Public Health Delivery In Mauritius

As the saying goes “health is wealth”, the provision of proper healthcare is extremely important as this implies well-being, happiness, and a good quality of life. A healthy population is essential for the growth and prosperity of a country. A nation’s health system should thus aim at providing quality healthcare to its population.

The Ministry of Health & Quality of Life, to whom an overall yearly budget of Rs 5 billion is allocated, provides public healthcare in Mauritius as a “welfare” service. (Source: Newsletter Ministry of Health & Quality of Life July 2009). As at the year ended 2008, health services were provided through 13 public hospitals including 5 specialised ones, 22 Area Health Centres and 108 Community Health Centres located throughout the country. (Source: Ministry of Health & Quality of Life).

Free healthcare provided by the Ministry of Health & Quality of Life has improved the health situation of the citizens of Mauritius. This is shown in table 1.2 below.

Table 1.2: Health Indicators in Mauritius for the years 1990 and 2008 (Source: Ministry of Health & Quality of Life)

The health indicators in Table 1.2 show favourable changes in the health situation of Mauritians in 2008 compared to 1990.

Apart from providing health services to the citizens of Mauritius through its hospitals and health centres, The Ministry of Health & Quality of Life being highly concerned about the well-being of the Mauritian population, tries to create awareness amongst them by carrying out several welfare activities. The latter include the launching of a Mobile Clinic which was done on 7 May 2009, public demonstration of physical activities such as yoga, aerobics, Tai Chi and physical exercise that are organised to encourage people to adopt a healthy lifestyle, tips given with regards to a healthy nutrition so as to fight obesity, organising empowerment programmes to sensitise the population on the adverse effects of tobacco and alcohol, talks on stress management and a National Cancer Control Programme has been developed to fight against cancer. (Source: Newsletter Ministry of Health & Quality of Life July 2009)

Furthermore, The Ministry of Health & Quality of Life aims at improving the quality of healthcare provided to the citizens of Mauritius. Recently, on 27 April 2009, it introduced the implementation of the ISO 9001: 2008 in health services so as to increase customer satisfaction and meet the needs of the Mauritian population. (Newsletter Ministry of Health & Quality of Life July 2009). The future plans of the Ministry include the setting up of Medical Schools where proper training will be given to healthcare providers and improving the hospitality and catering services provided in its hospitals. (Source: Newsletter Ministry of Health & Quality of Life March 2009)

From the above, it can be noted that The Ministry of Health & Quality of Life is highly concerned with the health of the citizens of Mauritius. However despite all the efforts of The Ministry of Health & Quality of Life, the Mauritian population does not seem to be fully satisfied with its healthcare services. Patients are increasingly filing medical malpractice cases which nowadays are repeatedly seen as being the headline of many newspapers. Media reporting has created an increased awareness of harm related to healthcare errors.

Additionally, despite the fact that industrialisation and economic growth during the last years have positively changed the lifestyle and the standard of living of the Mauritian population, the latter is highly exposed to diseases such as diabetes, hypertension, obesity, cancer, HIV/AIDS and so forth. Research has shown that 1 out of 5 Mauritians aged 30 and above has diabetes that is mostly caused due to obesity, unhealthy eating habits, lack of physical activity and alcohol abuse. (Source: Newsletter Ministry of Health & Quality of Life July 2009)

The HIV/AIDS status in Mauritius is quite high with 3792 cases registered from October 1987 to March 2009. This has resulted in 249 deaths as at March 2009. Prior to 2000, 20 to 30 new cases of HIV were being reported annually. However over the period of 2001 – 2005 the number had increased by almost twice annually: 55 in 2001, 98 in 2002, 225 in 2003, 525 in 2004 and 921 in 2005. The 538 new cases registered in 2008 showed that in spite of all the efforts of the Ministry of Health & Quality of Life, HIV in Mauritius is on a rising trend. (Source: Ministry of Health & Quality of Life: An analysis of Health Situation in Mauritius as at year ended 2008)

Furthermore each year more than 1400 new cases of cancer are registered in Mauritius. In 2008, 12% of all deaths were due to this disease. (Source: Newsletter Ministry of Health & Quality of Life July 2009)

Heart diseases and Diabetes mellitus were the first two main causes of mortality in 2008. Comparing the causes of death in 2008 with those of 1975:

Causes

1975

2008

All diseases related to the circulatory system including heart diseases

28.4%

35.0%

Diabetes Mellitus

2.7%

22.8%

Table 1.3: Causes of death in the years 1975 and 2008 (Source: Ministry of Health & Quality of Life: An analysis of Health Situation in Mauritius for the year ended 2008)

Table 1.3 shows a rapid increase in death due to heart diseases and diabetes mellitus over the last three decades. This can be explained by a change in the lifestyle and eating habits of the citizens of Mauritius which is making them become more prone to such non-communicable diseases.

Morbidity in Mauritius and the litigation/complaints concerning medical mal-practice therefore indicate that the Ministry of Health & Quality of Life is not meeting the needs of the Mauritian population.

The healthcare system in Mauritius is getting bigger and more complex as the expectations of the population are increasing. The citizens of Mauritius who are now better educated, have become highly demanding in terms of choice, access, quality of care and service. They furthermore feel that the system is deteriorating and becoming less responsive to their needs as the press only publicises the bad points. Such negative media comments definitely demoralise the health care providers.

The aim of this project is to investigate the problems faced by the public health care sector of Mauritius. This will be done through an empirical study at Flacq Hospital, one of the well-known general hospitals operated by the Ministry of Health & Quality of Life. Throughout this study, it is intended to assess the healthcare quality provided at Flacq Hospital and analyse the factors linked to service experience and patient satisfaction.

By evaluating patient experience important information can be obtained for identifying problems and taking appropriate measures for quality improvement in health-care facilities (Labarere and François, 1999; Batchelor et al., 1994). Improving the quality of service in hospitals will thus be beneficial to everybody namely patients, physicians, nursing staff, management and tax-payers. Such a “win-win” situation will be advantageous to the whole country.