Cook Islands country brief

The Cook Islands are divided into a northern and a southern group with the capital on Rarotonga, in the south. Most of the northern group is coral atolls. The Cook Islands are spread out over 1,830,000 km 2 of EEZ. The population has been in decline since 1996 as Cook Islanders have migrated to New Zealand and Australia in search of employment opportunities. Sixty percent of the population lives on Rarotonga.

Health infrastructure in the Cook Islands is well developed and health care delivery is well dispersed. Reproductive Health is one of the health priorities. The Cook Islands has a very good doctor, midwife and nurse to population ratio. Only two out of the 13 inhabited islands do not have a doctor - health officers serve on these. While the current immunization coverage rate for childhood diseases is just over 90%, the government is committed to pursing 100% coverage. Health care is free. The dispersed nature of the group requires good telecommunication and air links between the islands and atolls for medical evacuations and consultations. Education in the Cook Islands is free in primary and secondary schools and follows the New Zealand system. Tertiary education requires travel to other Pacific countries and to New Zealand.

The Cook Islands economy is based on tourism, pearl farming, fishing, agriculture and financial services. Remittances from Cook Islanders in New Zealand and Australia also contributes significantly to the economy. In addition to Rarotonga, Aitutaki is becoming an important tourism destination. New Zealand is the largest development partner contributing about 50% of total development assistance. This is partly responsible for the Cook Islands’ high GDP. Other development partners are AusAID and the European Union.

As New Zealand is responsible for foreign relations for the Cook Islands CEDAW ratification took place in 1985 when the former signed. Although women are underrepresented in Parliament they wield power as Arikis or traditional chiefs, exercising their influence through land use. The country has achieved most of the ICPD goals and is on track to achieve the MDGs by 2015.

Key indicators on reproductive health, population and development and gender

	Indicator ca 2000
Reproductive health
Adolescent fertility rate (births per 1,000 women aged 15-19)	68
Under five mortality rate (per 1,000 live births)	24
Proportion of births attended by skilled health personnel (%)	100
Contraceptive prevalence rate (modern methods) %	41.5

Population and development
Life expectancy at birth M/F	68/71
Age dependency ratio	58
Poverty headcount ratio (%)	12

Gender equality and empowerment of women
Ratio of girls to boys in primary/secondary education	0.89/1.03
Proportion of seats held by women in parliament (%)	8

Priorities

UNFPA’s Response

Greater access to quality RH services and information for every man, woman and adolescent in rural and urban Cook Islands

Strengthening project management skills

Improving responsiveness to the RH needs of adolescents, and to gender issues

Securing the right quantities and quality of essential RH commodities

Mobilising high level political support for RH and PDS issues including HIV/AIDS

Integrating population and development, and RH issues into national policies and programmes

Provision of technical assistance in the area of RH and PDS

UNFPA funded strengthening and expansion of quality RH information and services through development of RH protocols, attachment of outer-island midwives and upgrading the knowledge and skills of other health professionals, for the improved delivery of RH services
UNFPA fully funds the post-graduate Certificate in Reproductive Health course at the FSchM; Cook Islands has 2 graduates to date

UNFPA funded upgrading of management capabilities, including monitoring and evaluation, of project staff to improve programme delivery effectiveness

UNFPA funded Adolescent Reproductive Health (ARH) programme for improved accessibility and availability of quality information, education and services, in and out of school

UNFPA, with partners AusAID and NZAID, is funding the Reproductive Health Commodity Security project to ensure adequate management, logistics support and timely delivery of essential RH commodities including contraceptive supplies; the MOH in Fiji is providing a UNFPA-managed regional warehouse for RH commodities
UNFPA is raising awareness and the availability of the female condom

In October 2004 UNFPA was the principal sponsor of the first Pacific Parliamentarian meeting on HIV/AIDS
The UNFPA established and funded PPAPD is engaged in lobbying, community initiatives, thematic workshops and the development of advocacy packages

UNFPA is supporting various activities to improve national capacity to integrate gender, population and development concerns into national and sectoral development policies & programmes, in line with the ICPD PoA

UNFPA is providing technical support for technical training, producing concept papers and reports, research, and desk reviews.

Reproductive health

Population and development

Gender equality and empowerment of women