All health services are free. A nurses' training school is maintained at the 160-bed Central Hospital in Tarawa. There are four medical districts, each with its own medical officer and staff. Each inhabited island has a dispensary, and there is a medical radio network linking all the islands. In 1990, there were 1.8 hospital beds per 1,000 inhabitants. In 1998, there were 0.3 doctors, 2.4 nurses, and 0.05 dentists per 1,000 people. The population of Kiribati had increased access to safe water (99%) and sanitation (100%) in 1993.
Tuberculosis remains the most serious public health problem (about 200 cases per 100,000 people in 1990); other endemic diseases are leprosy, filariasis, and dysentery. There was a cholera outbreak in 1977, after which projects to construct water and sewage pipes were speeded up. Vitamin A deficiency, frequently causing night blindness and xerophthalmia, is a common occurrence among children in Kiribati. The prevalence of xerophthalmia was almost 15% in children in 1994.
Infant mortality was estimated at 53 per 1,000 live births in 2002 and average life expectancy was 60.5 years. The immunization rates for a child under one were as follows in 1995: diphtheria, tetanus, and whooping cough, 60%; polio, 100%; measles, 100%; and tuberculosis, 60%. As of 2002, the crude birth rate and overall mortality rate were estimated at 31.6 and 8.8 per 1,000 people respectively. The total fertility rate was estimated at 4.3 births per woman.