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Fiji: Fiji Health Profile 2012

2012/03/12

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Fiji Health Profile 2012

Ministry of Health's missions, vision and objectives

The Ministry of Health Strategic Plan 2007-2011 has as its vision:
A well financed health care delivery system that fosters good health and well-being for all citizens
and as its mission:

To provide quality health services through strengthened divisional health structures for the people of Fiji.
The Plan focuses on five main thematic areas:

  • Provision of affordable, well planned, quality health services to everyone in Fiji.
  • Protection of the health of citizens through the review of formulations and appropriate policies, legislation, regulations and standards that safeguard health.
  • Promotion of health through the development and maintenance of effective partnerships that empower all stakeholders in health promotion so as to reduce risk factors related to communicable and noncommunicable diseases.
  • Development and retention of a valued, committed and skilled workforce to enhance the delivery of quality health services.
  • Development and use of an integrated management system to empower managers to maximize resources and promote continuous improvement at all levels of health service delivery.

The Ministry of Health Strategic Plan 2007-2011 aims to achieve seven health outcomes:

  • a reduced noncommunicable disease burden;
  • a start in reversing the spread of HIV/AIDS and preventing, controlling or eliminating other communicable diseases;
  • improved family health and reduced maternal morbidity and mortality;
  • improved child health and reduced child morbidity and mortality;
  • improved adolescent health and reduced adolescent morbidity and mortality;
  • improved mental health, and
  • improved environmental health through safe water and sanitation.

The work of the Ministry is based on the following values: Customer focus (being genuinely concerned that customers receive quality health care, respecting the dignity of all people); Equity (striving for an equitable health system and being fair in all dealings, irrespective of ethnicity, religion, political affiliation, disability, gender or age); Quality (pursuing high quality outcomes in all facets of activities); Integrity (committing to the highest ethical standards in all activities); and Responsiveness (responsive to the health needs of the population, noting the need for speed in delivery of urgent health services).


Organization of health services and delivery systems
The Ministry of Health provides services to two types of user: internal (provision of health care to citizens); and external (monitoring of compliance with statutes and regulation; issue of permits, certificates and reports; professional board functions; provision of health care to visitors; provision of accommodation and meals for staff; provision of training to health staff of the region).

Health services are delivered through 900 village clinics, 124 nursing stations, three area hospitals, 76 health centres, 19 sub-divisional medical centres, three divisional hospitals and three speciality hospitals with TB, leprosy and medical rehabilitation units at Tamavua Hospital and St. Giles Mental Hospital. There is also a private hospital,l located in Suva.

HIV/AIDS laboratory testing in Fiji has undergone assessment and validation testing and has commenced confirmatory testing under the guidance of the National Reference Laboratory (Melbourne, Australia)-WHO Collaborating Centre for HIV/AIDS and funding from the Global Fund. Testing will be for diagnosis, surveillance and monitoring of patients on antiretroviral treatment.


Health policy, planning and regulatory framework
The Ministry of Health Strategic Plan 2007-2011 was developed through extensive consultations with major stakeholders, including the private sector, nongovernmental organizations, central government agencies and senior staff of the Ministry of Health. The Strategic Plan has been developed in recognition of the Government’s international commitments, the Government’s Strategic Development Plan 2007 to 2011, the major health priorities for the people of Fiji and the planning requirements of the Ministry of Finance and National Planning. The Strategic Plan forms the framework for the development of annual corporate plans for the Ministry of Health for each successive year, from 2007 to 2011 inclusive.

Health care financing
The public health care system is heavily dependent on general taxation. The increasing demand for and cost of health care, coupled with limited resources, requires the Ministry of Health to place a greater focus on health care financing and cost-recovery strategies. The Ministry is examining a range of health-financing options, including social insurance. Moreover, the proposed financial management reform is expected to provide opportunities for revenue generation and retention. Hospital fees and charges for services, as determined in the Public Hospital and Dispensary Act, need to be reviewed. However, any cost-recovery strategies and fee structures introduced must ensure that disadvantaged groups in the community are not adversely affected.

The immediate priority of the Government is to shorten long queues, reduce long waiting lists and turnaround times and facilitate patient flow. The Ministry hopes to rise to the occasion and to continue to provide quality health care to improve the health status of all citizens through: implementation of the Clinical Services Plan; improved planning and delivery of effective public health and promotion activities; performance budgeting; identification of appropriate financing/resource options to complement the health budget; and implementation of appropriate prevention strategies. However, this may be hampered further by the current political situation and the effects of the global economic crisis.


Human resources for health
The 2008 health worker-to-population ratio was 1:2609 for doctors, 1:493 for nurses, 1:4580 for dentists. Increasing demand for services has led to an expansion in the number of private general practitioners and specialists practising in Fiji under the Fiji Medical Council.

Emigration of health professionals, including doctors, nurses and paramedics, has increased over the last few years. The Ministry of Health is reviewing the health workforce plan to ensure that the training of doctors and nurses is aligned with the requirements of the health system. A review of the various professional structures in health is being undertaken and appropriate strategies will be put in place. A focus will also be placed on retaining existing staff, training nurse practitioners, employing part-time highly skilled staff and increasing the training opportunities for health professionals.

Implementation of the Government’s policy of reducing the retirement age for civil servants from 60 years to 55 years has greatly affected the human resource capacity within the Ministry of Health and will have a negative impact on the efficient delivery of health care services to the people of Fiji for some time.


Partnerships
With the idea of health being a collective responsibility, the Ministry of Health engages with other partners in delivering the best possible health care services to the people of Fiji. For noncommunicable diseases (NCD), health promotion, HIV/AIDS and suicide prevention there are national multisectoral committees that oversee and coordinate national implementation of the respective strategic plans developed by the same multi-stakeholders. These three committees are usually chaired by the Minister of Health, and members are from the permanent secretary or directorate level of government, non-state actors and civil society groups, including faith-based groups.

The Ministry also works in close partnership with the autonomous Fiji School of Medicine, the University of the South Pacific, Fiji Institute of Technology and other academic institutions for training of its staff members. At the regional level, WHO and the SPC are the main partners.
Challenges to health system strengthening

Fiji's health system compares relatively well with other Pacific island countries, but inadequate health financing and a shortage of health workers are hampering health care efforts. About 70%-80% of the population has access to health services, but only 40% have access to quality health services. Better government policy is needed to achieve health for all.

The country has a relatively well developed health system with an infrastructure of base hospitals in three geographical divisions, supported by area and subdivisional hospitals, health centres and nursing stations in the smaller towns and rural and remote areas. Clinical services for surgery, medicine, paediatrics, obstetrics and gynaecology, orthopaedics, ENT, emergency medicine and relevant support services, however, need to be strengthened.

Maintenance of appropriate levels of infrastructure and facility is vital for the delivery of health services. Over recent years, new facilities have been built and are in full operation in Nadi, Levuka, Vunidawa, and Taveuni. New infrastructure development is completed for Labasa Hospital, relocation of Navua Hospital, construction of a new hospital in Ba Nausori and the relocation of St Giles Hospital. As an ongoing activity, the Ministry of Health will continue to concentrate on maintaining and improving existing facilities. The safety of hospitals and health facilities in and during emergencies and disasters will be a challenge, especially in the face of changing weather patterns. During the course of the Health Strategic Plan 2007-2011, clinical services in the areas of cardiology, oncology, nephrology and hyperbaric medicine will be strengthened.