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Comoros is a country with an approximate area of 2 thousand sq. km. (UNO, 2001). The country is an archipelago with four main islands. Its population is 0.79 million, and the sex ratio (men per hundred women) is 101 (UNO, 2004). The proportion of population under the age of 15 years is 42% (UNO, 2004), and the proportion of population above the age of 60 years is 4% (WHO, 2004). The literacy rate is 63.5% for men and 49.1% for women (UNESCO/MoH, 2004).

The country is a low income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 3.1%. The per capita total expenditure on health is 29 international $, and the per capita government expenditure on health is 17 international $ (WHO, 2004). The main language(s) used in the country is (are) French, Arabic and Swahili. The largest ethnic group(s) is (are) Arab, and the other ethnic group(s) are (is) African, Malay-Indonesian and Creole. The largest religious group(s) is (are) Sunni Muslim (five-sixths), and the other religious group(s) are (is) Roman Catholic. The life expectancy at birth is 61.6 years for males and 64.9 years for females (WHO, 2004). The healthy life expectancy at birth is

54 years for males and 55 years for females (WHO, 2004).

EPIDEMIOLOGY

There is a paucity of epidemiological data on mental illnesses in Comoros in internationally accessible literature.

MENTAL HEALTH RESOURCES

Mental Health Policy A mental health policy is absent.

Substance Abuse Policy A substance abuse policy is absent.

National Mental Health Programme A national mental health programme is absent.

National Therapeutic Drug Policy/Essential List of Drugs A national therapeutic drug policy/essential list of drugs is present. It was formulated in 1991.

Mental Health Legislation Details about the mental health legislation are not available.

Mental Health Financing There are no budget allocations for mental health. Details about expenditure on mental health are not available. The primary source of mental health financing is out of pocket expenditure by the patient or family. The country does not have disability benefits for persons with mental disorders. Illness insurance has not been clearly defined by the Government, so benefits are not present.

Mental Health Facilities Mental health is not a part of primary health care system. Actual treatment of severe mental disorders is not available at the primary level. Patients are hospitalized in general hospitals. Regular training of primary care professionals is not carried out in the field of mental health. There are no community care facilities for patients with mental disorders. A centre was created but it is not operational even after 2 years. Patients are cared for by their families.

Psychiatric Beds and Professionals

 

  • Total psychiatric beds per 10 000 population
  • Psychiatric beds in mental hospitals per 10 000 population
  • Psychiatric beds in general hospitals per 10 000 population
  • Psychiatric beds in other settings per 10 000 population
  • Number of psychiatrists per 100 000 population
  • Number of neurosurgeons per 100 000 population
  • Number of psychiatric nurses per 100 000 population
  • Number of neurologists per 100 000 population
  • Number of psychologists per 100 000 population
  • Number of social workers per 100 000 population
  • 0
  • 0
  • 0
  • 0
  • 0
  • 0
  • 0
  • 0.1
  • 0.4
  • 0.15

One mental health student is in training.

Non-Governmental Organizations NGOs are not involved with mental health in the country.

Information Gathering System There is no mental health reporting system in the country. The reporting system has not worked for the last four years. The country has no data collection system or epidemiological study on mental health. A survey had been done in 1998, but it has not been circulated.

Programmes for Special Population There are no special services for any population group.

Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: phenobarbital, chlorpromazine, diazepam. If the drugs are not available in the PNAC they have to be bought from private pharmacies. Haloperidol may be ordered outside the PNAC by doctors. The essential list of drugs is presently being revised. 


Source: World Health Organization Mental Health Atlas