Benin: Benin Health Profile

Africa in the Gulf of Guinea, the Republic of Benin has a people of 7 839 914, with a rate of increase of 3.25 %. The people of Benin is mainly composed of youths, with 49% aged less than 15 years of age. Mean reproduction rate is 5.7 children. The Republic of Benin completed independence since 1960 and has been enjoying a political stability for about decades. Gross domestic product (GDP) per capita was US$314 in 2006. 1/3 of the people lives under poverty line. The economy is based upon agriculture which is a source of gain for 56% of the people. Trade balance is in deficit.

Human development index (HDI) is 0.437; which sets Benin at the 163rd rank out of a total of 177 nations. The rate of poor households is estimated at 52.2%. The country is made up of 12 territorial divisions and 77 local subdivisions.

HEALTH & DEVELOPMENT

General mortality and morbidity: The Republic of Benin is characterized by a high people increase of 3.25%, a decentralisation of the health system and a good distribution of health infrastructure across the country. As a matter of fact, 77% of the people live at less than 5 km from a health establishment, with a low frequenting rate of 44 %. Health financing is mostly provided by households up to 52%. The country is currently in epidemiological transition, with the existence of communicable diseases, the emergence of noncommunicable diseases and the growing relevance of health problems related to the environment.

Maternal and child health: In Benin, maternal, newborn and child health situation is characterized by a slow drop and a permanently high level of mortality and morbidity indicators,notwithstanding a satisfactory provision of maternal, child and adolescent health care. Maternal mortality ratio is estimated at 397 cases of maternal deaths for 100 000 live births in 2006. Nonetheless 9 women out of 10 use antenatal consultation services. About 22 % of childbirths still occur at home, particularly in the north of the country, in rural areas (26 %) and in the poorest households (43%). Needs for satisfactory emergency obstetrical care are still low; that is to say 22.9%. Contraceptive prevalence remains low, that is to say 6.2 % in 2006. Such Practices as female genital mutilations which prove to be harmful to women’s and young girls’ health are still current. Child and adolescent mortality dropped from 166.5 to 125 for 1000 live births during the same period.

 Over 70% of morbidity are attributable to communicable diseases. Malaria remains the prime cause of medical consultation in health establishments (39,7%), followed by acute respiratory infections (13,8%), gastro-intestinal complaints (6,6%) and traumas (5,6%). The mean incidence of critical malaria was 28.6 for 1000 inhabitants in 2006. Mean mortality nationwide is 6.2 for 1000 cases, as regards critical malaria against 14 for 1000 in 2005. 56.3% of children under 5 years of age and 54.8% of pregnant women slept under insecticide-treated mosquito nets in 2008. Even though epidemic cases of measles are sometimes recorded, the in general trend did show a reduction in the number of cases by additional than 60% in 2006-2008, compared with the year 2001. HIV/AIDS prevalence levelled off around 2 % from 2002 to 2005 formerly going down to 1.2 % in 2006. The number of people suffering from AIDS and who are under ARV therapy went up from 500 in 2003 to 9765 as of 31st December 2007.

Tuberculosis incidence is 44 cases for 100 000 inhabitants. The rate of successful therapies is 87 %. The number of Burili ulcer cases went up from 291 in 2000 to 1203 in 20007 Noncommunicable diseases: The major noncommunicable diseases constitute a major concern due to the frequent occurrence thereof and the deaths they cause. Hospital prevalence of cerebrovascular accidents is 13.86 %; that of hypertension is 27.5 % in adults; those of obesity and excess weight are respectively 9.4 % and 20.5 %. Tobacco consumption prevalence is 16 %, that of alcoholism is 2.9 % and that of physical inactivity is 8.3 %. Health and environment: 66 % of households have access to running water. Only 38% of households are equipped with sanitary facilities. Air pollution is high with a daily emission of 83 tons of carbon monoxide in the major towns of the country.

The Republic of Benin is composed of 34 health zones, half of which is functional.

The development of health services is adequate: 77% of the people live at less than 5 km from a health establishment. However, only 44% of this people resort to these health services. The share of the general National budget allocated to the health sector was 11% in 2009. The health sector financing is mainly based upon households up to 52%. There is a shortage of specialists, particularly in health zones and an unequal breakdown of the staff. The health system decentralisation which commenced several years ago is still under way.

OPPORTUNITIES

• * Strong political will
• * Poverty Reduction Strategic Paper
• * National Plan for Health Development 2008-2017
• * Decentralisation of the National resource allocation
• * Existence of initiatives conducive to poverty reduction such as the Poverty Fund, health care to children under 5 years of age and Caesarian section being free of charge
• * Availability of various sources of financing at international level such as the World Alliance for Vaccines and Immunization (GAVI), the World Fund, PMI
• * Better commitment of partners at local level to backing up the country as part of the Paris Declaration
• * Partners coordination mechanisms (UNDAF, UNAIDS, etc.)

CHALLENGES

• * Strengthening health system and enhancing the use thereof through the promotion of Primary Health Care
• * Reducing morbidity and mortality rate particularly in pregnant women and childrenunder 5 years of age
• * Reducing risks and assuring a better management of disasters and emergencies inclunding promoting a healthy environment
• * Assuring good governance and the financing of the sector.
• * Enhancing the consumption level of the resources put at the disposal of the sector
• * Making amount stakeholders adhere to a sectorial approach to health (IHP+/HHA)
• * Enhancing the involvement of civil society organisations and the private sector in the planning, implementation and monitoring/assessment of the activities of the Ministry of Health

In terms of health, the government has continued to implement the national health-development plan adopted in 2007. The aim is to reach the Millennium Development Goals (MDGs). The government has introduced measures to promote the health of mothers and reduce infant mortality. It is as well considering free health care for children under. The infant mortality rate dropped from 91 deaths per thousand live births in 2004 to 84 per thousand live births in 2008. Other measures aimed to improve the supply of pharmaceutical products, the prevention of HIV/AIDS and the fight against malaria and endemic diseases. Free caesarean sections were introduced in 2009. As far as malaria is concerned, the government has continued the activities of the Booster programme and former US President George W. Bush’s malaria initiative. In general, the health indicators show evolution over the completed three years. The attendance rate at health centres rose from 44% in 2006 to 45.6% in 2008, while vaccine coverage rose from 92% in 2006 to 94.2% in 2008. Otherwise, the prevalence rate of HIV/AIDS has dropped part pregnant women. Efforts still need to be made in relation to endemic and epidemic diseases, in particular malaria, which is the cause for 40.5% of consultations at the country’s health centres.

The government has as well looked at water and sanitation. A review of the national water and sanitation programme in May 2008 found that Benin was on target to reach by 2015 the MDG on access to drinking water in rural areas. The supply rate rose from 46.5% in 2007 to 49.9% in 2008. In terms of urban areas, Soneb, the public water utility, has undertaken several projects in secondary towns, with in particular three new wells drilled and the expansion of the drinking-water distribution system. The sector has as well been decentralised. Since January 2008 it has been the job of local authorities to plan next works and mobilise the people with funds made available by the government and several of the country’s development partners.