MINISTRY OF HEALTH

BRUNEI DARUSSALAM

DEPARTMENT OF POLICY AND PLANNING MINISTRY OF HEALTH BRUNEI DARUSSALAM

Contents
Brunei Darussalam's Vision and Strategies Ministry of Health's Vision and Health Strategies Organisation Structure Geography Demography Population Pyramid Vital Statistics Health Indicators Millennium Development Goals (MDGs) Indicators Health Facilities Distribution Map of Health Care Facilities Human Resource Government Health Expenditure Leading Causes of Death Cancer Cardiovascular Diseases Diabetes Mellitus Hospital Services Hospital Outpatient Morbidity Hospital Inpatient Morbidity Health Services General Outpatient Attendances For Health Centres Health Centres Outpatient Morbidity Notifiable Diseases Renal Services Dental Health Services Nutritional Status Occupational Health Services Road Traffic Accidents Definitions Formulae Contacts Acknowledgements 3 4 5 6 7 8 10 11 12 15 16 17 18 19 21 23 25 26 27 29 31 32 33 36 39 40 41 42 43 46 47 48 49

Brunei Darussalam's Vision and Strategies

WAWASAN BRUNEI 2035

1
Recognised for the accomplishment of its educated and highly skilled people as measured by the highest international standards.

Quality of life that is among the top 10 nations in the world.

A dynamic and sustainable economy with income per capita within the top 10 countries in the world.

Strategies
Education Strategy
To prepare the youth for employment and achievement in a world that is increasingly competitive and knowledgebased.

Economic Strategy
To create new employment for the people and expand business opportunities within Brunei Darussalam through the promotion of investment (foreign and domestic) both in downstream industries as well as in economic clusters beyong the oil and gas

Security Strategy
To safegurad political stability and sovereignty as a nation and link our defence and diplomatic capabilities and our capacity to respond to threats from disease and natural catastrophe.

Institution al Developm ent Strategy

To enhance good governance in both the public and private sectors, high quality public services, modern and pragmatic legal and regulatory frameworks and efficient government procedures that entail a minimum of bureaucratic

Local Business Developm ent Strategy

To enhance opportunities for local Small and Mediumsized Enterprises (SMEs) as well as enable Brunei Malays to achieve leadership in business and industry by developing greater competitive strength.

Infrastructu re Developme nt Strategy

To ensure continued investments by the Government and through public-private sector partnerships in developing and maintaining world-class infrastructure with special emphasis placed on education, health and industry.

Social Security Strategy

To ensure that, as the nation prospers, all citizens are properly cared for.

Environme nt Strategy

To ensure the proper conservation of our natural environment and cultural habitat that will provide health and safety in line with the highest international practices.

Health Information Booklet 2010 | 03

Ministry of Health's Vision and Strategies

04 | Health Information Booklet 2010

Organisation Structure
MINISTER OF HEALTH Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Awang Haji Adanan bin Begawan Pehin Siraja Khatib Dato Seri Setia Awang Haji Mohd Yusof

PERMANENT SECRETARY Dato Paduka Haji Abdul Salam bin Abdul Momin

DEPUTY PERMANENT SECRETARY (PROFESSIONAL AND TECHNICAL) Dr Hajah Norlila bte Dato Paduka Haji Abdul Jalil

DEPUTY PERMANENT SECRETARY (ADMINISTRATION AND FINANCE) Hajah Siti Mariam bte Haji Mohd Jaafar

GENERAL DIRECTOR

DIRECTOR-GENERAL OF MEDICAL SERVICES HEALTH CARE TECHNOLOGY SERVICES (DIRECTOR) HOSPITAL SERVICES RISK MANAGEMENT CENTRE NURSING SERVICES INTERNATIONAL AFFAIRS HUMAN RESOURCE DEVELOPMENT HUMAN RESOURCE MANAGEMENT BUILDING ENGINEERING AND VEHICLE SERVICES POLICY AND PLANNING (DIRECTOR) ADMINISTRATION AND FINANCE (DIRECTOR) ESTATE MANAGEMENT (SENIOR SPECIAL DUTIES OFFICER) HEALTH PROMOTION CENTRE

DIRECTOR-GENERAL OF HEALTH SERVICES

COMMUNITY HEALTH SERVICES

PUBLIC RELATIONS

SCIENTIFIC SERVICES

HEALTH INFORMATICS PHARMACEUTICAL SERVICES BIOMEDICAL ENGINEERING AND MEDICAL PHYSICS

PROJECT DEVELOPMENT ENVIRONMENTAL HEALTH SERVICES

CLINICAL LABORATORY SERVICES

RESEARCH AND DEVELOPMENT

PROCUREMENT AND SUPPLY

QUALITY IMPROVEMENT DENTAL SERVICES

FINANCE AND ACCOUNT

LEGISLATION RENAL SERVICES

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Geography
Brunei Darussalam lies on the northwest coast of Borneo island facing the South China Sea and about 443km north of the equator. With a land area of 5,765 square kilometres, Brunei Darussalam shares a common border with Sarawak, an East Malaysia State, which splits Brunei into two parts; the western part consisting of Brunei-Muara, Tutong and Belait districts while the eastern part is the Temburong district.
CAPITAL ~ BANDAR SERI BEGAWAN AREA ~ 5,765 sq. km DISTRICTS ~ 4 MUKIMS ~ 39 KAMPONGS / LOCALITY ~ 430

HOUSEHOLDS ~ 55,696 (2001 Census) AV. NO. PERSONS PER HOUSEHOLD ~ 6.0

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Demography
Brunei Darussalam conducted the first population census in 1971 and in June 2011, the fifth decennial census of population and housing was conducted by the Department of Economic Planning and Development, Prime Minister's Office. The main purpose of the census was to collect, process, analyse and disseminate information on the demographic, socio-economic and other related characteristics of the the country's population. The data collected through the census will provide the new benchmark for the purpose of review, planning and policy formulation by the Government.

Estimated Population Total Male Female Sex Ratio (in thousands) : (in thousands) : (in thousands) : (M / 100F) : : :

2007 390.0 206.9 183.1 113 68 1.8%

2008 398.0 211.0 187.0 113 69 2.1%

2009 406.2 215.0 191.2 112 70 2.1%

2010 414.4 219.1 195.3 112 72 2.0%

Persons / sq.km Annual rate of increase

Age Structure (in thousands) 0-4 5 - 19 20 - 54 55 - 64 65 & Over Race (in thousands) Malay * Chinese Others District (in thousands) Brunei-Muara Belait Tutong Temburong : : : : 270.3 (69.3%) 64.9 (16.6%) 44.8 (11.5%) 10.0 (2.6%) 276.6 (69.5%) 66.0 (16.6%) 45.3 (11.4%) 10.1 (2.5%) 283.3 (69.7%) 67.1 (16.5%) 45.7 (11.3%) 10.1 (2.5%) 290.1 (70.0%) 68.3 (16.5%) 45.8 (11.1%) 10.2 (2.5%) : : : 259.6 (66.6%) 43.1 (11.0%) 87.3 (22.4%) 265.1 (66.6%) 43.7 (11.0%) 89.2 (22.4%) 269.4 (66.3%) 44.6 (11.0%) 92.2 (22.7%) 273.6 (66.0%) 45.4 (11.0%) 95.4 (23.0%) : : : : : 34.9 (8.9%) 103.7 (26.6%) 223.1 (57.2%) 15.8 (4.1%) 12.5 (3.2%) 35.2 (8.8%) 105.3 (26.5%) 227.1 (57.1%) 17.2 (4.3%) 13.2 (3.3%) 34.7 (8.5%) 106.4 (26.2%) 232.5 (57.2%) 18.8 (4.6%) 13.8 (3.4%) 35.4 (8.5%) 106.5 (25.7%) 237.8 (57.4%) 20.3 (4.9%) 14.4 (3.5%)

Note : * - Including Other Indigenous Groups of the Malay race namely Belait, Bisaya, Brunei, Dusun, Kedayan, Murut or Tutong. Source : Department of Economic Planning and Development, Prime Minister's Office

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Population Pyramid (2010)

85+ 80 - 84 75 - 79 70 - 74

65 - 69

AGE-GROUPS (IN YEARS)

60 - 64 55 - 59 50 - 54 45 - 49 40 - 44 35 - 39 30 - 34 25 - 29 20 - 24 15 - 19 10 - 14 5- 9 0- 4 6 4 2 0 2 4 6

DISTRIBUTION (%)

Total population in 2001 Total population in 2010 Note: Population pyramid shows percentage distribution of population by gender and age-groups. For example, (0 - 4) age-group for the year 2010 is represented with 8.5% of total population in which 4.6% and 3.9% are made up of males and female population respectively.

Population Trend of Brunei Darussalam (1911 - 2010)

450,000 400,000 350,000 300,000

414,400

332,844

260,482
250,000 200,000

192,832 136,256 84,515 1911 21,718 25,451 193130,135 1921 1941 25,451
1921

150,000
100,000 50,000 YEAR 0

1951 45,000

45,000 1961

1971

1981

1991

2001

2010

POPULATION 21,718 Note:

1911

30,135
1931

84,515 136,256 192,832 260,482 332,844 414,400

1951 1961 1971 1981 1991 2001 2010

Data is not available for the year 1941

1941

Source : Department of Economic Planning and Development, Prime Minister's Office

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Population Pyramid by Age-Group, Gender and Residential Status (2001 and 2010)
POPULATION PYRAMID 2001
85+ 80-84

MALE

FEMALE

75-79
70-74 65-69 60-64 55-59

AGE-GROUPS (IN YEARS)

50-54
45-49 40-44 35-39 30-34

25-29
20-24 15-19 10-14 5-9 0-4

12

10

DISTRIBUTION (%)

10

12

Brunei Citizens and Permanent Residents Temporary Residents and Others

POPULATION PYRAMID 2010

85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 12 10 8 6 4 2 0 2 4 6 8 10 12

MALE

FEMALE

AGE-GROUPS (IN YEARS)

DISTRIBUTION (%)

Source : Department of Economic Planning and Development, Prime Minister's Office

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Vital Statistics
2006 Crude Birth Rate (per 1,000 Popn.) General Fertility Rate (per 1,000 Women (15-49)) Total Fertility Rate (per Women (15-49)) Crude Death Rate (per 1,000 Popn.) Infant Mortality Rate (per 1,000 LBs.) Late Fetal Death Ratio (per 1,000 LBs.) Perinatal Mortality Ratio (per 1,000 LBs.) Early Neonatal Mortality Rate (per 1,000 LBs.) Late Neonatal Mortality Rate (per 1,000 LBs.) Neonatal Mortality Rate (per 1,000 LBs.) Post Neonatal Mortality Rate (per 1,000 LBs.) Under 5 Mortality Rate (per 1,000 LBs.) : : : : : : : : : : : : 17.0 58.7 1.8 2.9 6.6 4.6 7.5 2.9 1.8 4.8 1.8 9.2 1 15.3 75.9 77.5 89.0 99.7 (#) 95.8 (#) 91.5 47.6 2007 16.2 55.6 1.7 3.0 7.6 6.3 10.0 3.6 0.8 4.4 3.2 9.5 1 15.8 75.2 77.8 88.5 99.9 (#) 95.8 (#) 91.5 47.3 2008 16.1 55.8 1.7 2.7 7.0 6.4 10.0 3.6 1.2 4.8 2.2 9.5 0 0.0 76.6 79.8 88.9 99.7 (#) 95.8 (#) 91.5 51.3 2009 16.3 56.2 1.7 2.9 7.4 4.8 8.9 4.1 1.2 5.3 2.1 8.2 1 15.1 77.1 78.3 88.8 99.9 (#) 95.8 (#) 91.5 38.4 2010 15.5 53.3 1.6 2.9 6.1 5.5 7.8 2.3 1.7 4.1 2.0 7.3 1 15.6 77.1 (2009) 78.3 (2009) 89.3 99.8 (#) 95.8 (#) 91.5 40.7

Number of Maternal Deaths * : Maternal Mortality Ratio (per 100,000 LBs.) :

Life Expectancy At Birth - Male : - Female : Percentage of Newborns Weighing At Least : 2500g At Birth Percentage of Deliveries by Trained Health : Personnel Literacy Rate (%) (Age 9 yrs +) - Male : - Female : Per Capita GDP at current prices (B$) Thousand Note : Popn. LBs (#) Red text * :

Population Live-births Census in 2001 Millennium Development Goals (MDGs) Indicators as per registered and published by Birth and Death Section, Immigration Department, accounting for misclassifications (if any).

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Health Indicators
The crude birth rate of Brunei Darussalam has declined from 17.0 in 2006 to 15.5 per 1000 population in 2010 and the crude death rate remained at 2.9 per 1000 population in 2010.

CRUDE BIRTH RATE PER 1000 POPULATION (1954 - 2010)

60.0
55.2 56.8

50.0
43.6

40.0

37.4

37.0

33.2

32.4 29.9

30.7 27.7 25.9 23.9

30.0

21.7 17.0 15.5

20.0

10.0

0.0

1966

2002

1954

1958

1962

1970

1974

1978

1982

1986

1990

1994

1998

2006

CRUDE DEATH RATE PER 1000 POPULATION (1954 - 2010)

14.0
12.7 11.8

12.0

10.0

8.0
6.9 6.0 5.5 4.2 4.2

6.0

4.0

3.9 3.2 3.0 3.2 3.0 3.0 2.9 2.9

2.0

0.0

1966

1994

1954

1958

1962

1970

1974

1978

1982

1986

1990

1998

2002

2006

Health Information Booklet 2010 | 11

2010

2010

Millennium Development Goals (MDGs) Indicators

Millennium Development Goal 4 (MDG4) is concerned with reducing by two-thirds the under-five mortality rate between 1990 and 2015. Under-five mortality rate is directly attributable to two other indicators namely infant mortality rate and proportion of 1 year-old children immunised against measles.
INFANT MORTALITY RATE PER 1000 LIVEBIRTHS (1946 - 2010)
180.0
161.1

160.0 140.0 120.0 100.0 80.0 60.0 40.0 20.0 0.0

50.8 42.3 33.8 22.7 20.0 12.8 93.6 88.9 137.7

10.0

7.4

8.4

6.5

8.3

6.6

6.1

1966

1990

1946

1950

1954

1958

1962

1970

1974

1978

1982

1986

1994

1998

2002

2006

Brunei Darussalam's infant mortality rate has reached a steady state since 1990 and is on par with figures in developed nations. Infant mortality rate has declined rapidly from 50.8 per 1000 livebirths in 1962 to 6.1 per 1000 livebirths in 2010.
TRENDS IN EARLY NEO-NATAL, LATE NEO-NATAL, POST NEO-NATAL AND INFANT MORTALITY RATES (PER 1,000 LIVE-BIRTHS ) (1978 - 2010 )
25.0

MORTALITY RATE (PER 1,000 LIVEBIRTHS)

20.0

Note :

15.0

7.9

1.2

Post NeoNatal (28-365 days) 5.2 4.2 Late NeoNatal (7-27 days) 2.0 1.7 2.4 Early NeoNatal (0-6 days)

10.0

Infant Mortality Rate

5.0

10.9

2.2

0.4 5.4

2.1 1.4

3.3 1.8 1.5 3.6 1.9 2.8

3.1

1.9
1.6 3.6 1.9 2.8

5.4

3.9

0.0 1978 1982 1986 1990 1994 1998 2002 2006 2010

12 | Health Information Booklet 2010

2010

Millennium Development Goals (MDGs) Indicators

Under-5 mortality rate has gradually reduced from 30 deaths per 1000 livebirths in 1976 to 7.3 deaths per 1000 livebirths in 2010.

Maternal and Child Health (MCH) services in Brunei Darussalam have contributed to the reduction in under-5 mortality. The MCH Service, a major primary health care services in Brunei Darussalam, has gone through rapid expansion. It is widely distributed and easily accessible in all four districts. Remote areas are served by the flying medical team. The objective is to provide optimum health care to all children below the age of 5 and all pregnant women throughout their antenatal and postnatal periods. MCH Service includes antenatal care, postnatal care, child-health care, well-woman clinic and health education, treatment of minor ailments, domiciliary care and home nursing.
35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1976 1980 1984 1988 1992 1996 2000 2004 2008 2010
30.0

UNDER-5 MORTALITY RATE PER 1000 LIVEBIRTHS (1976 - 2010)

22.7 16.0 9.2 11.7 9.0 10.3 9.8 9.5

7.3

LEADING CAUSES OF UNDER 5 MORTALITY IN BRUNEI DARUSSALAM (2006 - 2010)

2006 2007 2008 2009 2010
Congenital Malformations, Congenital Malformations, Certain Conditions Certain Conditions Certain Conditions Deformations and Deformations and Originating In The Perinatal Originating In The Perinatal Originating In The Perinatal Chromosomal Chromosomal Period Period Period Abnormalities Abnormalities 21 22 20 26 18

Congenital Malformations, Congenital Malformations, Congenital Malformations, Certain Conditions Certain Conditions Deformations and Deformations and Deformations and Originating In The Perinatal Originating In The Perinatal Chromosomal Chromosomal Chromosomal Period Period Abnormalities Abnormalities Abnormalities 14 18 Cancer 1 Anaemias 1 Heart Diseases 1 Influenza & Pneumonia 1 Acute Bronchitis and Bronchiolitis 1 19 Influenza & Pneumonia 4 Accidental Drowning and Submersion 4 Heart Diseases 3 Septicaemia 1 Cancer 1 Cerebrovascular Diseases 1 8 61 17 Heart Diseases 2 Septicaemia 1 Acute Upper respiratory Infection 1 Influenza & Pneumonia 1 Falls 1 Accidental Drowning and Submersion 1 4 54 16 Septicaemia 1 Cancer 1 Heart Diseases 1 Cerebrovascular Diseases 1 Bronchitis, Chronic & Unspecified Emphysema & Asthma 1

3 4

Cancer 4 Heart Diseases 3

Influenza & Pneumonia 3

Transport Accidents 2 Septicaemia 1

8 OTHERS ** TOTAL

Human Immunodeficiency Diseases of Musculoskeletal Virus (HIV) Diseases System and Connective Tissue 1 1 11 60 14 60

*
0 8 47

Note :

* - No other single cause of death. ** - Remainders.

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Millennium Development Goals (MDGs) Indicators

MDG5 is concerned with improving maternal health. The targets are to (i) reduce maternal mortality ratio by three quarters between 1990 and 2015 and improve health care in terms of attention during delivery; and (ii) achieve universal access to reproductive health. Brunei Darussalam continues to provide excellent Maternal and Child Health services including antenatal care, skilled care during childbirth including emergency obstetric care and postnatal care thorughout the country as to maintain low levels of maternal mortality which is comparable to other developed countries.
NUMBER OF MATERNAL DEATHS AND MATERNAL MORTALITY RATIO PER 100,000 LIVEBIRTHS (1960 - 2010)
600.0 40
487.2

MATERNAL MORTALITY RATIO PER 100,000 LIVEBIRTHS

30 400.0 25

300.0

20
15
20

200.0
95.7 40.7 4 2 4 5 4 79.9 94.3

10
69.2
47.4 3 0.0 0.0 13.1 1 26.7 2 14.0 1 0.0

100.0

0.0

15.6 1

5 0

1960

1964

1968

1972

1976

1980

1984

1988

1992

1996

2000

2004

2008

2010

Almost all deliveries in Brunei Darussalam are attended by skilled health personnel who can supervise, provide care and advice to women during pregnancy, labour and the postpartum period. They also conduct deliveries and care for the newborn child.
PERCENTAGE OF DELIVERIES AT HOSPITALS AND BY SKILLED HEALTH PERSONNEL (1996 - 2010)
100.0
99.6 99.0 98.0 99.0 99.0 99.6 99.4 99.4 99.6 99.7 99.7 99.9 99.7

99.9

99.8

99.0
98.0

97.0
PERCENTAGE 96.0 95.0 94.0 93.0 92.0 91.0 90.0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
98.3 99.0 98.7 99.1 99.2 99.4 99.4 99.4 99.4 99.6

99.6

99.9

99.7

99.8

99.8

% of deliveries in health facilities (as % of total deliveries)

% of births attended by skilled health personnel

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NUMBER OF MATERNAL DEATHS

500.0

35

Health Facilities (2010)

MEDICAL CARE HOSPITALS ( 4 GOVERNMENTS + 2 PRIVATES (1) ) MEDICAL CENTRES (Ministry of Defence) DIALYSIS CENTRES DENTAL CLINICS: GOVERNMENTS ARMY PRIVATES 20 7 10 NUMBER

6 9 (2) 5

HEALTH SERVICES HEALTH CENTRES ( 15 GOVERNMENTS + 1 PRIVATE (4) ) HEALTH/MATERNAL AND CHILD HEALTH CLINICS TRAVELLING HEALTH CLINICS FLYING MEDICAL SERVICES

16 15 4 4

DENTAL SERVICES

DENTAL SERVICES AT: HOSPITALS / NATIONAL DENTAL CENTRE HEALTH CENTRES HEALTH CLINICS STATIC SCHOOL CLINICS MOBILE SQUAD TRAVELLING (FLYING TEAM) 5 11 7 39 11 4

Note : (1) (2) (3)

Jerudong Park Medical Centre and Gleneagles Park Centre Including Air Forces Medical Clinic Panaga Health Centre

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Distribution Map of Health Care Facilites

The following two directorates under the Ministry of Health are responsible for delivery of health - Community

Muara HC Berakas 'B' HC Bandar Seri Begawan HC RIPAS HOSPITAL

Gadong HC JERUDONG PARK MEDICAL CENTRE GLENEAGLES JPMC Jubli Perak HC Tutong HC PENGIRAN MUDA MAHKOTA PENGIRAN MUDA HAJI AL-MUHTADEE BILLAH HOSPITAL

Berakas 'A' HC

Sg Kelugos HC

PAPHRSB HC Jubli Emas HC

Sg Liang HC

Telisai HC
Lamunin HC

PIHM HOSPITAL

SURI SERI BEGAWAN HOSPITAL

Seria HC Panaga HC

Kuala Belait HC

Legends Hospital Health Centre

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Human Resource in Health

Human Resources for Health for 2010 Male Doctors (1) Local Foreign Local Foreign TOTAL Population per Doctor Male Dentists (1) Local Foreign Local Foreign TOTAL Population per Dentist Male Pharmacists (2) Local Foreign Local Foreign TOTAL Population per Pharmacist Nurses (3) (including Dental Nurses and Midwives) Population per Nurse Male Midwives Female TOTAL Population per Midwive Sources: (1) (2) (3) 0 502 502 0 6 6 816 508 Male Female TOTAL 419 1,717 2,136 54 209 263 173 2,399 4 1 24 0 29 1 0 7 6 14 5 1 31 6 43 9,637 8 22 29 11 70 6 8 1 1 16 14 30 30 12 86 4,819 6 Government 61 226 94 114 495 Private 11 30 9 18 68 72 256 103 132 563 736 44 Total 328

Female

235

Female

42

Female

37

Brunei Medical Board Pharmacy Department Nursing Board

11,000 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 2006 Population per Doctor 2007 Population per Dentist 2008 2009 2010 Population per Nurse Population per Pharmacist

POPULATION RATIO

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Government Health Expenditure

2008/09 Total Health Budget (B$ Millions) Health Budget as % of National Budget Per Capita Health Budget ( B$ ) Health Budget as % of GDP Total Health Expenditure (B$ Millions) Health Expenditure as % of Government Expenditure Per Capita Health Expenditure (B$) Health Expenditure as % of GDP Note: GDP Source: (Budget) (Expenditure) - Gross Domestic Product - Not available - Budget Section, Ministry of Finance - Ledger Section, Treasury Department 264.44 7.08 664 1.30 322.13 8.41 809 1.58 2009/10 286.82 7.29 706 1.84 317.40 7.07 781 2.03 2010/11 295.41 7.48 713 1.75 318.7 769 1.89

330 320 310 300 290 B$Million 280 270 260 250 240 230 220 210 200 2005

Year 2003 2004 2005 2006 2007 2008 2009 2010 2011

BUDGET 225.46 233.32 240.86 244.33 259.72 264.44 286.82 295.41 306.85

EXPENDITURE 290.15 262.93 275.39 254.68 294.82 322.13 317.40 318.70 0.00

BUDGET

EXPENDITURE

2006

2007

2008

2009

2010

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Leading Causes of Deaths for the Year 2010 (Based on ICD-10)

The four leading causes of deaths which accounted for 50 percent of the total deaths were comprised of Non-Communicable Diseases namely Cancer, Heart Diseases, Diabetes Mellitus and Cerebrovascular Diseases.

No.

ICD-10

TYPE OF DISEASE

MALE

FEMALE

TOTAL

RATE PER 100,000 POPN.

C00 - C97

Cancer (Malignant Neoplasms)

134

118

252

20.9

60.8

I00 - I09, I20 - I52

Heart Diseases (Including Acute Rheumatic Fever)

121

65

186

15.4

44.9

E10 - E14

Diabetes Mellitus

59

41

100

8.3

24.1

I60 - I69

Cerebrovascular Diseases

45

54

99

8.2

23.9

J40 - J46

Bronchitis, Chronic & Unspecified Emphysema & Asthma

24

23

47

3.9

11.3

A40 - A41

Septicaemia

26

13

39

3.2

9.4

I10 - I15

Hypertensive Diseases

19

19

38

3.1

9.2

J10 - J18

Influenza and Pneumonia

15

13

28

2.3

6.8

V01 - V99

Transport Accidents Congenital Malformations, Deformations and Chromosomal Abnormalities Others

20

25

2.1

6.0

10

Q00 - Q99

11

10

21

1.7

5.1

196

177

373

30.9

90.0

ALL DEATHS

670

538

1,208

100.0

291.5

Health Information Booklet 2010 | 19

Leading Causes of Deaths (2006 - 2010)

No. 2006 2007 2008 Heart Diseases (Including Acute Rheumatic Fever) 211 (19.3%) Cancer (Malignant Neoplasms) 201 (18.4%) Diabetes Mellitus 97 (8.9%) Cerebrovascular Diseases 93 (8.5%) Influenza and Pneumonia 53 (4.9%) 2009 2010

Cancer (Malignant Neoplasms) 220 (20.1%)

Cancer (Malignant Neoplasms) 215 (18.3%) Heart Diseases (Including Acute Rheumatic Fever) 177 (15.1%) Diabetes Mellitus 140 (11.9%) Cerebrovascular Diseases 87 (7.4%)

Cancer (Malignant Neoplasms) 215 (18.4%) Heart Diseases (Including Acute Rheumatic Fever) 185 (15.8%) Diabetes Mellitus 100 (8.5%) Cerebrovascular Diseases 97 (8.3%)

Cancer (Malignant Neoplasms) 252 (20.9%) Heart Diseases (Including Acute Rheumatic Fever) 186 (15.4%) Diabetes Mellitus 100 (8.3%) Cerebrovascular Diseases 99 (8.2%) Bronchitis, Chronic and Unspecified Emphysema & Asthma 47 (3.9%)

Heart Diseases (Including Acute Rheumatic Fever) 188 (17.2%)

Diabetes Mellitus 116 (10.6%)

Cerebrovascular Diseases 102 (9.3%)

Hypertensive Diseases Hypertensive Diseases

Septicaemia

52 (4.7%)

57 (4.9%)

52 (4.4%)

Bronchitis, Chronic Bronchitis, Chronic Bronchitis, Chronic and Unspecified Transport Accidents and Unspecified and Unspecified Emphysema & Asthma Emphysema & Asthma Emphysema & Asthma 48 (4.4%) 55 (4.7%) 39 (3.6%) 43 (3.7%)

Septicaemia

39 (3.2%)

Transport Accidents

Bronchitis, Chronic and Unspecified Transport Accidents Emphysema & Asthma 51 (4.3%) Influenza and Pneumonia 35 (3.0%) Septicaemia 25 (2.1%) Congenital Malformations, Deformations and Chromosomal Abnormalities 23 (2.0%) 309 (26.3%) 1,174 (100.0%) 33 (3.0%) Septicaemia 32 (2.9%) Hypertensive Diseases 24 (2.2%) Certain Conditions Originating In The Perinatal Period 20 (1.8%) 288 (26.4%) 1,091 (100.0%)

Hypertensive Diseases Hypertensive Diseases

39 (3.6%) 8 Influenza and Pneumonia 37 (3.4%) 9 Certain Conditions Originating In The Perinatal Period 21 (1.9%) Congenital Malformations, Deformations and Chromosomal Abnormalities 17 (1.6%) OTHERS GRAND TOTAL 255 (23.3%) 1,095 (100.0%)

41 (3.5%) Transport Accidents 37 (3.2%) Certain Conditions Originating In The Perinatal Period 26 (2.2%) Congenital Malformations, Deformations and Chromosomal Abnormalities 25 (2.1%) 350 (29.9%) 1,171 (100.0%)

38 (3.1%) Influenza and Pneumonia 28 (2.3%) Transport Accidents 25 (2.1%) Congenital Malformations, Deformations and Chromosomal Abnormalities 21 (1.7%) 373 (30.9%) 1,208 (100.0%)

10

20 | Health Information Booklet 2010

Mortality due to Cancer for the Year 2010

The top three causes of cancers among male in Brunei Darussalam for 2010 were Trachea, Bronchus and Lung; Liver and Intrahepatic Bile Ducts; and Lip, Oral cavity and Pharynx and for female cancer deaths were Breast; Trachea, Bronchus and Lung; and Liver and Intrahepatic Bile Ducts.

TYPE OF CANCER Trachea, Bronchus and Lung Liver and Intrahepatic Bile Ducts Breast Lip, Oral Cavity and Pharynx Rectum and Anus Colon Meninges, Brain and Other Parts of Central Nervous System Multiple Myeloma and Malignant Plasma Cell Neoplasms Non-Hodgkin's Lymphoma Stomach Prostate Cervix Uteri Pancreas Oesophagus Other and Unspecified Parts of Uterus Ovary Leukaemia Remainder TOTAL

MALE 27 18 1 13 12 11 7 5 2 5 7

FEMALE 18 8 21 7 6 4 2 4 7 3

TOTAL 45 26 22 20 18 15 9 9 9 8 7

7 4 2 0 2 3 5 5 2 18 134 2 14 118

7 6 5 5 5 4 32 252

YEAR TOTAL NO. OF CANCER DEATHS

2006 220

2007 215

2008 201

2009 215 104 97

118

2010 252 134 118

NUMBER OF CANCER DEATHS BY GENDER (2006-2010) MALE 118 108 117 FEMALE 97 112 98
140 120 NUMBER OF DEATHS 100 80 60 40 118 112 97 108 117 98 104 97 134

20
0 2006 2007 2008 2009 2010

FEMALE MALE

Health Information Booklet 2010 | 21

Trend in Leading Cancer Deaths in Brunei Darussalam (2006 - 2010)

No. 2006 2007 2008 2009 2010

Trachea, Bronchus and Trachea, Bronchus and Trachea, Bronchus and Trachea, Bronchus and Trachea, Bronchus and Lung Lung Lung Lung Lung 39 (17.7%) 50 (23.3%) Rectum and Anus 21 (9.8%) Stomach 20 (9.3%) Liver and Intrahepatic Bile Duct 16 (7.4%) Breast 13 (6.0%) Cervix Uteri 10 (4.7%) Colon 8 (3.7%) Pancreas 8 (3.7%) Meninges, Brain and Other Parts of Central Nervous System 8 (3.7%) Lip, Oral Cavity and Pharynx 7 (3.3%) 54 (25.1%) 215 (100.0%) 50 (24.9%) 37 (17.2%) 45 (17.9%)

Breast 20 (9.1%)

Liver and Intrahepatic Liver and Intrahepatic Liver and Intrahepatic Bile Duct Bile Duct Bile Duct 14 (7.0%) Cervix Uteri 13 (6.5%) Stomach 12 (6.0%) Colon 11 (5.5%) Rectum and Anus 11 (5.5%) Breast 8 (4.0%) Leukaemia 7 (3.5%) Pancreas 6 (3.0%) Meninges, Brain and Other Parts of Central Nervous System 6 (3.0%) 63 (31.3%) 201 (100.0%) 24 (11.2%) Cervix Uteri 14 (6.5%) Colon 13 (6.0%) Stomach 10 (4.7%) Prostate 9 (4.2%) Non-Hodgkin's Lymphoma 9 (4.2%) Rectum and Anus 9 (4.2%) Leukaemia 8 (3.7%) Breast 8 (3.7%) 74 (34.4%) 215 (100.0%) 26 (10.3%) Breast 22 (8.7%) Lip, Oral Cavity and Pharynx 20 (7.9%) Rectum and Anus 18 (7.1%) Colon 15 (6.0%) Meninges, Brain and Other Parts of Central Nervous System 9 (3.6%) Multiple Myeloma and Malignant Plasma Cell Neoplasms 9 (3.6%) Non-Hodgkin's Lymphoma 9 (3.6%) Stomach 8 (3.2%) 71 (28.2%) 252 (100.0%)

Lip, Oral Cavity and Pharynx 16 (7.3%)

Rectum and Anus 16 (7.3%)

Colon 13 (5.9%)

Liver and Intrahepatic Bile Duct 12 (5.5%)

Stomach 11 (5.0%)

Ovary 10 (4.5%)

Pancreas 9 (4.1%)

10

Cervix Uteri 9 (4.1%)

OTHERS GRAND TOTAL

65 (29.5%) 220 (100.0%)

22 | Health Information Booklet 2010

Mortality due to Cardiovascular Diseases for the Year 2010 (Based on ICD-10)
AGE-GROUP IN YEARS ICD-10 CODE TYPE OF DISEASES M 1 i ii I00 - I09, I20 - I52 I00 - I09 I20 - I25 I21 I20, I22 - I25 iii 2 3 4 I26 - I52 I10 - I15 I60 - I69 I70 - I98 I70 I71 - I98 1 to 4 I00 - I98 Heart Diseases Acute Rheumatic Fever & Chronic Rheumatic Heart Diseases Ischaemic Heart Diseases Acute Myocardial Infarction Other Ischaemic Diseases Diseases of Pulmonary Circulation & Other Forms of Heart Diseases Hypertensive Diseases Cerebrovascular Diseases Other Diseases of the Circulatory System Atherosclerosis Others All Cardiovascular Diseases All Causes of Mortality 6 0 3 1 2 3 0 2 0 0 0 8 90 <35 F 5 0 2 2 0 3 0 2 1 0 1 8 56 35 - 44 M 14 0 10 8 2 4 2 3 1 0 1 20 55 F 2 0 2 2 0 0 3 5 0 0 0 10 34 45 - 54 M 15 0 15 13 2 0 5 4 1 0 1 25 76 F 2 0 0 0 0 2 2 2 0 0 0 6 43 55 - 64 M 32 0 27 20 7 5 6 9 0 0 0 47 118 F 7 0 5 4 1 2 2 9 1 0 1 19 74 65 - 74 M 20 0 15 10 5 5 1 11 1 0 1 33 127 F 24 0 17 13 4 7 2 5 0 0 0 31 112 M 34 0 27 15 12 7 5 16 3 0 3 58 204 75+ F 25 1 14 7 7 10 10 31 4 0 4 70 219 M 121 0 97 67 30 24 19 45 6 0 6 191 670 TOTAL F 65 1 40 28 12 24 19 54 6 0 6 144 538 T 186 1 137 95 42 48 38 99 12 0 12 335 1,208

Health Information Booklet 2010 | 23

Mortality Trend of Cardiovascular Diseases

MORTALITY DUE TO CARDIOVASCULAR DISEASES BY GENDER (2002 - 2010)
400 350 300 NUMBER OF DEATHS 153 250 200 150 100 50 0 2002 2003 2004 MALE 2005 2006 2007 2008 FEMALE 2009 2010 188 192 196 197 191 160 159 134 127 137 139 158 144

175

170

183

175

MORTALITY DUE TO HEART, HYPERTENSIVE AND CEREBROVASCULAR DISEASES (2001 - 2010)

250

200

NUMBER OF DEATHS

150

100

50

0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Heart Diseases

Hypertensive Diseases

Cerebrovascular Diseases

24 | Health Information Booklet 2010

Morbidity and Mortality due to Diabetes Mellitus for the Year 2010
AGE-GROUP IN YEARS 0-14 M F M 15-44 F M 45-64 F M 65+ F Unknown Age M F M TOTAL F TOTAL

OUTPATIENT MORBIDITY *

193

252

368

522

176

159

742

942

1,684

INPATIENT MORBIDITY *

61

86

133

138

89

96

286

328

614

MORTALITY

30

11

28

28

59

41

100

Note: * -

Hospital Morbidity only

MORBIDITY AND MORTALITY DUE TO DIABETES MELLITUS (2006 - 2010)

1800 1600 1400 1200 1000

800
600 400 200 0 2004 2005 2006 2007 2008 2009 Mortality 2010

Outpatient Morbidity

Inpatient Morbidity

Health Information Booklet 2010 | 25

Hospital Services
The Department of Medical Services is responsible for the delivery of hospital services in all four districts.
ACTIVITIES FOR THE YEAR 2010 OUTPATIENT ACTIVITIES General Outpatient Attendances Accident & Emergency Outpatient Attendances Specialist Outpatient Attendances INPATIENT ACTIVITIES Available Beds Admissions Discharges & Deaths Patient Days Day Patients PERFORMANCE INDICES Average Number of Inpatients / Day % Occupancy Average Duration of Stay (Days) Average Turnover of Patients / Bed Average Turnover Interval (Days) Note: N/A - Not Available GENERAL OUTPATIENT AND A&E ATTENDANCES AND ADMISSIONS BY DISTRICT HOSPITALS (2006 - 2010) 396 67 4.8 51 2.4 110 50 5.6 32 5.7 33 31 3.9 29 8.7 7 21 2.6 29 9.8 546 57 4.8 43 3.6 591 30,027 30,020 144,552 55,124 222 7,341 7,207 40,224 7,133 106 3,227 3,076 11,956 N/A 32 1,101 940 2,461 252 951 41,696 41,243 199,193 62,509 129,452 274,060 50,025 25,174 157,599 29,386 49,183 18,484 4,960 11,555 68,509 188,972 492,397 RIPAS SSB PMMPMHAMB PIHM TOTAL

120 110 100 90 80 70 60 50 40 30 20 10 0

Admissions Admissions Admissions Admissions General Outpatient and A&E Attendances General Outpatient and A&E Attendances General Outpatient and A&E Attendances

Thousands

RIPAS SSB PMMPMHAMB PIHM

General Outpatient and A&E Attendances

2006

2007

2008

2009

26 | Health Information Booklet 2010

General Outpatient and A&E Attendances 2010

Admissions

Hospital Outpatient Morbidity for the Year 2010 ( A&E + GOPD)

No. ICD-10 DISEASES MALE FEMALE TOTAL %

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

J00-J06 A09 J40-J46 L00-L99 W00-W19 R10 H10 I10-I15 V01-V99 J10-J11 E10-E14 M10 B01 K00-K08 T78.4

Acute Upper Respiratory Infection Gastroenteritis/ Diarrhoea Bronchitis, Chronic & Unspecified Emphysema & Asthma Diseases of Skin & Subcutaneous Tissue Falls Abdominal and Pelvic Pain Conjunctivitis Hypertensive Diseases Transport Accident Influenza Diabetes Mellitus Gout Chickenpox Diseases of Teeth & Supporting Structures Allergy, Unspecified Others GRAND TOTAL

28,976 7,496 5,704 4,131 4,106 2,811 2,554 1,867 2,203 1,064 742 1,337 667 735 580 65,224 130,197

28,842 6,649 4,685 4,336 2,899 3,841 2,150 2,348 1,167 907 942 188 647 509 660 57,165 117,935

57,818 14,145 10,389 8,467 7,005 6,652 4,704 4,215 3,370 1,971 1,684 1,525 1,314 1,244 1,240 122,389 248,132

23.3 5.7 4.2 3.4 2.8 2.7 1.9 1.7 1.4 0.8 0.7 0.6 0.5 0.5 0.5 49.3 100.0

Note: A & E - Accident & Emergency GOPD - General Outpatient Department

Health Information Booklet 2010 | 27

Leading Causes of Hospital Outpatient Morbidity (2006 - 2010)

No. 2006 2007 2008 2009 2010

Acute Upper Acute Upper Acute Upper Acute Upper Acute Upper Respiratory Infections Respiratory Infections Respiratory Infections Respiratory Infections Respiratory Infections 56,709 (31.2%) Bronchitis, Chronic & Unspecified Emphysema & Asthma 9,269 (5.1%) Gastroenteritis and Diarrhoea 7,987 (4.4%) 61,701 (30.7%) Gastroenteritis and Diarrhoea 10,084 (5.0%) Bronchitis, Chronic & Unspecified Emphysema & Asthma 9,656 (4.8%) Diseases of Skin & Subcutaneous Tissue 6,921 (3.4%) 62,547 (30.1%) Bronchitis, Chronic & Unspecified Emphysema & Asthma 9,722 (4.7%) Gastroenteritis and Diarrhoea 8,455 (4.1%) Diseases of Skin & Subcutaneous Tissue 7,101 (3.4%) Falls 5,518 (2.7%) 68,249 (31.8%) Gastroenteritis and Diarrhoea 9,339 (4.4%) 57,818 (23.3%) Gastroenteritis and Diarrhoea 14,145 (5.7%)

Bronchitis, Chronic & Bronchitis, Chronic & Unspecified Unspecified Emphysema & Asthma Emphysema & Asthma 9,177 (4.3%) Diseases of Skin & Subcutaneous Tissue 6,448 (3.0%) Falls 5,139 (2.4%) 10,389 (4.2%) Diseases of Skin & Subcutaneous Tissue 8,467 (3.4%) Falls 7,005 (2.8%)

Diseases of Skin & Subcutaneous Tissue 6,281 (3.5%)

Abnominal and Pelvic Abnominal and Pelvic Pain Pain 5,287 (2.9%) 5,595 (2.8%) Falls 4,536 (2.3%)

Conjunctivitis 4,440 (2.4%)

Abnominal and Pelvic Abnominal and Pelvic Abnominal and Pelvic Pain Pain Pain 5,088 (2.4%) 4,287 (2.0%) 6,652 (2.7%) Conjunctivitis 4,704 (1.9%) Hypertensive Diseases 4,215 (1.7%) Transport Accidents 3,370 (1.4%) Influenza 1,971 (0.8%) 129,396 (52.1%) 248,132 (100.0%)

Falls 3,801 (2.1%)

Hypertensive Diseases Hypertensive Diseases Hypertensive Diseases 4,007 (2.0%) Conjunctivitis 3,555 (1.8%) Influenza 1,916 (1.0%) Transport Accidents 1,803 (0.9%) 91,288 (45.4%) 201,062 (100.0%) 4,309 (2.1%) Conjunctivitis 3,251 (1.6%) Transport Accidents 1,972 (0.9%) Influenza 1,576 (0.8%) 98,388 (47.3%) 207,927 (100.0%) 4,258 (2.0%) Conjunctivitis 3,582 (1.7%) Influenza 2,718 (1.3%) Transport Accidents 2,361 (1.1%) 99,072 (46.2%) 214,630 (100.0%)

Hypertensive Diseases 3,173 (1.7%)

Transport Accidents 1,593 (0.9%)

10

Influenza 1,471 (0.8%)

OTHERS GRAND TOTAL

81,593 (44.9%) 181,604 (100.0%)

28 | Health Information Booklet 2010

Hospital Inpatient Morbidity for the Year 2010

NO ICD-10 TYPE OF DISEASES Diarrhoea and Gastroenteritis of Presumed Infectious Origin Acute Upper Respiratory Infections Acute Lower Respiratory Infections Pregnancy With Abortive Outcome Non-Inflammatory Disorders of Female Genital Tract Asthma Maternal Diseases Classifiable Elsewhere but Complicating Pregnancy, Childbirth and The Puerperium (Indirect Obstetric Causes) Hypertensive Diseases Fever of Unknown Origin Diabetes Mellitus Abdominal and Pelvic Pain 369 447 286 207 505 MALE FEMALE TOTAL %

1 2 3 4 5 6

A09 J00-J06 J10-J22 O00-O08 N80-N98 J45-J46

749 627 637

612 602 538 1,113 1,111 413

1,361 1,229 1,175 1,113 1,111 918

3.7 3.3 3.2 3.0 3.0 2.5

O98-O99

787

787

2.1

8 9 10 11

I10-I15 R50 E10-E14 R10

402 320 328 338

771 767 614 545

2.1 2.1 1.7 1.5

S02, S12, S22, S32, S42, S52, S72, S82, 12 S92, T02, T08, T10, T12 13 14 15 I00-I09, I20-I52 W00-W19 D50-D64

Fractures Of Specified and Multiple Body Regions

306

154

460

1.3

Heart Diseases Falls Iron Deficiency Anaemias Others GRAND TOTAL

284 267 172 8,250 13,106

174 171 179 16,371 23,613

458 438 351 24,621 36,719

1.2 1.2 1.0 67.1 100.0

Health Information Booklet 2010 | 29

Leading Causes of Hospital Inpatient Morbidity (2006 - 2010)

No. 1 2006
Asthma

2007
Acute Lower Respiratory Infections

2008
Acute Lower Respiratory Infections

2009
Acute Lower Respiratory Infections

2010
Diarrhoea and Gastroenteritis of Presumed Infectious Origin

1,051 (2.8%) 2
Diabetes Mellitus

1,226 (3.2%)
Diarrhoea and Gastroenteritis of Presumed Infectious Origin

1,201 (3.2%)
Pregnancy With Abortive Outcome

1,227 (3.4%)
Pregnancy With Abortive Outcome

1,361 (3.7%)
Acute Upper Respiratory Infections

1,038 (2.8%) 3
Acute Lower Respiratory Infections

1,151 (3.0%)
Asthma

1,067 (2.8%)
Asthma

1,065 (3.0%)
Non-Inflammatory Disorders of Female Genital Tract

1,229 (3.3%)
Acute Lower Respiratory Infections

958 (2.6%) 4
Pregnancy With Abortive Outcome

1,122 (3.0%)
Acute Upper Respiratory Infections

1,055 (2.8%)
Diarrhoea and Gastroenteritis of Presumed Infectious Origin

1,039 (2.9%)
Diarrhoea and Gastroenteritis of Presumed Infectious Origin

1,175 (3.2%)
Pregnancy With Abortive Outcome

942 (2.6%) 5
Acute Upper Respiratory Infections

1,071 (2.8%)
Diabetes Mellitus

1,026 (2.7%)
Acute Upper Respiratory Infections

1,032 (2.9%)
Asthma

1,113 (3.0%)
Non-Inflammatory Disorders of Female Genital Tract

903 (2.4%) 6
Diarrhoea and Gastroenteritis of Presumed Infectious Origin

988 (2.6%)
Pregnancy With Abortive Outcome

1,016 (2.7%)
Non-Inflammatory Disorders of Female Genital Tract

953 (2.6%)
Acute Upper Respiratory Infections

1,111 (3.0%)
Asthma

900 (2.4%)

937 (2.5%)

984 (2.6%)

893 (2.5%)

918 (2.5%)
Maternal Diseases Classifiable Elsewhere but Complicating Pregnancy, Childbirth and The Puerperium (Indirect Obstetric Causes)

Non-Inflammatory Disorders of Female Genital Tract

Non-Inflammatory Disorders of Female Genital Tract

Diabetes Mellitus

Fever of Unknown Origin

890 (2.4%) 8
Hypertensive Diseases

933 (2.5%)
Hypertensive Diseases

791 (2.1%)
Hypertensive Diseases

759 (2.1%)
Hypertensive Diseases

787 (2.1%)
Hypertensive Diseases

801 (2.2%)
Maternal Diseases Classifiable Elsewhere but Complicating Pregnancy, Childbirth and The Puerperium (Indirect Obstetric Causes)

758 (2.0%)

745 (2.0%)

664 (1.8%)
Maternal Diseases Classifiable Elsewhere but Complicating Pregnancy, Childbirth and The Puerperium (Indirect Obstetric Causes)

771 (2.1%)

Fever of Unknown Origin

Fever of Unknown Origin

Fever of Unknown Origin

612 (1.7%)

676 (1.8%)

737 (2.0%)
Maternal Diseases Classifiable Elsewhere but Complicating Pregnancy, Childbirth and The Puerperium (Indirect Obstetric Causes)

661 (1.8%)

767 (2.1%)

10

Heart Diseases

Heart Diseases

Diabetes Mellitus

Diabetes Mellitus

OTHERS GRAND TOTAL

561 (1.5%) 28,227 (76.5%) 36,883 (100.0%)

633 (1.7%) 28,325 (74.9%) 37,820 (100.0%)

660 (1.8%) 28,120 (74.9%) 37,538 (100.0%)

644 (1.8%) 27,040 (75.2%) 35,977 (100.0%)

614 (1.7%) 26,873 (73.2%) 36,719 (100.0%)

30 | Health Information Booklet 2010

Health Services
The Department of Health Services, Ministry of Health is responsible for providing public health services in the country. The mission of the department is to promote well-being and prevent ill health, whereby various activities and programmes have been developed and established under three main services: Community Health Services, Environmental Health Services, and Scientific Services.
WORKLOAD INDICATORS 1. Ante Natal attendances 2. Post Natal attendances 3. Child ( <5 ) attendances 4. General O/P attendances in Health Centres / Clinics - Extended Hours Services 5. No. of students medically examined (Primary I, IV & Form II) 6. No. of students screened (Primary I, III, IV, VI & Form II) 2008 46,419 8,396 122,229 469,033 71,526 21,984 37,174 2009 48,323 9,340 124,785 538,999 74,809 21,149 73,696 2010 44,068 12,169 111,199 465,448 79,794 20,091 28,548

A comprehensive National Immunisation Programme is in place to protect children against vaccine preventable diseases. This successful programme is delivered through the extensive network of MCH Services and by School Health Services. Over the years, immunisation coverage has consistently been above 95.0 percent for all vaccinations in the programme which met the targets set by the WHO. The success of this programme is one of the factors that contributed to the progression of Brunei Darussalam in achieving one of the health objectives under the United Nations Millennium Development Goal for reduction in child mortality.
IMMUNISATION COVERAGE % of infants immunised against Tuberculosis (at birth) Diphtheria/Tetanus/Whooping Cough (Tetract-HIB)3 Poliomyelitis (OPV)3 Hepatitis B3 Measles, Mumps and Rubella 1 (MMR1) 99.7 97.6 100.0 96.1 99.7 100.0 99.4 99.5 100.0 100.0 95.4 95.4 99.0 95.8 94.4 2008 2009 2010

% of pregnant women immunised against Primigravida Tetanus (TT2) 75.0 75.0 75.6

Note: Red text - Millennium Development Goals (MDGs) Indicators Source: Maternal and Child Health (MCH) Clinic Data

Health Information Booklet 2010 | 31

General Outpatient Attendances for Health Centres (2010)

2009 2010 GENERAL OUTPATIENT ATTENDANCES FOR HEALTH CENTRES IN 2010 29220 30118 BSB (EH) 74809 75068 75,068 80,000 B 'A' 32383 33373 70,000 B 'B' 48040 46315 M 33527 36306 60,000 JP 47533 48529 JE 23546 23579 50,000 RG 51760 55143 40,000 SA 35659 34967 BLT 48716 45049 30,000 S 22598 20481 20,000 SL (OH) 18619 18712 SL (EH) 1061 2435 10,000 SL (A&E) 2858 2292 TUT 0 24011 22864 TEL BSB 9685 B 'A' 9746 M BSB B 'B' JP JE RG SA BLT S SL SL SL TUT (OH) (EH) (OH) (EH) (A&E) 11948 12791 NoteLMN : (OH) - Office Hours SK 9400 10446 (EH) - Extended Hours
BSB (OH)
46,315 48,529 55,143 36,306 30,118 33,373

34,967

45,049

23,579

20,481

18,712

22,864

12,791 LMN 55,847 88,969 383,398

2,435

2,292

TEL

SK

(A&E) - Accident & Emergency

BRUNEI MUARA HEALTH CENTRES

BSB B 'A' B 'B' M JP : : : : : : : : BSB Health Centre Berakas 'A' Health Centre Berakas 'B' Health Centre Muara Health Centre Jubli Perak Health Centre Jubli Emas Health Centre Rimba Gadong Health Centre

BELAIT HEALTH CENTRES

BLT S SL : : : Belait Health Centre Seria Health Centre Sungai Liang Health Centre

TUTONG HEALTH CENTRES

TUT TEL LMN SK : : : : Tutong Health Centre Telisai Health Centre Lamunin Health Centre Sungai Kelugos Health Centre

JE
RG SA

PAP Hjh Rashidah Sa'adatul Bolkiah Health Centre

TOTAL OUTPATIENT ATTENDANCES OF HEALTH CENTRES BY DISTRICT (2006 - 2010)

600,000

500,000
54,719 50,175 87,220

50,908 86,272

55,044 93,852

400,000

84,009

300,000

200,000

359,090

352,033

361,261

376,477

100,000

0 2006 2007 BRUNEI MUARA 2008 BELAIT 2009 TUTONG 2010

32 | Health Information Booklet 2010

10,446

9,746

Health Centres Outpatient Morbidity (2010)

No. ICD-10 DISEASES MALE FEMALE TOTAL %

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

J00-J06 I10-I15 L00-L99 J10-J11 H10 A09 E70-E90 E10-E14 J40-J46 R10 H65-H66 K25-K27 K00-K08 M10 B01

Acute Upper Respiratory Infection Hypertensive Diseases Diseases of Skin & Subcutaneous Tissue Influenza Conjunctivitis Gastroenteritis/Diarrhoea Metabolic Disorders Diabetes Bronchitis, Chronic & Unspecified Emphysema & Asthma Abdominal and Pelvic Pain Otitis Media Gastric,Duodenal and Peptic Ulcer Diseases of Teeth & Supporting Structures Gout Chickenpox Others GRAND TOTAL

107,800 18,774 16,639 15,985 9,937 10,071 7,784 6,182 5,411 3,482 2,577 2,234 1,584 2,458 1,374 80,586 292,878

114,841 26,573 19,248 17,328 10,232 9,281 10,524 8,821 5,501 5,098 3,104 3,292 1,864 377 1,287 109,604 346,975

222,641 45,347 35,887 33,313 20,169 19,352 18,308 15,003 10,912 8,580 5,681 5,526 3,448 2,835 2,661 190,190 639,853

34.8 7.1 5.6 5.2 3.2 3.0 2.9 2.3 1.7 1.3 0.9 0.9 0.5 0.4 0.4 29.7 100.0

Note: Rimba Health Centre ( January - November 2010 only) Berakas 'B' Health Centre ( January - August 2010 only)

Health Information Booklet 2010 | 33

Leading Causes of Primary Health Care Outpatient Morbidity by District (2010)

HEALTH CENTRES No. BRUNEI MUARA 1 Acute Upper Respiratory Infections 167,291 (34.8%) 2 Hypertensive Diseases 35,672 (7.4%) 3 Influenza 33,305 (6.9%) 4 Diseases of Skin & Subcutaneous Tissue 24,954 (5.2%) 5 Metabolic Disorders 16,631 (3.5%) 6 Conjunctivitis 16,448 (3.4%) 7 Gastroenteritis and Diarrhoea 14,538 (3.0%) 8 Diabetes 12,958 (2.7%) 9 Bronchitis Chronic & Unspecified Emphysema & Asthma 9,267 (1.9%) 10 Abnominal and Pelvic Pain 7,133 (1.5%) OTHERS GRAND TOTAL 141,851 (29.5%) 480,048 (100.0%) BELAIT Acute Upper Respiratory Infections 34,765 (38.2%) Diseases of Skin & Subcutaneous Tissue 6,558 (7.2%) Gastroenteritis and Diarrhoea 3,185 (3.5%) Conjunctivitis 2,389 (2.6%) Hypertensive Diseases 2,030 (2.2%) Bronchitis Chronic & Unspecified Emphysema & Asthma 612 (0.7%) Abnominal and Pelvic Pain 583 (0.6%) Diseases of Teeth & Supporting Structures 423 (0.5%) Diabetes 368 (0.4%) Otitis Media 344 (0.4%) 39,715 (43.7%) 90,972 (100.0%) TUTONG Acute Upper Respiratory Infections 20,585 (29.9%) Hypertensive Diseases 7,645 (11.1%) Diseases of Skin & Subcutaneous Tissue 4,375 (6.4%) Diabetes 1,677 (2.4%) Gastroenteritis and Diarrhoea 1,629 (2.4%) Metabolic Disorders 1,455 (2.1%) Conjunctivitis 1,332 (1.9%) Bronchitis Chronic & Unspecified Emphysema & Asthma 1,033 (1.5%) ALL DISTRICTS Acute Upper Respiratory Infections 222,641 (34.8%) Hypertensive Diseases 45,347 (7.1%) Diseases of Skin & Subcutaneous Tissue 35,887 (5.6%) Influenza 33,313 (5.3%) Conjunctivitis 20,169 (3.2%) Gastroenteritis and Diarrhoea 19,352 (3.0%) Otitis Media 18,308 (2.9%) Diabetes 15,003 (2.3%)

Bronchitis Chronic & Abnominal and Pelvic Pain Unspecified Emphysema & Asthma 864 (1.3%) 10,912 (1.7%)

Gastric, Duodenal & Peptic Abnominal and Pelvic Pain Ulcer 561 (0.8%) 27,677 (40.2%) 68,833 (100.0%) 8,580 (1.3%) 210,341 (32.9%) 640,794 (100.0%)

Note: Rimba Health Centre ( January - November 2010 only) Berakas 'B' Health Centre ( January - August 2010 only)

34 | Health Information Booklet 2010

Leading Causes of Primary Health Care Outpatient Morbidity (2008 - 2010)

No. 2008 2009 2010

Acute Upper Respiratory Infections 197,348 (32.5%)

Acute Upper Respiratory Infections 229,878 (35.8%) Hypertensive Diseases 41,921 (6.5%) Diseases of Skin & Subcutaneous Tissue 38,538 (6.0%) Influenza 21,235 (3.3%) Conjunctivitis 17,566 (2.7%) Gastroenteritis and Diarrhoea 16,998 (2.6%) Metabolic Disorders 16,451 (2.6%) Diabetes 14,405 (2.2%) Bronchitis Chronic & Unspecified Emphysema & Asthma 14,107 (2.2%) Abnominal and Pelvic Pain 9,944 (1.5%) 221,432 (34.5%) 642,475 (100.0%)

Acute Upper Respiratory Infections 222,641 (34.8%) Hypertensive Diseases 45,347 (7.1%) Diseases of Skin & Subcutaneous Tissue 35,887 (5.6%) Influenza 33,313 (5.3%) Conjunctivitis 20,169 (3.2%) Gastroenteritis and Diarrhoea 19,352 (3.0%) Otitis Media 18,308 (2.9%) Diabetes 15,003 (2.3%) Bronchitis Chronic & Unspecified Emphysema & Asthma 10,912 (1.7%) Abnominal and Pelvic Pain 8,580 (1.3%) 210,341 (32.9%) 639,853 (100.0%)

Diseases of Skin & Subcutaneous Tissue 42,253 (7.0%)

Hypertensive Diseases 40,433 (6.7%)

Influenza 18,367 (3.0%)

Bronchitis Chronic & Unspecified Emphysema & Asthma 16,915 (2.8%)

Conjunctivitis 15,767 (2.6%)

Gastroenteritis and Diarrhoea 15,555 (2.6%)

Diabetes 14,428 (2.4%)

Metabolic Disorders 10,644 (1.8%)

10

Abnominal and Pelvic Pain 10,495 (1.7%)

OTHERS GRAND TOTAL

224,828 (37.0%) 607,033 (100.0%)

Note: Rimba Health Centre ( January - November 2010 only) Berakas 'B' Health Centre ( January - August 2010 only)

Health Information Booklet 2010 | 35

Notifiable Diseases (2010)

Notification of infectious diseases is required by law under the 'Infectious Diseases Order 2003'. A total of 57 infectious diseases are listed as notifiable in the country. All notifications must be reported to the Disease Control Division at the Department of Health.
DISEASES FOOD AND WATER BORNE DISEASES Cholera Dysentery (Shigella) Food Poisoning Gastroenteritis Hepatitis A Para/Typhoid Fever Salmonella Infection Total PERSON TO PERSON TRANSMITTED DISEASES Chicken Pox Ebola Fever Hand, Foot & Mouth Disease Influenza A Influenza B Influenza Others Leprosy Meningitis Scarlet Fever Severe Acute Respiratory Syndrome Total VACCINE PREVENTABLE DISEASES Diphtheria Hepatitis B Measles Mumps Pertussis Acute Flaccid Paralysis (AFP) Rubella Smallpox Tetanus Tetanus Neonatorum Tuberculosis (data from TB Clinics) Total 0 0 0 16 0 0 1 0 0 0 156 173 0 0 0 5 0 1 0 0 0 0 47 53 0 0 0 9 0 0 0 0 0 0 30 39 0 0 0 0 0 0 1 0 0 0 4 5 0 0 0 30 0 1 2 0 0 0 237 270 1,706 0 579 1954 0 0 3 1 0 0 4,243 404 0 79 195 0 0 0 0 0 0 678 487 0 32 31 0 0 0 0 0 0 550 98 0 6 34 0 0 0 0 0 0 138 2,695 0 696 2,214 0 0 3 1 0 0 5,609 0 1 43 172 0 4 90 310 0 1 13 116 2 0 1 133 0 0 0 3 0 0 5 8 0 0 0 6 0 0 0 6 0 2 56 297 2 4 96 457 BM TUT TEM KB TOTAL

36 | Health Information Booklet 2010

Notifiable Diseases (2010)

DISEASES SEXUALLY TRANSMITTED DISEASES AIDS Chancroid Chlamydial Infection Genital Herpes Gonorrhoea Infections Hepatitis C HIV * (Local only) Non Gonococcal Urethiritis Opthalmia Neonatorum Syphilis (All forms) Other STI - Genital Warts Total VECTOR BORNE DISEASES Dengue Fever Dengue Haemorhagic Fever Filariasis Leptospirosis Malaria Plague Typhus West Nile Fever Yellow Fever Total ZOONOTIC DISEASES Anthrax Bovine Spongiform Encephalitis Nipah Virus Rabies Total OTHER INFECTIOUS DISEASES Conjunctivitis (Chlamydia) Encephalitis Legionellosis Puerperal Infection Viral Encephalitis Viral Hepatitis Total GRAND TOTAL 4 0 0 0 0 0 4 5,306 0 0 0 0 0 0 0 904 1 0 0 0 0 0 1 643 0 0 0 0 0 0 0 173 5 0 0 0 0 0 5 7,026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 9 0 0 0 0 271 9 0 0 0 4 0 0 0 0 13 18 1 2 0 3 0 0 0 0 24 9 0 0 0 5 0 0 0 0 14 298 1 2 0 21 0 0 0 0 322 0 1 27 2 265 0 2 0 0 6 2 305 0 0 0 1 21 1 0 3 0 1 0 27 0 0 1 0 18 0 2 0 0 0 0 21 0 0 1 0 8 0 1 0 0 0 0 10 0 1 29 3 312 1 5 3 0 7 2 363 BM TUT TEM KB TOTAL

Note: * Indicate incidence of AIDS/HIV cases among local only. Source: Disease Control Division, MOH

Health Information Booklet 2010 | 37

Notifiable Diseases
TREND OF NOTIFIABLE DISEASES (2006 - 2010)
2,825 Hand, Foot and Mouth Disease

1,590 860 689 696

Tuberculosis

192

199

210

213

237

Dengue Fever & Dengue Haemorrhagic Fever

Introduction of NS1 Test (2009) 299

68

16

32

30

Malaria

6 HIV / AIDS

12

18

11

21

11

2006

2007
HIV-AIDS Malaria

2008

2009

2010

Dengue Fever & Dengue Haemorrhagic Fever Tuberculosis Hand, Foot & Mouth Disease

Note: NS1 Test - Dengue NS1 Antigen Test

38 | Health Information Booklet 2010

Renal Services
NO. OF PATIENTS DIALYSIS CENTRE / UNIT Male Rimba Dialysis Centre Kiarong Dialysis Centre Dialysis Centre RIPAS Hospital Dialysis Centre SSB Hospital, Belait Continuous Ambulatory Peritoneal Dialysis Transplant Unit Dialysis Centre PIHM Hospital, Temburong TOTAL 97 26 28 19 36 19 10 235 2008 Female 116 34 42 27 29 12 7 267 Total 213 60 70 46 65 31 17 502 Male 111 26 32 32 37 10 11 259 2009 Female 106 31 26 34 22 23 9 251 Total 217 57 58 66 59 33 20 510 Male 98 23 29 39 36 19 13 257 2010 Female 109 34 35 37 27 12 13 267 Total 207 57 64 76 63 31 26 524

Source: Renal Health Promotion Unit, Department of Renal Services, MOH DISTRIBUTION OF PATIENTS BY AGE-GROUPS (2010)
160 140 120 NUMBER OF PATIENTS 100 80 51 60 33 76 121 98 140

40
20 0 > 10 - 30 31 - 40 41 - 50 51 - 60 61 - 70 71 - 80 > 80 5

AGE-GROUPS (IN YEARS)

Source: Renal Health Promotion Unit, Department of Renal Services, MOH

Health Information Booklet 2010 | 39

Dental Health Services

ORAL HEALTH CARE COVERAGE OF THE POPULATION
YEAR 2006 2007 2008 2009 2010 New Patients 75,399 87,820 83,748 78,453 82,644 Population 383,000 390,000 398,000 406,200 414,400 Oral Health Care Coverage 19.7% 22.5% 21.0% 19.3% 19.9%

COVERAGE AT DENTAL HEALTH SERVICES BY AGE-GROUP FOR THE YEAR 2010

COVERAGE New Patients Ante Natal Edentulous 0-5 10,579 0 0 6 - 12 27,378 3 0 13 - 19 8,272 76 0 20 - 55 32,110 2,032 16 > 55 4,305 27 29 TOTAL 82,644 2,138 45

ATTENDANCES AT DENTAL HEALTH SERVICES BY AGE-GROUP FOR THE YEAR 2010

TYPES OF ATTENDANCES Outpatients Prosthetics TOTAL 0-5 8,693 5,491 14,184 6 - 12 20,848 20,812 41,660 13 - 19 11,591 8,102 19,693 20 - 55 45,532 22,421 67,953 > 55 6,950 3,822 10,772 TOTAL 93,614 60,648 154,262

TREATMENT AT DENTAL HEALTH SERVICES BY AGE-GROUP FOR THE YEAR 2010

TYPES OF TREATMENT Conservative Periodontic Endodontic F Pros R Pros Orthodontic OS Implantologist PV Others TOTAL 0-5 3,770 2,351 31 28 4 2 1,237 0 4,376 2,008 13,807 6 - 12 9,133 9,487 65 8 55 651 6,275 0 14,219 3,736 43,629 13 - 19 3,882 3,566 458 34 239 3,952 1,692 0 3,117 2,210 19,150 20 - 55 13,466 10,947 2,618 891 2,124 3,250 13,183 275 2,055 7,723 56,532 > 55 1,437 1,051 264 339 1,595 15 2,796 247 289 1,191 9,224 TOTAL 31,688 27,402 3,436 1,300 4,017 7,870 25,183 522 24,056 16,868 142,342

Source: Research and Development Division, Department of Dental Services, MOH

40 | Health Information Booklet 2010

Nutritional Status
SCHOOL HEALTH (Primary I, IV & VI and Form 2 only) 1. 2. 3. 4. Normal weight Overweight Obese Underweight 2006 70.0 13.7 11.9 4.4 2007 64.8 16.0 14.1 5.1 PERCENTAGE (%) 2008 69.8 13.3 12.3 4.5 2009 68.9 14.0 12.4 4.7 2010 67.1 14.7 13.4 4.8

Note : In 2010, the Total Number of School Target Population is 28,231 for Primary I, III, IV & VI and 7,468 for Form 2 Source : School Health Services. MOTHER & CHILD HEALTH CLINICS (BELOW 5 YEARS) 1. 2. 3. Underweight Overweight Others * 2006 60.1 33.0 6.9 PERCENTAGE OF CHILDREN ATTENDING NUTRITION CONSULTATION BY WEIGHT STATUS (%) 2007 60.3 33.5 6.3 2008 54.3 40.1 5.6 1,331 2009 48.9 42.0 9.2 1,158 2010 46.9 44.5 8.6 960

TOTAL NUMBER OF 1,690 1,423 CASES Note : * - Others including Healthy Eating, Low Birth Weight and Premature. Source : Community Nutrition Unit.

PERCENTAGE OF CHILDREN ATTENDING NUTRITION CONSULTATION BY WEIGHT STATUS (2006 - 2010)

70.0 57.2 60.0

60.1

60.3 54.3 48.9 46.9 44.5

50.0 PERCENTAGE 36.0 40.0 33.0 33.5

40.1

42.0

30.0

20.0

10.0

0.0
2005 2006 2007 2008 2009 2010

OVERWEIGHT

UNDERWEIGHT

Health Information Booklet 2010 | 41

Occupational Health Services

Occupational Health Division is responsible to monitor health and safety at workplace. The activities are streamlined to include worker's health surveillance, worksite surveillance and industrial hygiene, training, information and advisory functions as well as in the areas of compensation, counselling and rehabilitation. A total of 136 work accidents were reported to the Occupational Health Division in 2010, a decrease of 4 percent from the previous year. About 73 percent were in non-health care settings. Majority of these accidents occurred at the construction sites. Within the healthcare sector, most of the injuries involved needlestick injuries.
NATURE OF INJURY (NON HEALTHCARE) 1. 2. 3. 4. 5. 6. 7. 8. 9. Construction Manufacturing Engineering Community Service Electricity Agriculture Transport Business Activities Private Households TOTAL

2007 41 17 20 4 4 2 2 4 2 96

2008 55 43 37 5 6 14 7 5 172

2009 28 20 14 6 2 1 8 7 6 92

2010 30 20 16 11 1 6 1 8 6 99

TYPE OF INJURY (HEALTHCARE) 1. 2 Needle Prick Other Injuries * TOTAL

2007 45 9 54

2008 39 14 53

2009 44 6 50

2010 28 9 37

Note * - Other Injuries including Blood/Body Fluid Splash, Scalpel/Elevator and Glass Cut. Source : Occupational Health Division, Ministry of Health

42 | Health Information Booklet 2010

Road Traffic Accidents

Road traffic accidents continue to be one of the leading causes of deaths in Brunei Darussalam. In 2010, Brunei Darussalam reported 3414 road accidents, an increase of 9.8% than the previous year. In the same year, road traffic accidents inflicted 698 injuries and 29 deaths.
ROAD TRAFFIC ACCIDENTS Y E A R 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 NUMBER KILLED PER 100,000 POPN. 14.2 12.6 13.5 11.6 8.0 10.0 10.3 8.4 13.8 7.3 9.4 6.3 NUMBER CASE FATALITY INJURED FOR RATE EACH PERSON % KILLED (CFR) 11.4 13.5 11.9 13.7 23.0 17.2 13.9 17.3 10.3 17.8 16.0 26.8 8.0 6.9 7.7 6.8 4.2 5.5 6.7 5.5 8.9 5.3 5.9 3.6 REGISTERED VEHICLES (revised) 200,034 206,994 213,816 225,650 238,061 252,428 267,995 281,524 297,592 318,816 333,203 348,266

ACCIDENTS

KILLED

INJURED

2,900 2,861 2,794 2,801 2,625 2,625 2,771 2,710 2,674 2,775 3,110 3,414

45 41 45 40 28 36 38 32 54 29 38 26

515 554 537 549 645 620 528 555 556 515 608 698

Sources : The Royal Brunei Police Force Land Transport Department

200.0 180.0 RATE PER 100,000 POPULATION
184.5 162.5 170.6 172.4 161.3 159.5

160.0
140.0 120.0 100.0 80.0 60.0 40.0
14.2

20.0
0.0

12.6

13.5

11.6

1998 1999 2000 2001 2002 2003 2004 2005 2006 8.0 2007 2008
2003

10.0

1999

2000

2001

2002

2009

2004

14.5 13.8 142.7 13.1 12.4 11.0 10.4 10.3 9.6 9.0 10.3 8.7 9.3 9.8 2005

168.4 144.9 142.6 129.4 149.7

8.4

13.8

7.3

9.4

6.3

2006

2007

2008

2009

2010

NUMBER KILLED PER 100,000 POPN.

NUMBER INJURED PER 100,000 POPN

Health Information Booklet 2010 | 43

Transport Accidents
MORBIDITY DUE TO TRANSPORT ACCIDENTS IN 2010 RIPASH OUTPATIENT * INPATIENT Note: * 1,873 223 SSB 851 97 PMMPMHAMB 532 1 PIHM 17 11 TOTAL 3,273 332

Newly reported cases only

MORBIDITY DUE TO TRANSPORT ACCIDENTS IN BRUNEI DARUSSALAM (2006 - 2010)

3,500 3,000 2,500
2,288 1,770 1,845 3,273

2,000
1,259

1,722

1,500 1,000
425 415 424

500 0 2005 2006 2007 Outpatient Morbidity 2008

340

343

332

2009

2010

Outpatient Mor Inpatient Morb

Inpatient Morbidity

Source : Statistics Unit, Department of Policy and Planning, Ministry of Health

44 | Health Information Booklet 2010

Definitions
1 INFANT DEATHS : Deaths aged less than 1 year 2 EARLY NEONATAL DEATHS : Deaths aged less than 7 days 3 LATE NEONATAL DEATHS : Deaths aged 7 - 28 days 4 POST NEONATAL DEATHS : Deaths aged 28 - 365 days 5 NEONATAL DEATHS : Deaths aged less than 28 days 6 PERINATAL DEATHS : Fetal Deaths + Early Neonatal Deaths 7 MATERNAL DEATH : Death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (Source: WHO ICD-10 International Statistical Classification of Diseases and Related Health Problems) 8 DIRECT OBSTETRIC DEATHS : Those resulting from obstetric complications of the pregnancy state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above (Source: WHO ICD-10 International Statistical Classification of Diseases and Related Health Problems). 9 INDIRECT OBSTETRIC DEATHS : Those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but which was aggravated by physiologic effects of pregnancy (Source: WHO ICD-10 International Statistical Classification of Diseases and Related Health Problems). 10 LIVEBIRTH : The complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn (Source: WHO ICD-10 International Statistical Classification of Diseases and Related Health Problems). 11 STILLBIRTH (ALSO REFERRED AS LATE FETAL DEATH) : Refers to any child which has issued forth from its mother after the twenty-fourth (24th) week of pregnancy and showing NO signs of life at birth (complete expulsion from its mother).

HOSPITAL INPATIENT ACTIVITIES 1 ADMISSIONS : Patients admitted direct to the hospitals or transferred from other institutions. It includes newborn babies born outside the hospital and admitted to the hospital but excludes babies born in the hospital. 2 DISCHARGES (ALIVE AND DEATHS) : These relate to live separations from the hospital or transfers to other institutions. 3 DEATHS : These include deaths after admissions to the hospital and exclude patients brought in dead and dying before admissions. 4 PATIENT DAYS : The number of days inpatient stayed in the hospital (services received by one inpatient in one 24-hour period). Patients admitted and discharged the same day are counted as having stayed one day in the hospital. The days a patient does not use his bed because he is on leave or absence are excluded. 5 DAY PATIENTS : Patients with conditions without the need to stay in the hospital overnight.

46 | Health Information Booklet 2010

Formulae
1 CRUDE BIRTH RATE = (LIVEBIRTHS / POP.) x 1000 2 GENERAL FERTILITY RATE = [LIVEBIRTHS / WOMEN POP. AGED (15-49)] x 1000 3 CRUDE DEATH RATE = (NO. OF DEATHS / POP.) x 1000 4 UNDER 5 MORTALITY RATE = [(0-4) DEATHS / LIVEBIRTHS) x 1000 5 LATE FETAL DEATH RATIO = (FETAL DEATHS / LIVEBIRTHS) x 1000 6 PERINATAL MORTALITY RATIO = (PERINATAL DEATHS / LIVEBIRTHS) x 1000 7 EARLY NEONATAL MORTALITY RATE = (EARLY NEONATAL DEATHS / LIVEBIRTHS) x 1000 8 LATE NEONATAL MORTALITY RATE = (LATE NEONATAL DEATHS / LIVEBIRTHS) x 1000 9 NEONATAL MORTALITY RATE = (NEONATAL DEATHS / LIVEBIRTHS) x 1000 10 POST NEONATAL MORTALITY RATE = (POST NEONATAL DEATHS / LIVEBIRTHS) x 1000 11 INFANT MORTALITY RATE = (INFANT DEATHS / LIVEBIRTHS) x 1000 12 MATERNAL MORTALITY RATIO = (MATERNAL DEATHS / LIVEBIRTHS) x 100000 HOSPITAL PERFORMANCE INDICES 1 AV. INPATIENTS / DAYS = PATIENTS DAYS / NO OF DAYS 2 % OCCUPANCY = [(AV. INPATIENTS / DAYS) / AVAILABLE BEDS] x 100 3 AV. LENGTH OF STAY (days) = PATIENT DAYS / DISCHARGES & DEATHS 4 AV. TURNOVER OF PATIENTS / BED = DISCHARGES & DEATHS / AVAILABLE BEDS 5 AV. TURNOVER INTERVAL (days) = [(AVAILABLE BEDS x 365) - PATIENT DAYS] / DISCHARGES & DEATHS 6 DAY CASE PERCENTAGES (per 100 admissions) = (DAY-PATIENTS / ADMISSIONS) x 100 7 HOSPITAL DEATH RATE (per 100 discharges & deaths) = (DEATHS / DISCHARGES & DEATHS) x 100 POPULATION BASED HOSPITAL ACTIVITIES 1 OP ATTENDANCE RATE / 1000 POP. = (GENERAL OP ATTENDANCES / POP.) x 1000 2 A&E OP ATTENDANCES RATE / 1000 POP. = ( A&E OP ATTENDANCES / POP.) x 1000 3 HOSPITALIZATION RATE / 1000 POP. = (ADMISSION / POP.) x 1000 4 RATE OF PATIENT DAYS / 1000 POP. = (PATIENT DAYS / POP.) x 1000 Note: AV. = Average OP = Outpatient POP. = Population

Health Information Booklet 2010 | 47

Contacts
For further information please contact: Statistics Unit Research and Development Section Department of Policy and Planning 2G5-02, 5th Floor Ong Sum Ping Condominium Bandar Seri Begawan Brunei Darussalam Tel: Fax: E-mail: Website: +673 - 2230018 / 2230019 +673 - 2230019 statistics.moh@gmail.com www.moh.gov.bn

48 | Health Information Booklet 2010

Acknowledgements
We wish to acknowledge and express sincere appreciation to the relevant departments in the Ministry of Health and other government departments who have given their continuous assistance and invaluable support and commitment in providing the data for the publication of HIB 2010.

Prime Minister's Office Department of Economic Planning and Development Royal Brunei Police Force

Ministry of Finance Budget and Tender Section Ledger Section, Treasury Department

Ministry of Home Affairs Birth, Death and Adoption Section Immigration and National Registration Department

Ministry of Communication Land Transport Department

Ministry of Health Department of Medical Services Department of Health Services

Health Information Booklet 2010 | 49