Primary healthcare and prevention as social and economic policy
Primary healthcare is where a health system meets people before illness becomes an emergency. In Seychelles, that means regional health centres, community programmes, screening, immunisation, maternal and child services, medicines and referrals. It is also a policy question about fairness: whether people on Mahé, Praslin, La Digue and smaller islands can obtain timely care without avoidable travel, waiting or expense.
The latest national service evidence is more current than the last annual performance report identified in the original research brief. The Ministry of Health’s Primary Healthcare Services Statistical Report 2025 describes service use during 2025. It is mainly descriptive facility data, mostly from public providers. It shows activity, not by itself the health outcomes or cost-effectiveness of each intervention. Primary Healthcare Services Statistical Report 2025
A wide primary-care footprint
In 2025, the report records 286,628 doctor consultations during working hours and 171,433 nursing-care visits during working hours. It also records after-hours consultations and nursing-care visits. The totals combine facilities across Mahé, Praslin, La Digue and Silhouette, so they should not be read as unique patients or as a measure of unmet need.
The same data show why island-level reporting matters. Praslin recorded 31,511 doctor consultations when working-hours and after-hours figures are combined, while La Digue recorded 13,853. Silhouette recorded 1,458. These numbers reflect population, service arrangements and recorded use. They do not show whether a lower total means lower need, better access elsewhere or barriers to seeking care.
The report also records 11,601 domiciliary care visits in 2025. That is close to the 11,797 recorded in 2024 and well above the pandemic-era low of 4,796 in 2021. A service count cannot tell us whether home visits reached the people at greatest risk, but it points to the importance of care outside a clinic building, especially for older people and those with limited mobility.
Prevention has measurable wins and unfinished work
Routine infant immunisation remained above the national 95% target for most vaccines in 2025. Coverage was 98% for the first measles-mumps-rubella dose, 97.7% for the DPT booster and 96.5% for BCG. The report also identifies weaker coverage: hepatitis B at birth was 92.5%, MMR dose two was 87.4% in one listed age category, and HPV coverage was 88.1% for the first dose and 84% for the second among girls aged 10–12. For boys, the listed HPV coverage was lower. The ministry says adolescent vaccination needs stronger follow-up.
Screening shows a similar pattern. Primary-care clinics recorded 3,373 Pap-smear attendances in 2025, while laboratory records counted 3,985 Pap-smear screenings. The report says the difference reflects screenings conducted outside PHC clinics or not captured in clinic attendance records. That distinction matters: a higher laboratory total is useful evidence of activity, but it does not tell us how many eligible people were reached, how quickly results were returned or whether abnormal results received follow-up.
The Nutrition Unit recorded screening of 833 school-aged children and 1,119 adults in community or workplace settings. It also recorded 2,943 nutrition cases, including new and repeat cases. These data support a prevention approach that includes nutrition and early risk identification. They do not establish that screening reduced later disease or expenditure.
The burden that prevention must address
The Ministry’s 2025 Vital Statistics Report records 830 deaths and says 54% had one of four key non-communicable diseases as the underlying cause. It reports 845 deaths in the civil-registration summary and 830 deaths in the cause-of-death analysis; the report’s tables use different statistical bases, so the figures should not be casually combined. The broader point is clear without claiming causation: NCDs remain a major part of the recorded mortality pattern. Annual Vital Statistics Report 2025
The same report estimates life expectancy at birth for the all-resident population at 77.0 years in 2025, with 73.1 years for males and 81.4 years for females. Estimates from 2022 onward use population projections based on the 2022 Census, and the report notes a revised method that excludes deaths among visitors and people resident for less than six months. These are important qualifications when comparing years.
Spending is an input, not proof of value
The 2026 Budget proposes SCR 1.4 billion for the health portfolio, equal to 12% of the total appropriation bill. It includes SCR 12 million for vaccines, SCR 69 million for medical supplies, SCR 87 million for haemodialysis and SCR 61 million for health-sector capital projects. The budget also provides SCR 42 million for the Prevention of Drug Abuse and Rehabilitation Agency and SCR 5.5 million for the Mental Health Care Agency. 2026 Budget Speech
These allocations can support prevention and access, but an allocation is not a delivered service. A serious value-for-money test would connect spending to outcomes: vaccination completion, screening coverage by island and income, medicine availability, waiting times, avoidable admissions, referral completion and patient costs. It should also show whether capital projects open on schedule and whether staff are available to operate them.
The National Health Strategic Plan 2022–2026 sets goals to increase healthy life expectancy, sustain universal health coverage, prevent and respond to health emergencies, and promote healthy populations. Its six directions include protecting universal coverage, promoting healthy populations, investing for results and improving data for impact. Those priorities provide a useful framework, but a strategy is not evidence that delivery targets were met. National Health Strategic Plan 2022–2026
What better accountability would look like
Seychelles does not need to choose between treatment and prevention. It needs to make the link visible. Current public reporting should show who is reached, where gaps remain, how quickly people move from screening to care and what happens after referral. It should separate activity from outcomes and report denominators clearly.
The 2025 data show a system with substantial primary-care activity, strong coverage for many childhood vaccines and clear gaps in adolescent vaccination and follow-up. They do not yet show whether prevention is lowering avoidable illness or reducing total costs. That economic claim requires local evaluation, not assumption. The next step is therefore not simply to spend more or to shift money from hospitals. It is to publish the service, equity and outcome evidence needed to decide which preventive interventions deliver the greatest benefit for people across the islands.
Sources
Ministry of Health, Primary Healthcare Services Statistical Report 2025. Ministry of Health, Annual Vital Statistics Report 2025. 2026 Budget Speech, Government of Seychelles. National Health Strategic Plan 2022–2026, Ministry of Health. Annual Health-sector Performance Report 2023, Ministry of Health.
Image: original AI-generated editorial illustration for the Development and Resilience Research Monitor (DRRM). People and settings are illustrative, not a documentary photograph of a real household, institution or event.