Djibouti 
Health sector strenghtening in Djibouti

afrol News, 10 June - The World Bank approved a US$ 15 million loan last week that will finance the government of Djibouti's long-term health sector development program aimed at meeting the Millennium Development Goals for the reduction of child mortality and maternal mortality rates. 

The first in a series of three projects slated for 2002-2015 period, the Health Sector Development Project (HSDP) falls in line with the World Bank's country assistance strategy of improving human development indicators by providing the poor with better access to health and basic services, according to the Bank. 

- Plans for the project were widely discussed in the country through open town meetings, and endorsed by the government, civil society and the international donor community in Djibouti, the World Bank reports. 

Despite a relatively high per capita income of US$ 780 in comparison to the average for sub-Saharan Africa, Djibouti suffers from a precarious health situation. Infant mortality rate stands at 106 per 1,000 live births and health facilities are constrained by lack of basic medicine and qualified personnel. 

Maternal mortality rates, estimated at about 800 per 100,000 live births, is one of the highest in the world. In addition, the incidence of endemic and infectious diseases such as HIV/AIDS, malaria and tuberculosis are on the rise. As a result, the government of Djibouti developed a long-term strategy to respond to the challenges and reform of the health sector.

Djibouti has hitherto been noted by poor investements in the public health sector. This is mirrored by the lack of adequate health facilities, the high population growth rate of 6 percent, the high infant mortality and maternal mortality rates and a very short life expectancy for women; only 49 years.

The first phase of the new health project will focus on "the improvement of maternal and child health services; improved availability and quality of para-medical personnel; better availability of medicines in health facilities; and increased capacity of the government to implement and execute reforms," the Bank reports.

The helath project, in conjunction with an ongoing World Bank project to increase enrollment in schools and an upcoming HIV/AIDS project "are all targeted towards supporting Djibouti in achieving the Millennium Development Goals," said Qaiser Khan, Task Manager for the health project.

The Millennium Development Goals grew out of the agreements and resolutions of world conferences organized by the UN in the past decade. At the UN's Millennium Summit held in September 2000, eight goals were set by world leaders, to reduce poverty in all its forms. The goals have been commonly accepted as a framework for measuring development progress. They include eradicating extreme poverty and hunger, achieving universal primary education, promoting gender equity, reducing child mortality, improving maternal health, combating HIV/AIDS and other diseases and ensuring environmental sustainability. 

In a letter to the International Monetary Fund (IMF) sent in December 2001 by the Djiboutian government and National Bank, the IMF was asked to resume its funding. The letter said the government was to "continue and intensify" its reform program in 2002 "so as to put the economy of Djibouti on the path of higher growth, boost per capita incomes, reduce unemployment, roll back poverty, and ensure domestic financial viability." 

Sources: Based on World Bank and afrol archives

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