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Cook Islands has ranked poorly in the Pacific according to a Universal Health Coverage (UHC)
Global Monitoring Report, produced by the World Health Organization (WHO) and the World Bank.
The 2023 report revealed an alarming stagnation in the progress towards providing people everywhere with quality, affordable, and accessible health care.
According to report, Cook Islands is placed third to bottom – behind Niue and Papua New Guinea, in the Sustainable Development Goal (SDG) indicators of universal health coverage by country.
Cook Islands’ service coverage index in 2021, based on the country data from the “latest year available” of 2015, is 46 with Niue on 44 and PNG on 30. New Zealand and Australia are ranked among the highest in the region on 85 and 87 respectively.
The service coverage index tracks progress in 194 countries, measured by 14 key indicators under four headings: reproductive, maternal, newborn and child health; infectious diseases (such as TB and HIV/AIDS); non-communicable diseases and overall health access and capacity.

Professor Heather Worth, director of Te Puna Vai Marama Cook Islands Research Centre, wrote in a letter to the editor,that while the Cook Islands performed reasonably well in maternal and child health, and access to essential medical equipment,the country scored low in the area of non-communicable diseases, particularly in hypertension treatment and diabetes prevention. “The report indicated that we are off-track to make significant progress to universal health coverage. Universal health coverage means that all people can receive quality health services when and where they need it and without incurring financial hardship,”Worth wrote. Secretary of Health Bob Williams said the results reported by the WHO reflect the same concerning trend observed in previous years. He emphasised that the Cook Islands’ current health situation stems from “most people not prioritising their health”. “Some people are worse off with their health due to the lifestyle choices they made which is self-inflicted,”Williams said. “To address the current health situation affecting our people would require a whole of country solution.” To tackle this prevalent issue, Williams stressed the need for “a whole-of-country solution”.
He further highlighted the concerning state of oral health among children, revealed by Te Marae Ora’s healthy island screening programme. “It is for this reason the Healthy and Smoke Free Island initiatives is being rolled out to address the increasing rate of NCDs,the level of physical inactivity and the need to reduce the consumption of sweet and sugar beverages, reduce salt and sugar intake, stop smoking and also reduce the consumption of alcohol.”
Williams also said that Te Marae Ora is finalising its Dietary Guidelines, before it plans to introduce policies and measures on food, and Physical Activity Guidelines to tackle the Cook Islands’ obesity rate.
According to the report, while health service coverage improved since the beginning of the century, progress has slowed since 2015,when the Sustainable Development Goals were adopted.
Notably,there was no improvement from 2019 to 2021,the report said, adding while services for infectious diseases saw significant gains since 2000,there has been little to no improvement in service coverage for noncommunicable diseases and reproductive, maternal, newborn, and child health services in recent years.
“The 2023 UHC Global Monitoring Report serves as a wake-up call to the global community, highlighting the urgent need to prioritise and invest in UHC to ensure that everyone gains access to quality, affordable, and accessible healthcare without suffering financial hardship.”

Wednesday 24 January 2024 | Written by Rashneel Kumar |