Kiribati is a lower middle-income Pacific Island country with an estimated population of 119,940. Increased public revenue in recent years has led to a strong growth in gross national income per capita. However, human development indicators remain relatively low. Annual health expenditure in Kiribati increased by 7% percent in the period 2008-2018 while per capita spending has declined. The COVID-19 impact likely posed a risk to some of the health gains made in recent years.
A historically shaped and publicly funded health system
Apart from some minor out-of-pocket (OOP) charges, health services in Kiribati are provided free at the point of care. The bulk of health services in Kiribati are funded from domestic sources (77% percent in 2018), and an estimated 20% percent of funding comes from external sources.
Publicly funded and provided health service over time resulted in improved health of Kiribati’s population. Average life expectancy at birth has risen from 60 years in 1990 to 66 years in 2015. The incidence of communicable diseases such as diarrhoea and respiratory tract infections has also declined. In 2015, the maternal mortality ratio was 90 per 100,000 births, and infant and under-5 mortality rates were 44 and 56 per 1000 live births, respectively. However, high levels of neonatal mortality and malnutrition are central concerns. There are also health issues relating to the prevalence of communicable diseases, including tuberculosis (TB) and leprosy cases, which are among the highest in the Pacific. The burden of noncommunicable diseases (NCDs) also remains significant.
Government health policy priorities
The Kiribati Ministry of Health and Medical Services (MHMS) is responsible for overseeing health policy and delivering health care services, managing health workforce training and development, as well as implementing statutory and regulatory functions. The recently proposed National Health Strategic Plan (NHSP, 2020-2023) aims to “improve population health and health equity through continuous improvement in the quality and responsiveness of health services, and by making the most effective and efficient use of available resources.”
These objectives include prioritizing mortality and morbidity related to NCDs; maternal and child health; communicable diseases including tuberculosis, leprosy and other emerging diseases; as well as other challenges for the health system.