LAO PEOPLE'S DEMOCRATIC REPUBLIC

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COUNTRY HEALTH INFORMATION PROFILE LAO PEOPLE'S DEMOCRATIC REPUBLIC WESTERN PACIFIC REGION HEALTH BANK, 2011 Revision Demographics 1 Area (1 000 km2) 236.80 2009 1 2 Estimated population ('000s) 6128.00 a 3058.00 a 3070.00 a 2009 est 1 3 Annual population growth rate (%) 2.10 1995-2005 2 4 Percentage of population - 0 4 years - 5 14 years - 65 years and above 14.20 14.40 13.90 2009 est 1 23.70 24.00 23.40 2009 est 1 3.70 3.40 4.10 2009 est 1 5 population (%) 33.20 2010 est 3 6 Crude birth rate (per 1000 population) 30.70 a 2009 est 1 7 Crude death rate (per 1000 population) 8.40 a 2009 est 1 8 Rate of natural increase of population (% per annum) 2.35 b 2009 est 1 9 Life expectancy (years) - at birth - Healthy Life Expectancy (HALE) at age 60 63.90 a 2009 est 1 10 fertility rate (women aged 15 49 years) 3.90 a 2009 est 1 Socioeconomic indicators 11 Adult literacy rate (%) 73.00 2005 2 12 Per capita GDP at current market prices (US$) 914.00 2009 est 1 13 Rate of growth of per capita GDP (%) 7.30 2008 4 14 Human development index 0.50 2010 5 Environmental indicators 15 Health care waste generation (metric tons per year) Communicable and noncommunicable diseases Number of new cases 16 Selected communicable diseases Hepatitis viral - Type A - Type B - Type C - Type E - Unspecified Cholera Dengue/DHF Encephalitis Gonorrhoea Leprosy Malaria Plague Syphilis Typhoid fever 632 0 0 0 2002 6 10 0 0 0 2002 6 61 0 0 0 2002 6 622 0 0 0 2010 7 1272 2002 6 22 929 46 2010 6 50 3 0 0 2010 7 86 66 20 2010 6 22 800 24 2010 6 0 0 0 0 0 0 2010 7 3975 6 2010 7 17 Acute respiratory infections 7176 21 2008 7 - Among children under 5 years 174 COUNTRY HEALTH INFORMATION PROFILES

Communicable and noncommunicable diseases Number of new cases 18 Diarrhoeal diseases 19 604 20 2010 7 - Among children under 5 years 19 Tuberculosis - All forms - New pulmonary tuberculosis (smear-positive) 3848 740 i 2009 6 3034 2009 6 20 Cancers All cancers (malignant neoplasms only) - Breast - Colon and rectum - Cervix - Leukaemia - Lip, oral cavity and pharynx - Liver - Oesophagus - Stomach - Trachea, bronchus, and lung 21 Circulatory All circulatory system diseases - Acute myocardial infarction - Cerebrovascular diseases - Hypertension - Ischaemic heart disease - Rheumatic fever and rheumatic heart diseases 22 Diabetes mellitus 23 Mental disorders 24 Injuries All types - Drowning - Homicide and violence - Occupational injuries - Road traffic accidents - Suicide Leading causes of mortality and morbidity Number of cases Rate per 100 000 population 25 Leading causes of morbidity (inpatient care) 1. Malaria 2. Pnuemonia 3. Gastritis 4. Influenza 5. Diarrhoea 6. 7. 8. 9. 10. 104 434 4083.17 2000 8 18 096 728.00 2000 8 17 132 690.00 2000 8 12 987 523.00 2000 8 12 334 496.49 2000 8 COUNTRY HEALTH INFORMATION PROFILES 175

Rate per 100 000 population 26 Leading causes of mortality 1. Malaria 2. Pneumonia 3. Diarrhoea 4. Heart failure 5. Injury 6. 7. 8. 9. 10. 996 40.09 2000 8 83 3.34 2000 8 34 1.36 2000 8 34 1.36 2000 8 33 1.32 2000 8 Maternal, child and infant diseases 27 Percentage of women in the reproductive age group using modern 36.60 c 2005 9 contraceptive methods 28 Percentage of pregnant women immunized with tetanus toxoid (TT2) 31.00 2010 6 29 Percentage of pregnant women with anaemia 30 Neonatal mortality rate (per 1000 live births) 26.00 2005 9 31 Percentage of newborn infants weighing less than 2500 g at birth 32 Immunization coverage for infants (%) - BCG - DTP3 - Hepatitis B III - MCV2 - POL3 72.00 2010 6 74.00 2010 6 74.00 2010 6 64.00 2010 6 76.00 2010 6 Number of cases 33 Maternal causes - Abortion - Eclampsia - Haemorrhage - Obstructed labour - Sepsis 34 Selected diseases under the WHO-EPI - Congenital rubella syndrome - Diphtheria - Measles - Mumps - Neonatal tetanus - Pertussis (whooping cough) - Poliomyelitis - Rubella - Tetanus 34 2010 6 153 2010 6 7 2010 6 6 2010 6 0 2010 6 31 2010 6 14 2010 6 Health facilities 35 Facilities with HIV testing and counseling services 91 2008 6 176 COUNTRY HEALTH INFORMATION PROFILES

Health facilities Number Number of beds 36 Health infrastructure Public health facilities - General hospitals 20 d 4426 2010 11 - Specialized hospitals - District/first-level referral hospitals - Primary health care centres 3 e 2010 11 130 2010 11 862 2010 11 Private health facilities - Hospitals 0 0 2010 12 - Outpatient clinics 222 2010 11 Health care financing 37 health expenditure - amount (in million US$) - total expenditure on health as % of GDP - per capita total expenditure on health (in US$) 226.75 b 2009p 13 4.10 2009p 13 35.83 b 2009p 13 Government expenditure on health - amount (in million US$) - general government expenditure on health as % of total expenditure on health - general government expenditure on health as % of total general government expenditure External source of government health expenditure - external resources for health as % of general government expenditure on health Private health expenditure - private expenditure on health as % of total expenditure on health - out-of-pocket expenditure on health as % of total expenditure on health Exchange rate in US$ of local currency is: 1 US$ = 43.38 b 2009p 13 19.10 2009p 13 3.80 2009p 13 80.90 2009p 13 61.30 b 2009p 13 8516.04 2009p 13 38 Health insurance coverage as % of total population 9.00 2008 14 39 Human resources for health Public Private Physicians - Number 1283 2005 10 - Ratio per 1000 population 0.23 2005 10 Dentists - Number 83 2005 10 - Ratio per 1000 population 0.02 2005 10 Pharmacists - Number 276 2005 10 - Ratio per 1000 population 0.049 2005 10 Nurses - Number 5 291 f 2005 10 - Ratio per 1000 population 0.93 2005 10 Midwives - Number - Ratio per 1000 population Paramedical staff - Number - Ratio per 1000 population Community health workers - Number 40 Annual number of graduates - Ratio per 1000 population Physicians Dentists Pharmacists 53 2005 10 COUNTRY HEALTH INFORMATION PROFILES 177

Public Private 40 Annual number of graduates Nurses 30 g 2005 10 Midwives Paramedical staff 41 Community health workers Workforce losses/ Attrition Physicians Dentists Pharmacists Nurses Midwives Paramedical staff Community health workers Health-related Millennium Development Goals (MDGs) 42 Prevalence of underweight children under five years of age 37.10 2006 8 43 Infant mortality rate (per 1000 live births) 59.20 a 2009 est 1 44 Under-five mortality rate (per 1000 live births) 80.40 a 2009 est 1 45 Proportion of 1 year-old children immunised against measles 64.00 2010 6 46 Maternal mortality ratio (per 100 000 live births) 405.00 2005 2 47 Proportion of births attended by skilled health personnel 18.50 2005 9 5.70 j 2005 9 12.80 j 2005 9 48 Contraceptive prevalence rate 38.40 2005 9 49 Adolescent birth rate 50 Antenatal care coverage - At least one visit 28.50 2005 9 - At least four visits 51 Unmet need for family planning 52 HIV prevalence among population aged 15-24 years 53 Estimated HIV prevalence in adults 0.20 2007 6, 15 54 Percentage of people with advanced HIV infection receiving ART 100.00 100.00 100.00 2007 15 55 Malaria incidence rate per 100 000 population 369.35 2010 6 56 Malaria death rate per 100 000 population 0.39 2010 6 57 Proportion of population in malaria-risk areas using effective malaria 81.20 2010 6 prevention measures 58 Proportion of population in malaria-risk areas using effective malaria 87.00 2010 6 treatment measures 59 Tuberculosis prevalence rate per 100 000 population 131.00 2009 6 60 Tuberculosis death rate per 100 000 population 12.00 2009 6 61 Proportion of tuberculosis cases detected under directly observed 68.00 2009 6 treatment short-course (DOTS) 62 Proportion of tuberculosis cases cured under directly observed 93.00 2008 6 treatment short-course (DOTS) 63 Proportion of population using an improved drinking water source 57.00 72.00 51.00 2008 16 64 Proportion of population using an improved sanitation facility 53.00 86.00 38.00 2008 16 65 - Percentage of deliveries at home by skilled health personnel (as % of total deliveries) - Percentage of deliveries in health facilities (as % of total deliveries) Proportion of population with access to affordable essential drugs on a sustainable basis 178 COUNTRY HEALTH INFORMATION PROFILES

Notes: est a b c d e f g h i s: 1 2 3 4 5 6 7 8 9 10 Information furnished by National Ministry of Health, Department of Personal and Organization. 11 12 13 14 15 16 Data not available Estimate Results from the Population and Housing Census 2005 Computed by Information, Evidence and Research Unit of the WHO Regional Office for the Western Pacific. Figure refers to married women Figure refers to four central teaching and referral hospitals and 16 district hospitals Figure refers to specialized centres Includes medical assistants Includes only nurses trained at university. Due to a reformulation of the curricula there has not been any graduate from the nursing schools for the past two years Revised data Estimated number of deaths Ministry of Planning, Department of Statistics of Lao PDR [http://www.nsc.gov.la/selected_statistics.htm] National Population Census 2005. National Statistical Centre, 2006 - [http://www.nsc.gov.la/populationcensus2005.htm] Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2008 Revision and World ization Prospects: The 2009 Revision, http://esa.un.org/wup2009/unup/, Monday, June 06, 2011; 9:20:08 PM. Lao PDR Economic Monitor Issue 14, 2009 Human Development Report 2010: The Real Wealth of Nations: Pathways to Human Development. United National Development Programme. [http://hdr.undp.org/en/reports/global/hdr2010/chapters/en/] WHO Regional Office for the Western Pacific, data received from technical units National Centre for Laboratory and Epidemiology, Vientiane 2008 Lao National Health Survey. National Statistical Centre and NIOPH, January 2001. 6a MICS 2006 Lao Reproductive Health Survey 2005. National Statistical Centre 2007. Statistical report, 2010. Department of Planning and Finance, Lao People's Democratic Republic. Information furnished by WR Office in the Lao People's Democratic Republic dated 29 July 2011. National health accounts: country information. Geneva, World Health Organization. Accessed in July 2011 from [http://www.who.int/nha/country/en/index.html] World Bank. Poverty Reduction Support Operation. Vientiane, April 2008 National Centre for HIV/AIDS, Vientiane 2007 Progress on Sanitation and Drinking Water: 2010 Update. World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation (JMP). UNICEF, New York and WHO, Geneva, 2010. [http://www.wssinfo.org/en/welcome.html] COUNTRY HEALTH INFORMATION PROFILES 179