Health Information Booklet 2013 1 2 Health Information Booklet 2013 Contents Preface 4 Brunei Darussalam’s Vision and Strategies 5 Ministry of Health’s Vision and Health Strategies 6 Organisational Structure 7 Geography 8 Demography 9 Economy 9 Health Status 10 Healthcare Delivery System 10 Population 11 Population Pyramid 12 Vital Statistics 14 Health Indicators 16 Millennium Development Goals (MDGs) 17 Millennium Development Goals (MDGs) Indicators 19 Health Facilities 22 Distribution Map of Health Care Facilities 23 Human Resource 24 Government Health Expenditure 27 Hospital Services 28 Leading Causes of Death 32 Health Services 35 Maternal and Child Health Services 36 General Outpatient Attendances 39 Notifiable Infectious Diseases 41 Cancer 44 Cardiovascular Diseases 46 Age Standardised Mortality Rate (Noncommunicable Diseases) 48 Renal Services 52 Dental Health Services 53 Nutritional Status 54 Occupational Health Services 56 Tobacco Control 58 Pharmacy 59 Road Traffic Accidents 61 Definitions 62 Formulae 63 Contacts 64 Acknowledgements 65 Health Information Booklet 2013 3 Preface Bismillah Hirrahman Nirrahim. The Ministry of Health through the Department of Policy and Planning is pleased to share the Health Information Booklet 2013 publication which marks the eighteenth edition. The department continues to enhance efforts in ensuring the provision of accurate, timely and reliable health statistical information that serves as useful reference to policy makers, planners, healthcare providers, researchers and to the public at large. This is also in meeting the needs for monitoring of our health indicators which aligns with the Millennium Development Goals and in providing health data that are regularly reported to international organisations particularly the World Health Organisation (WHO). This 2013 publication has incorporated additional information such as relating to Pharmacy Services, Maternal and Child Health Services, Hospital Specialist Services Attendances, and Age Standardised Mortality Rate of Noncommunicable Diseases. The implementation of the Brunei Darussalam Healthcare Information Management System (Bru-HIMS) also contributes to enhancing the efficiency of data collection process and that health information can be easily and timely accessed, hence also improving the quality of health information publication in the future. Our sincere gratitude and appreciation to all the departments that continue to assist and give us their full cooperation in providing the relevant information in the Health Information Booklet. Together Towards A Healthy Nation HAJAH ZAHRAH DP HAJI MD HASHIM Director of Policy and Planning Ministry of Health Brunei Darussalam 4 Health Information Booklet 2013 Brunei Darussalam’s Vision and Strategies “ WAWASAN BRUNEI 2035 ” Recognised for the accomplishment of its A dynamic and sustainable educated and highly skilled Quality of life that is among economy with income per people as measured by the top 10 nations in the capita within the top 10 the highest international world. countries in the world. standards. Strategies Education Economic Security Institutional Local Business Infrastructure Social Security Environment Strategy Strategy Strategy Development Development Development Strategy Strategy Strategy Strategy Strategy To ensure that, To prepare To create new To safegurad To enhance To enhance To ensure as the nation To ensure the youth for employment political good opportunities continued prospers, all the proper employment for the people stability and governance in for local investments citizens are conservation and and expand sovereignty both the public Small and by the properly cared of our natural achievement business as a nation and private Medium-sized Government for. environment in a world that opportunities and link our sectors, high Enterprises and through and cultural is increasingly within Brunei defence and quality public (SMEs) as public-private habitat that will competitive Darussalam diplomatic services, well as enable sector provide health and through the capabilities and modern and Brunei Malays partnerships in and safety knowledge- promotion of our capacity pragmatic legal to achieve developing and in line with based. investment to respond and regulatory leadership in maintaining the highest (foreign and to threats frameworks business and world-class international domestic) both from disease and efficient industry by infrastructure practices. in downstream and natural government developing with special industries catastrophe. procedures greater emphasis as well as that entail a competitive placed on in economic minimum of strength. education, clusters bureaucratic health and beyond the ‘red tapes’. industry. oil and gas industry. Health Information Booklet 2013 5 Ministry of Health’s Vision and Strategies VISION 2035 “TOGETHER TOWARDS A HEALTHY NATION” Comprehensive A Nation that Sustainability Effective Transparent Healthcare Embraces and through Policies and and Proactive System Practices Resource Regulations Governance 1that 2Healthy Optimization,3 that4 Ensure 5 Emphasizes Lifestyle Innovation and Protection Service Excellence for All Excellence 6 Health Information Booklet 2013 Organisational Structure MINISTER OF HEALTH The Honourable Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Awang Haji Adanan bin Begawan Pehin Siraja Khatib Dato Seri Setia Awang Haji Mohd Yusof PERMANENT SECRETARY Datin Paduka Dr Hajah Norlila bte Dato Paduka Haji Abdul Jalil DEPUTY PERMANENT SECRETARY DEPUTY PERMANENT SECRETARY (PROFESSIONAL AND TECHNICAL) (ADMINISTRATION AND FINANCE) Dr Hajah Rahmah bte Haji Md Said Hajah Siti Mariam bte Haji Md Jaafar GENERAL DIRECTOR DIRECTOR-GENERAL DIRECTOR-GENERAL OF MEDICAL SERVICES OF HEALTH SERVICES POLICY AND PLANNING COMMUNITY HEALTH HOSPITAL SERVICES SERVICES ADMINISTRATION AND FINANCE NURSING SERVICES SCIENTIFIC SERVICES HEALTH CARE PHARMACEUTICAL TECHNOLOGY SERVICES ENVIRONMENTAL HEALTH SERVICES SERVICES CLINICAL LABORATORY ESTATE MANAGEMENT SERVICES DENTAL SERVICES HEALTH PROMOTION CENTRE 7 RENAL SERVICES Health Information Booklet 2013 Geography Brunei Darussalam lies on the northwest coast of Borneo island facing the South China Sea and is about 443km north of the equator. With a land area of 5,765 square kilometres, Brunei Darussalam shares a common border with Sarawak, an East Malaysia State, which splits Brunei into two parts; the western part consisting of 3 districts namely Brunei-Muara, Belait and Tutong while the eastern part is the Temburong district. The largest district is Belait District whilst the capital, Bandar Seri Begawan is situated in the smallest district i.e. Brunei Muara. CAPITAL KAMPONGS / LOCALITY ~ BANDAR SERI BEGAWAN ~ 430 AREA HOUSEHOLDS ~ 5,765 sq. km ~ 68,208 (2011 Census) DISTRICTS AVERAGE NUMBER OF ~ 4 PERSONS PER HOUSEHOLD ~ 5.8 MUKIMS ~ 39 8 Health Information Booklet 2013 Demography The population of Brunei Darussalam is estimated to have been 406,200 in 2013 ESTIMATED POPULATION BY AGE-GROUPS comprising of 51.8% males and 48.2% 500 females with a gender ratio of 107. The average growth rate was recorded at 1.6% 400 per annum. Despite the slowing growth 300 rate since 2001, the total population is still 200 showing an increase. 100 0 Population (in Thousands) Population 2009 2010 2011 2012 2013 From the 2001 and 2013 population pyramids, a thicker distribution of temporary residents 0-4 5-19 20-54 55-64 65+ and others in the working age range of 25-49 years old was observed. The demographic structure is essentially that of a young population; about 7.9% are under five years of age, 24.5% are under 15 years, and only 3.8% are 65 years or over. Brunei Darussalam has a multi-ethnic population, with Malays, comprising 65.8%, the predominant ethnic community, and Chinese, with 10.2%, the next major group. Other races and expatriates make up the rest of the population with 24.0%. Economy Brunei’s economy is dominated by the oil and gas sector, which contributes nearly two thirds of the nominal income. Oil and gas exports made up about 95 percent of Brunei’s export revenues, and generated about 90 percent of government revenue. Per capita GDP is one of the highest in the world, estimated at US$32,000 in 2010. The economy has remained stable over the past 20 years with an average inflation rate of 1.5%. The Government’s flexible and prudent fiscal policy has also enabled fiscal and economic sustainability over the years. 59.2 59.5 Economic diversification is a major agenda 55.1 60 in the Government’s drive for economic 48.3 50 41.1 sustainability and reducing reliance on 40 hydrocarbon resources. Government policies increasingly emphasize economic 30 and commercial viability in supporting 20 (B$ Thousand) development spending. Accelerated structural 10 reforms and successful implementation of the 0 2009 2010 2011 2012 2013 various economic diversification initiatives Per Capita GDP at Current Price at Current Per Capita GDP could increase growth further. Source: Oxford Business Group - The Report: Brunei Darussalam 2009 The Government spending continues to include matters such as payroll and subsidies for basic necessities such as rice and housing and seen as important in driving domestic demands. Health Information Booklet 2013 9 Health Status Brunei Darussalam has achieved most of the health related targets set in the Millennium Development Goals. These include significant reductions in under 5 mortality rate (U5MR) and infant mortality rate (IMR). IMR has declined from 42.3 per 1000 live births in 1966