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Health Sector: Good performance, high costs, says the World Bank

The Maldives has the best health performance among South Asian countries, but it was achieved at a higher cost than other countries, the World Bank has said.

The World Bank's Maldives Public Expenditure Review (PER) shows that infant mortality in the Maldives fell by 2.8 percent from 2014 to 2019. The report said maternal mortality was also reduced by three percent during the period.

The report said the Maldives' performance is similar to the performance of other middle-income countries. However, the Maldives has spent more on health than other middle-income countries, it noted.

The review said it is likely that Maldives' spending on the health sector is disproportionate to the results achieved. Noting some reasons for this, the Bank said it is possible that the Maldives had to spend more money to produce results on par with other middle-income countries, perhaps because there were not enough trained people in the health sector. Due to the lack of trained personnel in the health sector, Maldives has to spend more to bring in trained professionals from abroad. As of 2019, 64 percent of doctors and 42 percent of nurses working in the Maldives are foreigners, the review said.

The World Bank also noted that the health infrastructure in the Maldives, compared to other countries in the region, is significantly better. The World Bank noted that the Maldives' health infrastructure was already in a good place even before major infrastructure development projects were implemented in the Maldives.

The review further said the Maldives' health sector had received good investments and that the burden on the public's pockets has been greatly eased with the national health insurance scheme, Aasandha. However, the World Bank has recommended that the scheme be strengthened as the expenditure on Aasandha is increasing.

Meanwhile, the average life expectancy in the Maldives reached 78.9 years in 2019, higher than other middle-income countries and other countries in the region, the World Bank noted. The average life expectancy in middle-income countries is 75.9 years, compared to 70.6 years for other countries in the region, according to the World Bank.

The Maldives has already achieved the health sector's Millennium Development Goals and Mortality-Based Sustainable Development Goals, the World Bank review said. Infant and under-five mortality in the Maldives have been reduced by 90 percent from 1990 to 2019. Maternal mortality due to pregnancy-related complications reduced by half between 2000 and 2017, the report said.

In addition, the Maldives has made significant progress in health compared to other middle-income countries and other countries in the region, the World Bank said.