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Geographical Locations - Tonga
 The WWW Virtual Library: Public Health
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- (Statistical) Number of Inhabitants per Doctor: 2,130
- CIA - World Factbook: Tonga (by ODCI)
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National Policy and Related Documents
Reports, Guidelines, and Projects
- Disaster and Emergency Preparedness in Tonga
The Kingdom of Tonga, geographically fragmented into 172 islands, is located within the “Ring of Fire” in the South Pacific. It is vulnerable to external economic shocks and natural disasters. The government is committed through legislation, plans and strategies to address disaster risk reduction and strengthen emergency management in all sectors to achieve national sustainable development in the priority areas: economic, social and environmental. An Emergency Fund with TOP15 million (USD 7.8 million) was established in 2008. Several stakeholders have provided assistance for an ongoing capacity-building program (both institutional and human resources). A recent initiative through the churches to establish a community-focused integrated disaster preparedness and response plan in 24 of the most vulnerable villages in Tonga is underway. The challenge, however, is to mainstream disaster risk reduction strategies into the operational plans of all government sectors and to coordinate relief measures with affected communities in the event of a major disaster. [author abstract] [Southeast Asian J Trop Med Public Health, Vol 40 (Suppl 1) 2009: pp.31-40]
- Gambling issues for Tongan people in Auckland, Aotearoa-New Zealand
This paper focuses on a research project on gambling issues within the Tongan community in Auckland, New Zealand that was conducted by the Auckland Regional Public Health Service (ARPHS). It outlines the background and rationale for the research, progress as of the time of writing, preliminary findings, and future plans. [publication abstract] [Journal of Gambling Issues, 12 (December 2004)]
- Intentional injury reported by young people in the Federated States of Micronesia, Kingdom of Tonga and Vanuatu
Background: Intentional injury presents a threat to the physical and psychological well being of young people, especially in developing countries, which carry the greatest part of the global injury burden. While the importance of this problem is recognized, there are limited population data in low and middle income countries that can guide public health action. The present study investigates the prevalence and distribution of intentional injury among young people in three Pacific Island societies, and examines behavioural and psychosocial factors related to risk of intentional injury. Methods: Population surveys were conducted with students aged 11–17 years in Pohnpei State in the Federated States of Micronesia (n = 1495), the Kingdom of Tonga (n = 2808) and Vanuatu (n = 4474). Surveys measured self-reported injury and intentional injury, sources of intentional injury, and the range of behavioural, psychological, educational and social variables that may be related to injury risk. Results: Among boys and girls aged 14–17 years the respective period prevalence of intentional injury was 62% and 56% in Pohnpei, 58% and 41% in Tonga, and 33% and 24% in Vanuatu. The prevalence of intentional injury declined with age in Tonga and Vanuatu, but there was little evidence of an age-trend in Pohnpei. Across the three societies, the major sources of intentional injury among boys were 'other persons' followed by boyfriends/girlfriends and fathers. Mothers, boyfriends/ girlfriends and other persons were primary sources of injury among girls. An intentional injury was reported more often by those who had been bullied (OR 1.40–1.66, P < 0.05), by regular smokers in Tonga and Vanuatu (OR 1.52–2.21, P < 0.05), and illicit drug users in Pohnpei and Vanuatu (OR 1.87–1.92, P < 0.05). Conclusion: Intentional injury was reported extensively in these three populations. Interventions directed towards the school environment and which take into account the role of bullying and drug use need to be considered. [author abstract] [BMC Public Health 2008, 8: 145]
- Lessons from the Pacific programme to eliminate lymphatic filariasis: a case study of 5 countries
Background: Lymphatic Filariasis (LF) is an important Neglected Tropical Disease, being a major cause of disability worldwide. The Global Programme to Eliminate Lymphatic Filariasis aims to eliminate LF as a public health problem by the year 2020, primarily through repeated Mass Drug Administration (MDA). The Pacific region programme commenced in 1999. By June 2007, five of the eleven countries classified as endemic had completed five MDA campaigns and post-MDA prevalence surveys to assess their progress. We review available programme data and discuss their implications for other LF elimination programs in developing countries. Methods: Reported MDA coverage and results from initial surveys and post-MDA surveys of LF using the immunochromatographic test (ICT) from these five Pacific Island countries (Tonga, Niue, Vanuatu, Samoa and Cook Islands) were analysed to provide an understanding of their quality and programme progress towards LF elimination. Denominator data reported by each country programme for 2001 was compared to official sources to assess the accuracy of MDA coverage data. Results: Initial survey results from these five countries revealed an ICT prevalence of between 2.7 and 8.6 percent in individuals tested prior to commencement of the programme. Country MDA coverage results varied depending on the source of denominator data. Of the five countries in this case study, three countries (Tonga, Niue and Vanuatu) reached the target prevalence of <1% antigenaemia following five rounds of MDA. However, endpoint data could not be reliably compared to baseline data as survey methodology varied. Conclusion: Accurate and representative baseline and post-campaign prevalence data is crucial for determining program effectiveness and the factors contributing to effectiveness. This is emphasised by the findings of this case study. While three of the five Pacific countries reported achieving the target prevalence of <1% antigenaemia, limitations in the data preclude identification of key determinants of this achievement. [author abstract] [BMC Infectious Diseases 2009, 9: 92]
- Sociocultural factors relating to Tongans' and Indigenous Fijians' patterns of eating, physical activity and body size
This paper reviews literature between 1974 and 2007 that addresses the impact of sociocultural factors on reported patterns of eating, physical activity (activity) and body size of Tongans and indigenous Fijians (Fijians) in their countries of origin. There have been changes in diet (more imported and fewer traditional foods), activity (reduced, especially in urban settings), residence (rural-urban shift) and body size (increased obesity and at a younger age). The prevalence of overweight/obesity in Tongans and Fijians has increased rapidly over the last two decades and remains among the highest in the world (>80% in Tonga; >40% in Fiji), with more females reported to be obese than males. The few studies that investigated sociocultural influences on patterns of eating, activity and/or body size in this population have examined the impact of hierarchical organisation, rank and status (sex, seniority), values (respect, care, co-operation) and/or role expectations. It is important to examine how sociocultural factors influence eating, activity and body size in order to i) establish factors that promote or protect against obesity, ii) inform culturally-appropriate interventions to promote healthy lifestyles and body size, and iii) halt the obesity epidemic, especially in cultural groups with a high prevalence of obesity. There is an urgent need for more systematic investigations of key sociocultural factors, whilst taking into account the complex interplay between sociocultural factors, behaviours and other influences (historical; socioeconomic; policy; external global influences; physical environment). [author abstract] [Asia Pac J Clin Nutr 2008; 17 (3): 375-384]
- The Prevalence of Diabetes in the Kingdom of Tonga
Objective: To determine the prevalence of diabetes, impaired glucose metabolism, and related risk factors in Tonga. Research design and methods: A randomly selected representative national sample of 1,024 people aged >15 years was surveyed. Each participant had fasting blood glucose and HbA1c measured. Subjects with a fasting blood glucose > 5.0 mmol/l (90 mg/dl) and < 11.1 mmol/l (200 mg/dl) or a fasting blood glucose ≤ 5.0 mmol/l and an HbA1c > 6.0% and every fifth subject with a fasting blood glucose ≤ 5.0 mmol/l and a normal HbA1c had a 75-g oral glucose tolerance test (OGTT). A total of 472 individuals had an OGTT based on these criteria. Subjects with a fasting blood glucose ≥ 11.1 mmol/l and an elevated HbA1c were diagnosed as having diabetes. Results: The mean age was 41.3 years, and the mean BMI was 32.3 kg/m2. The age-standardized prevalence of diabetes was 15.1% (CI 12.5–17.6), 12.2% (8.7–15.8) in men and 17.6% (14.0–21.1) in women (NS), of which only 2.1% was previously diagnosed. A total of 75% of people with newly diagnosed diabetes had a fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl). The prevalence of impaired glucose tolerance was 9.4% (7.3–11.5) and of impaired fasting glycemia 1.6% (0.7–2.6). Undiagnosed diabetes was significantly associated with increasing age, obesity, hypertension, and a family history of diabetes. Conclusions: The current prevalence of diabetes in Tonga is 15.1%, of which 80% is undiagnosed. A similar survey in 1973 reported a 7.5% diabetes prevalence, indicating a doubling of diabetes over the past 25 years. In addition, lesser degrees of glucose intolerance are common, and much of the community is overweight. [author abstract] [Diabetes Care 25:1378–1383, 2002]
- Tonga: A Situation Analysis of Children, Women and Youth
"Despite Tonga’s low population growth rate over the last few decades, approximately 50 per cent of the population are under the age of 20 years. This major demographic feature of the Kingdom of Tonga poses complex challenges including: (i) A growing demand for services, such as education, health, and employment opportunities in the short to medium term; (ii) Continuing expansion in the numbers of young imposing increasing demands on services provision in the long run; [and] (iii) Heavy demands on both service provision and the labour market will require considerable investment, diverting scarce financial resources from capital investment to recurrent expenditure. New and much needed development initiatives require additional resource allocation, and increasing numbers of young people will put further pressure on already stretched government, health and community development budgets. This has enormous socio-economic implications for the Government. … Social issues, including domestic violence, disintegration of family and kinship, early school drop-outs, youth unemployment, alcohol and substance abuse, are some of the major concerns. Numbers of secondary school drop-outs have increased, especially males, adding to youth unemployment. Domestic violence is believed to be widespread, and the proportion of young people infected with STIs is increasing. There is also a need to increase participation of women in the decision making arena." [UNICEF Pacific Office, Fiji. 2006]
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