Medical services is provided free by Government and consists of 85 health centers/clinics on outer islands staffed by medical assistants and/or nurses, and one referral hospital service on the capital island of Tarawa. Communicable diseases like acute respiratory infections and diarrhoea are common. Tuberculosis and HIV/AIDS are on the rise becoming a cause for concern for Government. In the midst of all these, non-communicable diseases (NCDs) like diabetes, high blood pressure and heart disease are also on the increase. There is a very high prevalence of smoking in Kiribati with more adult males smokers (70%) than adult females smokers (<50%), while the proportion of household with at least one smoker ranges from 60% to 90%.
The demographic transition from high fertility and mortality to low fertility and mortality has only just begun in Kiribati as in other Paciﬁc Island countries of comparable development levels. In the midst of that transition there is now increasing incidences of NCDs, and the Government is hard pressed with a double burden of improving services in the face of increasing population especially in urban areas, receding communicable diseases and increasing NCDs.
The Government has embarked on the development of the Kiribati National Population and Development Policy of which a number of components such as family planning, universal primary education, housing, outer island growth centers and increasing employment opportunities including overseas employment and emigration to Paciﬁc rim countries especially New Zealand and Australia are being implemented. MDGs are therefore well incorporated into Kiribati national development strategies and Population Policy.
Gross Domestic Product (GDP) is measure of the value of all goods and services produced in a country and is a good indicator of economic performance of a country. GDP per capita is often used as an indicator of average standard of living of individuals in that country. Because the national income (and expenditure) of Kiribati is determined more by earnings from abroad than domestic production of goods and services, it is argued (Republic of Kiribati, 2004), that GNI, which covers income from abroad (RERF, Fishing license fees, green passport, remittances of Kiribati seamen, etc.) is a more useful indicator of economic performance than GDP. Others however (Republic of Kiribati, 2000) opted for GDP as a better indicator of economic performance given the relatively high population growth rate in Kiribati.
Since the early 1990s Kiribati economic growth, as measured by GDP growth rate, GDP trends and GDP per capita, has gone through changes that shows a not so good economic performance for the period leading up to 1997, followed by very positive economic growth up to 2002-2003, and ﬁnally, a decline in growth from 2003 to 2006. The Kiribati National Sustainable Development Plan, 2008-2011, describes these positive and negative growths as ‘boom’ and ‘recession’ periods respectively, with boom periods above, and recession periods below the regression line, or expected GDP levels for that period, (see Figure 2).
Source: MDGs Kiribati Report 2007; Kiribati Poverty Report 2006.