Malnutrition is severe and the incidence of tuberculosis high. Malaria is endemic. There were 3,111 reported cases of tuberculosis in 1994. The city of Djibouti's publicly supplied water is suspect because the system is in disrepair.
At last estimate, there were 18 hospitals, medical centers, and dispensaries, with a total of 1,283 beds; medical personnel included 89 physicians, 14 dentists, 20 pharmacists, and 1,314 paramedical personnel. As of 1996, there were 0.1 physicians, 0.7 nurses, 0.02 dentists, and 0.02 pharmacists per 1,000 people. Djibouti's government has developed plans to improve public health and the management of hospitals, train more staff, and rehabilitate existing facilities.
There was an estimated fertility rate of 5.6 as of 2002. Life expectancy was 51.5 years and the infant mortality rate was 100 per 1,000 live births. In 1993, 75% of the country's children were vaccinated against measles. In 1999, there were 14.4 deaths per 1,000 inhabitants. As of 2002, the birth rate was estimated at 40 births per 1,000 people.
As of 1999, the number of people living with HIV/AIDS was estimated at 37,000. Deaths from AIDS in 2002 were estimated at 4,400. There were 1,007 cases of malaria in 1994. Between the mid-1970s and the mid-1990s, 23% of children under five were underweight. In Djibouti nearly every woman has had female genital mutilation.