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For the purposes of this commentary, Oceania is understood to encompass the Pacific Island states of Micronesia, Polynesia and Melanesia including Papua New Guinea (PNG) (but excluding the western half of mainland New Guinea, politically a province of Indonesia), Timor Leste, Australia and New Zealand. In geopolitical Oceania (which excludes Timor Leste), 25 countries, 12 with a population <100 000, are scattered over an area of 8 525 989 km2 (figure 1). The total population is 35 670 000, 27.5 million of whom are in Australia and New Zealand. PNG accounts for the large majority of the remainder. The great majority of the population in Australia and New Zealand are urban dwellers, while the majority of the population in the other countries is rural, the people often living in villages with very difficult access on small islands or atolls or in remote mountain ranges.
The region includes countries with widely differing economies, infrastructure development, education, health service provision, and health indices. Table 1, based on data from Unicef's State of the World's Children and the United Nations Development Programme reports, indicates some of the important indices relating to child health from a selection of the countries.1 ,2 Only one country, Timor Leste, had reached the Millennium Development Goal (MDG)-4 target by 2012, but from a very high under 5 mortality rate in 1990. Australia, New Zealand and Vanuatu may reach the target, but most of the countries are unlikely to do so.
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Mortality rates and economic indicators in Australia and New Zealand are similar to those throughout the rest of the Organization for Economic Cooperation and Development (OECD) countries. However, the overall figures mask, as they do in …