Sociology

International health is a subject which largely occupies the worlds concerns. As such, it has become necessary that international organizations take part in numerous surveys of the worlds health care systems. It is in this light that the essay will aim at providing a comprehensive analysis of the primary health care system in Comoros. This analysis will be determined in terms of chosen indicators of primary health care and supported by information from select datasets.

The primary health care indicators for Comoros are life expectancy, maternal mortality, and access to clean water sources, sanitation, HIVAIDS prevalence, TB prevalence and child mortality. These indicators serve the purpose of establishing whether the primary health care system influences life expectancy rates for Comoros. The rest of the indicators are crucial in supporting the formation of a sound health care system as they represent health issues which are present all around the globe.

The datasets to be used for analysis include the World Health Organization database, the UNICEF database and the CIA Fact Book. The WHO database is crucial in providing statistics regarding the above mentioned health care indicators, while the UNICEF database will be helpful in sourcing additional information on child health care in Comoros. Lastly, the CIA, Fact Book provides a country comparison of health care indicators across all countries in the African region.

The primary healthcare system in Comoros is strong in its capacity to ensure high life expectancy rates. As indicated in the WHO Global Health Atlas (2007), the life expectancy rates from 1999 to 2004 continued to rise with every single year. They moved from 56 years to 62 years. Moreover, the health life expectancy rates have improved the same way from 50 years to 55 years. Apart from life expectancy rates, maternal mortality rates are also significantly low, in 2004, per every 100, 000 live births there were only 480 maternal deaths which are mainly caused by communicable diseases and HIVAIDS together with its opportunistic ailments like TB. Another impeccable strength in the health care system is the reduced prevalence of HIVAIDS. In essence, only a very minimal amount of individuals succumb to death as a result of HIVAIDS. In fact in 2000, among the 480 maternal deaths only 3.7  were caused by HIVAIDS. This incurable disease is almost foreign in Comoros with the prevalence rates in 2007 estimated at 0.1 . Significantly so, the prevalence of the same in 2003 had been inexistent in Comoros.

On the other hand, TB incidence in 2004 was recorded at 46 per every 100,000 population which compared to the previous years which was at 22 indicates an increment of the same. Indeed the prevalence rates for TB were 95 per 100,000 populations. Regardless of these strengths there exists an adamant weakness with regard to the child mortality rates. Child mortality rates are at a high in Comoros with children under 5 years dying at a rate of 66 per 100,000 live births. These rates are attributed to such causes like malaria, pneumonia, diarrhea and neonatal causes. As showcased in the UNICEF (2004), Malaria caused 17  of these deaths with only 9  of the children below 5 years of age sleeping under treated mosquito nets. In addition, 16  of the same deaths were caused by Pneumonia considering that only 49  of those suspected to have pneumonia managed to seek health care between 2000 and 2007.  However, the countrys healthcare system has a very impressive immunization policy which sees over 75  of infants immunized against measles, polio and DPT among others.

Clean water and sanitation are vital elements of a proper health care system and Comoros has endeavored to accomplish this. In 2006, 85  of the entire population had access to improved drinking water while only 35  of the population could access improved sanitation (WHO Global Health Atlas, 2007). Furthermore these statistics indicate both upward and downward trends over the years since 1999. In 1999, 93  of the population had access to improved water but this has decline to 85  in 2006. An upward trend is reflected from 1999, when only 18  of the population had access to improved sanitation which has increased to 35 .  These changes are attributed to a lack of modern facilities especially in the rural areas where people dispose of waste in the open environment. This has made it impossible to provide sustainable sanitation for the entire population. However, the decline in access of improved water is also attributed to a lack of sound economic systems responsible for maintaining the water reservoirs and treatment plants in both the rural and urban areas.

Another factor which has attributed to failure of the health care system is the reduced government expenditure especially that which is directed to health. Evidently, only 6.4  of the total government expenditure in 2003 was used on health care. It seems that most of the health expenses are catered for by individuals with very little help from the government (WHO Global Health Atlas, 2007). Another influential factor is the lack of ample health workers in the country. The country in 2002 had only a total of 1175 health works with a density of 1.487 per 100 populations. In comparison with other countries in the African region where the density of health workers is at 2.626, the country is lacking a very important component of a sound health care system. However, while compared to countries along the Indian Ocean which border Comoros, the country has the least HIVAIDS prevalence rates. Mozambique has 12.5  and Mauritius at 1.70. This is quite remarkable as both of these countries have higher GDP rates but still manage to have higher mortality rates and HIVAIDS prevalence rates. However, Comoros has similar prevalence rates of 0.1 as Madagascar (CIA, World Fact Book, 2007). In comparison to the entire African region, Comoros is struggling to meet the Millennium Development Goals especially those related to improving health care and reducing mortality rates. For instance, there progress towards reduction of child mortality rates, the country managed to reduce this to only 70 per 100,000 live births but still falls short of the expected target of 40 per 100,000 live births. Also, in comparison to the rest of Africa, Comoros reflected similar reduction rates of maternal mortality which decreased with 90 per 100,000 live births (WHO Global Health Atlas, 2007).

In conclusion, this analysis has clearly depicted the strengths and weaknesses of the health care system in Comoros. The countrys capacity to provide clean water to a majority of the populations contributes highly to the reduction of communicable diseases. Moreover, the country has high life expectancy rates. Regardless of this, the weaknesses showcased lie in the countrys lack of ample health care funds and health care workers. However, the country does fare well in comparison to other countries in the African region although there is still room for improvement. In order to foster an improved health care system, Comoros needs to increase its expenditure on health care and with a change of existing health policies become open to international aid.