Current health issues and progress in Trinidad and Tobago
Trinidad and Tobago is currently working towards achieving the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms MDG 4, Trinidad and Tobago should reduce under-five deaths per 1,000 live births to 11 and increase measles immunisation to 100 per cent by 2015. In 2012, under-five mortality stood at 21 deaths per 1,000 live births and measles immunisation at 85 per cent. While the under-five mortality rate shows an improvement from 2011, when it stood at 25 deaths per 1,000 live births, the rate of measles immunisation decreased substantially in this time period, from 92 per cent. This suggests that significant progress still needs to be made if the country is to achieve MDG 4 by 2015. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. When applying this target to Trinidad and Tobago, maternal mortality should fall to 22 cases per 100,000 live births. In 2011 Trinidad and Tobago had 46 maternal deaths per 100,000 live births (an estimate from UN agencies/World Bank), indicating that this target is some way from being met. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007-12 this figure stood at 98 per cent. This is promising, and suggests that this target may be met by 2015.
The Third International Conference on Small Island Developing States – National Report by the Ministry of Planning and Sustainable Development of Trinidad and Tobago attributed the overall reduction in under-five and maternal mortality to increased antenatal care and funding towards maternal health. However, the report suggests a need for increased immunisation coverage, education and awareness as infant mortality is still off target. There has been an overall increase in maternal mortality from 16 per 1,000 live births in 2008 to 18 in 2012. Although the rate for 2012 is a significant improvement from a high rate of 27 in 2010, the fluctuation in infant mortality rates needs to be addressed if the goals are to be achieved.
MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Prevalence of HIV in Trinidad and Tobago has seen no decrease since 1990, plateauing at 1.6 per cent in the period 2008-12 for the 15-49 age group. Additionally, there has been an increase in the estimated incidence of tuberculosis (TB) and only a slight decrease in the estimated mortality (when mortality data excludes cases co-morbid with HIV) from TB since 1990. The incidence rate of the disease saw a promising decline from 24 incidences per 100,000 in 2009 people to 19 in 2010, however 2012 saw the rate rise back to 24. Accordingly, significant progress in these areas is required if the country is to achieve MDG 6, and it is unlikely to do so by 2015.