HEALTH OF OUR NATION Annual Health Sector Performance Report 2019 Department of Health, Seychelles June 2020 Annual Health Sector Performance Report 2019 Sector Performance Health Annual HEALTH OF OUR NATION HEALTH SECTOR PERFORMANCE REPORT, 2019 This is a publication of Department of Health, Seychelles. This document is licensed under a Creative Commons Attribution-Non-commercial-No Derivatives 4.0 International License (https://creativecommons.org/licenses/by/4.0/). Under the terms of this licence, you may copy and redistribute work for non-commercial purposes. You must give appropriate credit to organization that created the document and provide a link to the li- cense. When sharing the document, you must license your work under the same or equivalent Creative Commons licence. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. I ACKNOWLEDGEMENTS Several people contributed to the development of this report. Writing Team: Agnes Chetty, Jacques Filez, Susan Fock Tave, Emelyn Shroff, Ituen-Umanah Williams, Bharathi Viswanathan. Statistics Unit: Joachim Didon, Richard Ibrahim Husseini, Rosalie Isnard. Annual Health Sector Performance Report 2019 Sector Performance Health Annual Key Contributors: Marie-Josee Dangkow, Anne Finesse, Georgette Furneau, Bella Henderson, Patricia Rene. Reviewers: Agnes Chetty, Sanjeev Pugazhendhi, Conrad Shamlaye, Shobanke Dolapo Abidemi, Bernard Valentin. Health Promotion Unit:David Marguerite. II Annual Health Sector Performance Report 2019 Sector Performance Health Annual TABLE OF CONTENT TABLE OF CONTENT ......................................................................................................................................III ACRONYMS/ ABBREVIATIONS .......................................................................................................................VI SUMMARY INDICATOR TABLE .......................................................................................................................VIII FOREWORD ..................................................................................................................................................IX EXECUTIVE SUMMARY ..................................................................................................................................X 1. INTRODUCTION ........................................................................................................................................1 2. GOVERNANCE AND LEADERSHIP ...............................................................................................................3 2.1 HEALTH SECTOR STEWARDSHIP AND MANAGEMENT CAPACITY ................................................................4 2.2 SECTOR LEGAL AND REGULATORY FRAMEWORK ........................................................................................6 2.3 SECTOR ACCOUNTABILITY ...........................................................................................................................6 2.4 EMPOWERED CIVIL SOCIETY/COMMUNITY ................................................................................................7 2.5 PRIVATE SECTOR PARTICIPATION .................................................................................................................7 3. HEALTH STATUS .........................................................................................................................................8 3.1 VITAL STATISTICS ..........................................................................................................................................9 3.2 MAIN CAUSES OF MORTALITY .....................................................................................................................12 3.3 MORBIDITY ..................................................................................................................................................16 3.4. FERTILITY ....................................................................................................................................................17 4. RISK FACTORS FOR HEALTH .......................................................................................................................19 4.1 NCD RISK FACTORS ......................................................................................................................................20 4.2 PREVENTION OF NCDS ................................................................................................................................21 5. HEALTH SYSTEM ........................................................................................................................................24 5.1 FINANCING FOR HEALTH .............................................................................................................................25 5.2 HEALTH WORKFORCE ..................................................................................................................................26 5.3 SERVICE DELIVERY .......................................................................................................................................28 5.4 ESSENTIAL MEDICINES ................................................................................................................................33 5.5 HEALTH INFORMATION ...............................................................................................................................33 5.6 NEW DEVELOPMENTS .................................................................................................................................34 6. ORAL HEALTH SERVICES ............................................................................................................................35 6.1 INTRODUCTION ...........................................................................................................................................31 6.2 COMMUNITY DENTAL SERVICES ..................................................................................................................31 6.3 SPECIALIST DENTAL SERVICES ......................................................................................................................37 6.4 DENTAL PUBLIC HEALTH SECTION ...............................................................................................................38 6.5 DENTAL LABORATORY SERVICES ..................................................................................................................39 7. PROGRESS ON SDG3 .................................................................................................................................40 LIMITATIONS.................................................................................................................................................47 RECOMMENDATIONS ...................................................................................................................................48 ANNEX 1. MORTALITY BY DISTRICT, 2019 ......................................................................................................49 ANNEX 2. TREND IN MATERNAL MORTALITY, 1978-2019 ...............................................................................50 ANNEX 3. LEADING CAUSES OF ADMISSIONS SEYCHELLES HOSPITAL, 2019 (SELECTED WARDS) .....................51 III TABLES AND FIGURES TABLE 2.1 REGISTERED HEALTH CARE PROFESSIONALS, 2019 ...............................................................................7 TABLE 3.1 LIVE BIRTHS BY SEX, 2015-2019 ............................................................................................................9 TABLE 3.2 ANNUAL DEATHS BY SEX, 2015-2019 ....................................................................................................9 TABLE 3.3 ANNUAL DEATHS BY AGE GROUP AND SEX, 2019 .................................................................................9 TABLE 3.4 ANNUAL DEATHS BY SELECTED DISTRICTS, 2019 ..................................................................................10 TABLE 3.5 MATERNAL AND INFANT DEATHS, 2018-2019 .......................................................................................10 Annual Health Sector Performance Report 2019 Sector Performance Health Annual TABLE 3.6 CEREBROVASCULAR ACCIDENTS (INCLUDING DEATHS), SEYCHELLES HOSPITAL 2019 ..........................13 TABLE 3.7 TOP 10 BURDEN OF DISEASE .................................................................................................................14 TABLE 3.8 DEATHS DUE TO DROWNING, 2017 – 2019 ...........................................................................................16 TABLE 3.9 COMMON CAUSES OF ADMISSIONS, 2019 ...........................................................................................17 TABLE 3.10 ABORTIONS BY AGE GROUP, 2019 .......................................................................................................17 TABLE 3.11 REGISTERED LIVE BIRTHS TO TEENAGE GIRLS, 2014-2019 ...................................................................18 TABLE 5.1 MOH BUDGET BREAKDOWN, 2017-2019 .............................................................................................25 TABLE 5.2 NATIONAL HEALTH COUNCILS BUDGET BREAKDOWN, 2017-2019 ......................................................25 TABLE 5.3 DONATIONS, 2019 .................................................................................................................................26