldives

Are you planning to build or restructure or venture in any healthcare venture in Maldives? Looking for information about the major healthcare players in Government, Private diagnostic centers that are available in Maldives? Are you looking to find out which part of the of the city’s is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario in Maldives.

The Maldives are an archipelago of 1,192 coral islands grouped into 26 coral atolls (200 inhabited islands plus 80 islands with tourist resorts) in the Indian Ocean. They lie south-southwest of India and are considered part of Southern Asia. Maldives is smallest Asian country by land, area and population. Malé is the capital and most populated city, traditionally called the “King’s Island” for its central location.

Demography Statistics

Economy

The Maldivian economy is heavily dependent on fisheries and tourism, which are the major sources of foreign exchange earnings and government revenue and which together directly account for about 40 percent of gross domestic product, while indirectly accounting for a much larger proportion of GDP (45%). Maldives is ranked 136 among 190 economies in the ease of doing business, according to the latest World Bank annual ratings.

Connectivity

Airway: Maldives is widely interconnected as well as connected to the world. There are nine regional airports & Velana International Airport is the principal gateway to the Maldives with frequent services to Beijing, Shanghai, and Hong Kong. Government owned Island Aviation Services provides direct service to Chennai and Thiruvananthapuram, India, and Dhaka, Bangladesh.

In Maldives there are three main ways to travel between islands: by domestic flight, by seaplane or by boat. Speedboats and seaplanes tend to be more expensive, while travel by boat (dhoni), although slower, is relatively cheaper and convenient.

Top 5 Corporates in Maldives

  • AAA Hotels & Resorts
  • Adaaran Resorts
  • ADDU International Airport
  • AH Brothers
  • AL Shaali Marine, Maldives

Growth Plan of Maldives

Maldives is the lowest lying country in the world which sits about 5 ft above sea level. It is in danger of becoming uninhabitable due to elevated water levels & other effects of climate change. Maldives’s new strategy is renting out islands and using the money to reclaim, fortify and even build new islands. People living on smaller lower-lying islands could then be relocated to more flood-resistant islands when needed.

One of those is the City of Hope being built on an artificial island called Hulhumale, near the capital Male. To build it, a state-owned company is pumping sand from surrounding atolls and depositing it on shallow reefs that surround the original lagoon. It is being fortified with walls 3 metres above sea level which is higher than the highest natural island at only 2.5 metres above the sea. Eight such islands have already been built, and three more are planned.

The Maldives government is also planning for 50 more tourist resorts to be opened by 2018. They are also planning for a floating Golf course, a project of 320 million Euro covering more than 80 million square feet of water.

Some Important Health Statistics

The Healthcare Scenario

Morbidity Trends

Maldives is in a status of epidemiological transition, moving from a high burden of communicable diseases towards an increasing burden of non-communicable diseases.

The Prevalent Diseases

The Healthcare System 

Maldives have been certified by World Health Organization as a “Malaria Free Country” in 2015. This is an addition to other vaccine preventable diseases that have been controlled to such an extent that diseases like polio, neonatal tetanus, whooping cough and diphtheria are non-existent in the country. Leprosy and Filaria have reached to zero transmission levels and elimination targets. Tuberculosis and HIV prevalence have been maintained at very low levels.

The public integrated system is supplemented by a mosaic of private clinics ranging from single doctor consultations to poly clinics with laboratory services and some with inpatient capacity. The system is further complemented by different NGO’s participating in public health functions & a competitive pharmaceutical market.

It is a daunting challenge for Maldives to sustain accessibility of health services equitably throughout the country. The delivery of services is hampered by the geographical nature of the country with numerous islands scattered throughout and often the means of transport is by sea which can be affected by unfavorable weather. In terms of cost effectiveness and sustainability, it is not favorable to have hospitals or health centers in each island as the population in some islands reach up to a few hundred only. Moreover, due to the limited and unreliable public transport system, people in many islands are unable to travel or have to pay high amounts to the private transport services to reach appropriate health care. Considering these factors, health care services provision in Maldives is a costly undertaking.

Population Trend

Fig 1. Population Trends (Since the early 1990s the population growth rate has shown steady decline)

The Public Healthcare Scheme

According to the healthcare bill called the Aasandha (well-being) Program, which came into effect in January 2012, all Maldivian citizens are entitled to receive government-financed medical coverage of up to 100,000 MVR (US$6,500) a year. Foreign national workers are also beneficiaries of this program. They qualify for medical coverage, provided that their employers pay an upfront fee of 1,000 MVR (US$65).

Sex & Age Structure

The proportion of male and female population differed much in the early years which diminished with time. The proportion of the female population increased from 45.7% in 1911 to 49.2% in 2014. The disparity in the male female composition over time can be clearly seen from the presentations of the sex ratios.

Sex Ratio (Males per 100 Females)

The sex ratio recorded in 1911 was 119 males per 100 females. It ranged between 119 and 114 till the late 1960s. The sex ratio started to dramatically fall from then on. In 1985 it was at 108 and fell to 105 in the next 10-year period. Currently the sex ratio of the total population stands at 103 (Census, 2014). The lowering of the sex ratio shows improvements in women’s health over the years.

Children’s Nutritional Status

Despite improvements in many areas of health, malnutrition among children continues to be an area of public health concern.

Fig. 2 Children’s Nutritional Status

Past studies have shown that percentage of children under 5 years who are underweight has gradually declined from 43% in 1996 to 17.3% in 2009. Similarly, stunting declined from 30% in 1996 to 18.9 % in 2009; wasting declined from 17% in 1996 to 10.6 % in 2009 (MDHS, 2009).

Nutritional Status of Women

Women with a body mass index (BMI) below 18.5 are considered too thin, reflecting chronic energy deficiency. Women with a BMI over 25 are overweight, while a BMI over 30 is considered obese. In 2009, it was found that 46% of women in the Maldives are overweight or obese (MDHS, 2009). The proportions of women who have a BMI below 18.5 have declined from 23% in 2001 to 8% in 2009.

Immunization

Maldives has long maintained universal high coverage of EPI. Since early 1990s, the coverage rate has been maintained over 90 percent for all vaccines. The MDHS 2009 found that 93% of children aged between 12 and 23 months have received all the recommended immunizations. In 2001 this coverage was at 85% (MICS, 2001).

The Public Sector in Health

Fig 3 Centralized Hierarchical System of Public Health Sector

The public sector operates a centralized hierarchical system. The system is organized into five tiers comprising of the central, regional, atoll, sub-atoll and island level services, arranged to follow a referral pathway from the island level through to the central level. However, patients are neither required nor do they follow this pathway and can enter the system at any point.

Lack of skilled personnel is acute. Maldives has an estimated total of 160 doctors and 445 nurses and midwives per 10,000 people.

The Private Sector in Health

The private sector has grown rapidly in the past decade. At present there are some tertiary hospitals and 50 different clinics throughout the country. The private clinics provide services ranging from inpatient care to sports medicine and even traditional medicine as well as alternative forms of medicine. These clinics are either one doctor practices or group practices and many of them have their own laboratories capable of performing simple investigations. Many of these clinics are owned and run by public sector doctors on a part time basis. Only 13 of the 50 clinics operate in rural areas.

Medical Colleges in Maldives

The Maldives National University will offer medical degree courses for the first time in 2018 with assistance from the Pakistani government. The intake capacity will be 50. 200 Maldivian students are pursuing MBBS degrees in seven countries across the world.

Major Hospitals in Maldives

1.Indira Gandhi Memorial Hospital (IGMH) – 350 Beds

It is a state-owned Multi-Specialty hospital, and one of two hospitals in Malé, Republic of Maldives. The hospital has 350 beds and provides a range of basic and specialty services as of May 2009.

2.ADK Hospital – 50 Beds

It is the first private hospital situated in Malé, Republic of Maldives. The hospital is second major hospital located in Malé. ADK Hospital is owned by ADK Enterprises which also owns one of the biggest pharmacy lines in Malé.

3.Tree Top Hospital – 210 Beds

Established in March 2018. The hospital, managed in collaboration with Australia’s Ramsey Group and Malaysia’s Sine Darby, boasts 210 beds with staff from 30 different countries.

4.Ungoofaru Regional Hospital – 32 Beds

It is a multi-specialty tertiary care hospital equipped with ICU & NICU. It is the largest hospital in the Northern Province which has population of 1,575 citizens.

5.Gan Regional hospital – 32 Beds

It is a multi-specialty hospital provides preventive and curative health care facilities to all the islands of south central province and serves as the highest referral center for this region.

Diagnostic Facilities

1.International Medical & Diagnostic Centre – 30 beds

It is a multi-specialty hospital established in 2008. They provide services in Southern Province of the Republic of Maldives who, despite being the second largest and most populous community, remains at a disadvantage given its geographical distance and public health system limitations.

2.Azmi-Naeem Medical & Diagnostic Centre (AMDC)

It is a multi-specialty clinic as well as a Diagnostic Centre & a Pharmacy providing services in Male.

3.Kuramathi Medical Center

It opened in 6th March 2000, a joint venture between owning company Universal Enterprises Pvt Ltd, Maldives and the Martin Luther University Halle, Wittenberg, Germany. In addition, they have the Kuramathi Medical Centre equipped with modern diagnostic facilities and Hyperbaric chamber (largest in the Maldives) on the island.

Conclusion

Maldives is a growing economy & a major tourist spot. They are also progressing in healthcare services but still there is lot of scope for improvement as major healthcare services are available in the capital island of Male only. The number of healthcare professionals in the country is also less. To serve an archipelago of 1,192 islands, it will need a vast network & infrastructure to come in play. This situation is giving new opportunities to private hospitals & corporates to start services in Maldives & provide quality care.

if you need any support in planning and designing of a new hospital you can contact us: Hospaccx healthcare business consulting Pvt. Ltd on: hospaccx.india@gmail.com. Or you can visit our website  www.hhbc.in.

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