COMMONWEALTH
OF THE NORTHERN
MARIANA ISLANDS
WHO
Country Cooperation Strategy
2018–2022
OVERVIEW
The Commonwealth of the Northern Mariana Islands is one of five inhabited United States
island territories. It spans 464 square kilometres and comprises four inhabited islands (Saipan,
Tinian, Rota and Pagan) and 10 uninhabited ones. The population was 53 883 in 2010, with
90% of people living in the capital of Saipan.
The Constitution of the Commonwealth was adopted in 1977. The three branches of the
Government are Executive (headed by the governor), Legislative (Senate and House of
Representatives) and Judicial.
The Commonwealth’s gross domestic product rose by 3.5% in 2015, a 0.7% increase on 2014,
according to data compiled by the United States Bureau of Economic Analysis. Economic
growth is attributed to flourishing tourism, the gaming industry and the amusement sector.
HEALTH AND DEVELOPMENT
Public Law 16-51 (2009) transferred the national health system to the Commonwealth
Healthcare Corporation (CHCC), a public entity that is headed by a chief executive officer. The
Corporation consists of a primary hospital, a modernized haemodialysis facility, a community
health centre, rural health centres in Rota and Tinian, public health services, and behavioural
health services. There are also four private health clinic groups. The majority of the physicians
are from the United States of America, and there are five times more nurses than physicians.
The Government is supportive of increased training opportunities for local health-care staff.
The Medicaid programme, a federal–state shared insurance for the poor, covers only American
citizens. Poverty is a major determinant of health. The 2010 population census found that 34%
of the population were uninsured for health care. Almost the same percentage holds true at
the present time. The Medical Referral programme provides logistical and other support to
people needing off-island tertiary care, for example in the Philippines or Hawaii.
Non-communicable diseases (NCDs) were the leading causes of death from 2011 to 2014.
Diseases of the circulatory system accounted for 252 deaths (33%), cancers accounted for 133
(18%), endocrine, nutritional and metabolic disease accounted for 54 (7%), and diseases of the
respiratory system accounted for 52 (7%).
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