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Republic of Kiribati

Capital

Tarawa

Official Languages

English, Gilbertese

Area

811 km2
(313 sq mi)

Population

110,136

Currency

Australian Dollar, Kiribati Dollar

Health infrastructure

Health services are delivered free of charge through a network of health facilities, including four hospitals, 30 health centres staffed by medical assistants and 75 clinics staffed by public health nurses, with sustained high levels of essential services coverage. Delivering services to its widely scattered population is challenging and costly, especially in terms of transportation and communication costs. Significant gaps in health services delivery include: deteriorating health facilities with limited bed capacity and frequent shortages of medical equipment and drug supplies. Improper solid and chemical waste disposal, including hospital wastes, are threats to public health.

Four levels of health facilities exist within Kiribati:

1.The central referral hospital, Tungaru Central Hospital , located in the capital, South Tarawa, receives referrals from the hospitals and health centres
2.There are three other referral hospitals– one based at Betio (Tarawa), one at Kiritimati Island (for the Line and Phoenix Island Groups) and one at Tabiteuea North (for the southern Gilbert Islands). The hospitals receive referrals from health centres and are operated by doctors, nurses and allied health staff
3. In the rural outer islands where there are no hospitals, two levels of health facilities exist. Health Centres provide primary health care curative and preventive services and are staffed by medical assistants (registered nurses who have undertaken additional training). These nurses are the key health personals on each island
4. Health Clinics (also referred to as dispensaries) are staffed by community nurses and nurse aids. Nurse aids do not dispense medicines but are trained to recognise the danger signs of illness

There are four levels of health facility in Kiribati: central referral hospital, subdivisional hospitals, health centres and dispensaries. The 120-bed central referral hospital (Tungaru Central Hospital) in South Tarawa receives referrals from subdivisional hospitals and health centres around the country. Tungaru Central Hospital offers a range of secondary medical, surgical, laboratory, radiology, pharmacy and physiotherapy services. The three subdivisional hospitals are Betio Hospital in North Tarawa, which has 10 beds and provides basic medical services; London Hospital on Kiritimati Island, a seven-bed hospital that serves the Line and Phoenix Island groups and offers basic surgical, medical and maternity services; and
Southern Kiribati Hospital (SKH), which services the Southern Gilbert Islands. Subdivisional hospitals are staffed by doctors, nurses and allied health staff and receive referrals from health centres.

Health workforce

Kiribati has a similar level of healthcare professionals as other countries in the Pacific. The health workforce is ageing and relies on retired health staff employed on contract to fill some nursing and medical positions. With no doctors in the majority of Kiribati, nurses provide the backbone of the health work force, and the scope of nursing is wide and varied. The workforce is largely female due to the large proportion of female nurses. Females are also predominant in most of the other health worker categories. The gender of the 188 nurse aides employed by the Island Councils is not known but generally thought to be all or mostly female.

WHO

In May 1953, Kiribati (formerly Gilbert Islands) was assigned to the Western Pacific Region at the Sixth World Health Assembly "without prejudice to any questions regarding sovereignty" as an area. On 12 July 1979, Kiribati became an independent Republic, within the British Commonwealth. It joined WHO on 26 July 1984 as a Member State.
The WHO Representative Office in the South Pacific has covered Kiribati since its establishment, and the Country Liaison Officer was designated in 1982.

The WHO Country Liaison Officer in Kiribati:
Dr Ezekiel Nukuro
Office address:
World Health Organization Bikenibeu, Tarawa Kiribati
Postal address:
World Health Organization P.O. Box 210 Bikenibeu, Tarawa, Kiribati
Telephone number:(686) 28231
Fax number:(686) 28188Email:
wpkirclo@who.int

Ministry of Health

Kiribati has a well-established, publicly-funded and provided health system administered by the Ministry of Health and Medical Services. Health remains among the top six priorities of the Government, receiving the second highest government budget allocation in 2015 and 2016, with the education sector being the highest. The structure of the Ministry of Health and Medical Services of Kiribati is shown in the following organizational chart:

Health training institutions

Post-secondary education in Kiribati centres around the University of the South Pacific (USP), which has a campus in Tarawa for distance learning. It is usually undertaken on a flexible schedule, and involves live streaming of lectures.
Kiribati has only one health worker training institution, Kiribati School of Nursing (KSN. The training course is 3 years in length and now leads to a Diploma in Nursing (New Zealand) since 2010, which was developed with assistance of WHO and Auckland University. A combined post-basic course in midwifery and public health leads to further training as a medical assistant. All other health workers who require formal training go overseas, mostly to Fiji National University (FNU) or institutions in Australia or New Zealand. In recent years, medical students have also gone to Cuba.

Kiribati Institute of Technology
Betio Island, Kiribati, Kiribati
Telephone: +686 26516
http://kit.edu.ki/

Accrediting bodies

A legislative and policy framework for education has been established. It has sought services from Educational Quality and Assessment Programme (EQAP) to accredit qualifications and register providers. The Pacific Qualifications Framework (PQF) and the Pacific Quality Assurance Framework (PQAF) were adopted.
EQAP
http://www.eqap.org.fj/Home.aspx

Scholarships

Almost all students are supported by scholarships offered by the Kiribati Government or international aid donors (predominantly AusAID and New Zealand Aid Programme). A few private students pay their own tuition. Pre-service scholarships are managed by the Ministry of Education. Open scholarships are advertised on the radio and/or promoted in secondary schools. The Ministry of Education and donor representatives review academic performance and then select qualified applicants. In addition to a maximum age limit, applicants need to have passed English with a mark of A or B. In 2012, approximately 90 applicants were vying for 40 scholarships. AusAID and New Zealand Aid Programme scholarships are awarded to the best students. Awardees of Government of Kiribati scholarships are then chosen from the leftover pool of applicants.

AusAID
http://dfat.gov.au/geo/kiribati/development-assistance/Pages/development-assistance-in-kiribati.aspx

New Zealand Aid
https://www.mfat.govt.nz/en/aid-and-development/scholarships/who-can-apply-for-a-scholarship-3/kiribati-scholarships-2/

Geography and demographics

The Republic of Kiribati includes three islands groups- Gilbert, Phoenix and Line- and comprises 32 atolls and one elevated coral island with a total land area of 811 square kilometres dispersed over five million square kilometres of ocean. It is one of the most geographically isolated countries in the world. The country is vulnerable to sea-level rise and extreme weather events including those resulting from climate change. Among Pacific island countries, Kiribati has high levels of poverty and domestic overcrowding, particularly in the capital city of South Tarawa where half the population lives.

Kiribati became independent from the United Kingdom in 1979. Today, it is a democratic republic headed by a president. Kiribati has a unicameral House of Assembly, the Maneaba Ni Maungatabu, and a number of islands councils. The main revenues for its unstable economy come from fishing licences and seafood exports. Most of its food, fruits and vegetables are imported.

Politics

Kiribati became independent from the United Kingdom in 1979. Today, it is a democratic republic with 45 Members of Parliament (MPs) that are elected every four years, with the exception of one that is appointed. The President, who is also the head of state, is also elected by the people after being nominated by MPs.

Economy

Kiribati’s main exports are fish and Copra- the dried kernel of coconuts. Other important economic sectors include the sale of fishing licences and the tourism industry. The country’s official currency is the Kiribati dollar; however the Australian Dollar is also legal tender.

Tourism

Kiribati’s wide expanse of islands means there is much to offer every kind of tourist. Fishing is the most popular activity, with both onshore and offshore available. Other outdoor activities include scuba diving, surfing and bird watching. There is also an abundance of cultural experiences on offer, such as visiting World War II relics and visiting the various communities and villages on some of the world’s most remote islands.

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