In addition there were 28 private clinics in Male and 3 in the atolls. A fifth regional hospital was under construction. The Institute of Health Sciences was upgraded in 1992 and a National Thalassaemia Centre established in 1991. The existing health infrastructure development suffers from a lack of foresight at the planning stage which has resulted in future needs not being anticipated. Most islands do not have a health post from which the FHW can work.
Food safety is compromised by the lack of a public health laboratory.
An acute shortage of biomedical expertise has created major problems with the maintenance and repair of equipment. The Ministry of Health regularly updates the essential drugs list and only drugs contained in this list can be imported, by both the private and public sector. The bulk of drugs are financed through payment by patients. DPH purchases and distributes free medicines for its disease control programmes, such as tuberculosis and malaria, and also provides a part of the drugs to atoll health centres and island health posts. Pharmacies are fairly widely distributed throughout the country.