Health in Kiribati

MHMS provides public health promotion, prevention, immunization, screening, treatment, maternal and newborn care, child health, reproductive health, family planning, mental-health support and follow-up for chronic conditions. Health clinics and dispensaries usually provide community-level care through a community nurse and nurse aide. Health centres usually have a medical assistant or community midwife. Hospitals provide outpatient and inpatient care, diagnosis, medicines, maternal and child health services and treatment for common illnesses and injuries. The usual referral pathway runs from a clinic to a health centre, then to a district hospital and, when necessary, to Tungaru Central Hospital in South Tarawa. Tungaru Central Hospital provides national referral care, specialist services, acute care, chronic-care support and surgery. Betio Hospital serves local needs in South Tarawa. Southern Kiribati Hospital serves the Southern Gilbert Islands, while London Kiritimati Hospital serves the Line and Phoenix Islands. Hospitals also provide primary care in their surrounding areas. Official planning documents give different counts because they use different dates or facility definitions. The National Health Strategic Plan 2020–2023 lists one referral hospital, three district hospitals, 37 health centres, 74 health clinics and 115 government facilities. A 2016 health concept note lists one Tungaru Central Hospital, three other hospitals, 30 health centres and 75 health clinics. These figures describe the planned public network rather than a guaranteed level of service on every island. Access is uneven across the 32 atolls and one raised island. Some outer islands are several days by boat from a hospital, and ship or air connections can be irregular. A local clinic may have only one nurse and limited electricity, water, sterilization equipment, infection-control supplies or communications. Specialist surgery, complex diagnosis and other advanced services are limited nationally, so MHMS may arrange treatment overseas when the required capacity is unavailable. Government health services are documented as free for citizens and residents, and essential medicines and surgical materials are generally free in the government system when prescribed. Availability is not stable across the country because pharmaceutical supply remains a major constraint. Transport, accommodation, overseas referral, private or non-government care and medicines that are unavailable locally can create separate expenses. No general insurance requirement or uniform public waiting-time standard is established in the available national information. Prevention and continuous care have a large role because non-communicable diseases, including diabetes and hypertension, accounted for 54% of deaths in 2019. Public-health work also addresses tuberculosis and other infectious diseases, smoking, nutrition, physical activity, water and sanitation, and environmental health. National figures reported for 2024 show 94% coverage for the third DTP vaccination dose and 47% for the second measles dose; island and population-group differences may be hidden by these national figures. In 2024, 15% of children were reported as stunted. In 2019, 92% of births had a skilled birth attendant and 86% took place in a health facility. For emergencies, 994 is identified as the local ambulance number, while 999 appears as a general emergency number in foreign authorities' information. KIRIMAT is an MHMS emergency medical team trained for outbreaks and health emergencies; it does not replace regular island ambulance or transport services. Sea-ambulance support is planned within the health system, but actual response times depend heavily on the island, weather and available transport. The new Betio Hospital maternity and paediatrics ward opened on 20 October 2025, while the Old Betio Hospital continues or continued to provide outpatient and emergency functions during the transition. Admission is decided by a clinician, and facility-specific visitor or caretaker rules apply. Medicine logistics use mSupply, and Tamanu, a Pacific electronic medical-record system, is being introduced. Earlier records were partly paper-based and fragmented, and data quality and system compatibility remain limited. Telehealth and remote clinical support are included in health-system planning but are not equally available on every island. Follow-up may include monitoring for diabetes or hypertension, continuation of medicines, maternal and postnatal care, child immunization and nutrition checks, and return referral instructions. Rehabilitation and mental-health continuity vary by location. Traditional healers and traditional birth attendants remain functionally relevant in some communities, including through local medicines, massage, antenatal support, delivery support and postnatal care. These practices are often combined with biomedical care, but they are not formally integrated into the health system in the available evidence. MHMS is responsible for policy, financing, staffing, facilities and health delivery; the Ministry of Finance and Economic Development supports financial oversight and planning, while international partners provide technical and infrastructure assistance. Facility-specific rules should be checked because a nationally uniform patient-rights, consent, records, complaint or appeal procedure has not been identified in the reviewed sources.