65. Although, the study ICPD Beyond 2014, Maldives Operational Review 2012by Department of
National Planning suggests that sex education and access to reproductive health services is
absolutely necessary to tackle the issue of high numbers of unsafe abortions and rising infanticide,
age appropriate sex education is not provided in schools and life skill programs do not cover the
subject.107,108
66. Public awareness on communicable diseases is conducted by Health Protection Agency (HPA) and
through public health units in islands and HPA believes that health centers are capable of preventing
outbreaks of life‐threatening communicable diseases. However, in 2011 there was a Dengue
outbreak which reported a total of 2909 dengue cases and also reported the highest number of
deaths to date that was reported in a year.109 There have been dengue outbreaks each year since
2010 and many infants and children died of such outbreaks between 2010 and 2014 and most of
them died while been treated at hospitals/health centers. Most common cause of these deaths is
communicable diseases and neonatal deaths caused by lack of intensive care.110,111,112
TABLE: NEONATAL DEATH RATE PER 1000 LIVE BIRTHS, 2002 ‐ 2012
Year
Early Neonatal Death Rate
(0‐6 Days)
Late Neonatal Death Rate
(7‐27 days)
Neonatal Death Rate
(0‐27 days)
Total
Male’
Atolls
Total
Male’
Atolls
Total
Male’
Atolls
2002
9
9
9
2
2
2
11
11
12
2003
9
3
18
1
1
1
10
3
19
2004
9.01
6.06
11.07
0.96
1.40
0.65
9.97
7.46
11.73
2005
7.22
7.73
6.82
1.08
0.41
1.62
8.31
8.14
8.44
2006
8.75
7.02
10.26
2.75
3.69
1.92
11.50
10.71
12.18
2007
6.23
5.18
7.16
0.91
1.62
0.29
7.15
6.80
7.45
2008
5.89
5.38
6.36
2.15
2.99
1.38
8.04
8.36
7.74
2009
6.87
9.5
4.28
0.54
1.09
0.00
7.95
11.67
4.28
2010
6.18
6.3
6.16
1.97
2.89
0.62
8.15
9.18
6.77
2011
5.71
6.52
4.12
1.11
1.76
0.00
6.82
8.27
4.12
2012
4.44
4.93
4.11
1.48
2.02
0.37
5.92
6.95
4.48
Source: ministry of health, 2015
67. It is concerning to learn that some parents refuse to give vaccine to their children due to
fundamentalist thinking and there have been more than a few recorded cases of such extremists
refusing to give necessary vaccines to their children.113 However, Health Protection Agency believes
that the need for mass public awareness on the importance of vaccination is low in the country.
Even though there is a legislation under which actions can be taken against such parents, it is not
clear how effectively it is being implemented. HPA is faced with challenges in monitoring and
assessing the vaccination situation and keeping records of coverage information.
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