Expanding beyond maternal clinics and
wards to improve maternity and
newborn care – Vanuatu experience.
Dr Margaret Tarere
Country Profile
• Population: 234,023
(2009).
• Annual growth rate: 2.3
% (2009).
• 14% of pop under 5
years old, 21.5% are
women of reproductive
age (15 – 49) & 3.5%
over 65 years of age.
• 76% of pop (rural) &
24% (urban) in 2009.
• Estimated CBR 31.1 per
1000 population & CDR
was 5.5% (2008).
• Infant mortality rate
was 27 per 1000 live
births in 2008.
• MMR 86 per 100,000
live births (2007).
• Life expectancy 68
(males) & 70 (females).
Health Facilities
Health Facilities
• 83 islands & 6 provinces.
• 5 public hospitals & 1
private hospital.
• 2 referral public hospitals:
VCH (Port Vila) & NDH
(Luganville).
• 27 Health Centers, about 4
in each province (RN &
midwife)
• 97 Active Dispensaries (RN)
& 231 Aid Posts (Village
Health Workers).
Vanuatu Archipelago
Human Resources
Doctors
• 32 Ni – Van doctors.
• 3 Ausaid Consultants (2 Solomon
& 1 NZ)
• 10 expats doctors including
private doctors (French,
Canadian, Chinese & Cubans).
• 1 doctor: 5,087 (pop).
• 2 Obstetricians – 2 @ VCH &
None @ NDH.
• 1 Obstetrician: 25,168 (Females
15 – 49 years old).
Midwives/Registered Nurses
•
•
•
•
Total numbers of RN: 312.
1 nurse: 750 (population).
Total numbers of midwives: 59.
20 midwives at VCH, 5 in ANC &
15 in labor ward (200+ deliveries/
month) & 10 NDH, 2 in ANC, 1 in
NP training school & 7 in labor
ward (100+ deliveries/month).
• Remaining 29 in 3 other
Provincial Hospitals & Health
Centers in the provinces.
• 1 midwife: 853 (Females 15 – 49
years old).
Continue…
• The bulk of the deliveries are handle at the
H/C (52%), followed by the hospitals (40%).
• Around 8% of deliveries were conducted by
TBA’s.
• 80% of the deliveries reported were attended
by skilled health personnel.
• 95.5% of the newborn babies weighed more
than 2500g.
CURRENT ACTIVITIES
• Provincial hospital visits twice annually to
Tanna and Santo.
• Conduct CME’s for maternity staff at Lenakel &
NDH.
• Facilitate ongoing programs on PMTCT , FP, BF,
MCH etc in Tanna and Santo.
• Breast feeding support group.
• Provide courtesy visit and teaching at the
Nurse Practitioners school attached to the
Northern District Hospital in Santo that has a
maternal and neonatal care component.
Cont…
• For the remote northern region (Torba Province)
there is an established flying doctor service (“ Wings
of Hope’’) through a partnership with the SDA
mission and the government (> 5 years).
• A Maul aircraft was used. The government provide
subsidy for the aviation gas with VAT exemption.
• The doctor (Dr Mark Turnbull - GP) that service this
remote Torba province is the pilot of the aircraft as
well.
Cont…
Dr Mark Turnbull
Landing at Motalava Island
bush airstrip.
OT BUILT BY Dr Mark @ Gaua
Island.
Pregnant mother with severe
malaria treated at Gaua after flown
in from Hiu island.
Cont…
• Dr Mark Turnbull (GP) doing
an EMLSCS - twin pregnancy
at Gaua Island.
• Dr Mark usually liaise with
obstetricians about cases
and the best possible
outcome i.e. to fly pt to
Santo or treat them in
Gaua.
• Dr Mark has a small coulter
counter (for FBC), mini lab &
portable U/Scan available .
Cont…
• Obstructed labour from
Toga island – the first
island in the Vanuatu
group, south of the
Solomons. She was
flown to Gaua and had
EMLSCS – Maternal
Death Avoided.
Future Activities
• Establish mobile clinics that will service
Paunagisu H/C north of Efate (do T/L,
Vasectomy etc).
• Conduct EMOC training for the Penama and
Shefa province midwives, nurse practitioners
and registered nurses. All other provinces has
already received EMOC training.
• ALSO (Australia) training to be conducted for
Vanuatu 2014/2015.
TANK YU TUMAS