Nicknamed the “Perfumed Islands” thanks to its fragrant plant life and natural beauty, the Comoros archipelago, formally known as Union of the Comoros, is a small, mountainous island country in the Indian Ocean, off the coast of Eastern Africa. The population of 865,000 people is composed of several ethnic groups including Antalote, Cafre, Makoa, Oimatsaha, and Sakalava; the overwhelming majority are Sunni Muslim. Three official languages are spoken throughout the country: Arabic, French, and Shikomoro, a blend of Swahili and Arabic. Of the three islands that make up the Comoros, Anjouan is the most densely populated, with the capital, Maroni, also being fairly dense. Despite these high-density areas, as much as two-thirds of the population live in rural areas.

Comoros is considered one of the world’s poorest countries, with much of its population relying on subsistence agriculture and fishing. One fourth of the population is considered to be extremely poor, living below the national poverty line. A limited number of job opportunities, no universities, a lack of advanced healthcare, and widespread poverty have resulted in a steady migration of Comorans moving abroad (mainly to France) in search of a better life. The diaspora has grown to such an extent that 25 percent of Comoros’ 2013 GDP was attributed to remittances.

The most common causes of death in Comoros include stroke, lower respiratory infections, ischemic heart disease, neonatal disorders, tuberculosis, diarrheal diseases, malaria, diabetes, cirrhosis, and hypertensive heart disease. Death due to malaria has decreased by over 50 percent in the past 10 years, however it still causes substantial mortality in the country. The risk factors that contribute most to deaths and disabilities include malnutrition, air pollution, high blood pressure, dietary risks, high body-mass index, high fasting plasma glucose, tobacco use, and insufficient water, sanitation, and hygiene.