FNU-CMNHS FIPHR Institutional Research Repository
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‘First of all, I need training’: a qualitative study evaluating the Fiji community health worker training program
No full textAbstract
Background Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening
the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance
their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement.
Methods A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus
group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji’s Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analyzed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM).
Findings While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its
implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training
content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training.
Interpretation To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service
and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications
in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing
essential community-based care.
Keywords Community health worker, Qualitative study, Training program, Republic of Fij
The Impact of Covid19 on blood transfusion services at Colonial War Memorial Hospital, Suva, Fiji
No full textThe aim of this study was to find the impact of Covid19 on blood transfusion services at Colonial War Memorial Hospital, Suva, Fiji. The objectives were to identify trends in blood donation and its management before and during the pandemic.
The data collected demonstrated an 8.8% (n=690) decline in donation between 2022- 2021. The finding suggests that the major cause of the decline was due to the COvid19 lockdowns and movement restrictions. Demographics e.g. age of donors were also evaluated, to find blood donor referral, and age of donors with the findings showing the age category of 16-45years, to be common for deferrals as well as for donations.
A strategic approach needs to be formulated for scenarios like the Covid19 pandemic to implement working policies
Routledge Handbook of Infectious Diseases
No full textABSTRACT
The new addition of this unique resources, grounded on an understanding that our global world is more connected than it has ever been, provides an essential survey of infectious disease based on both clinical presentation and geographical area of exposure.
This book is split into 3 main sections, The first section offers an overview of the geopolitics of infectious disease, highlights the channels through which a disease can spread from one region or country to another, including air travel, shipping or migration. The second section provides a comprehensive overview of each region, highlighting the infectious disease common to that part of the world. The final section includes a chapter examining new infections of concern, and a chapter discussing infectious diseases in the context of global climate change.
Thoroughly updated with the latest clinical data and featuring contributions from leading scholars and clinicians in the fields, this book is a timely and important resources for practitioners and scholars across Clinical Medicine, Epidemiology and Public Health
Determinants of Food Choices and Physical Activity among secondary school Adolescents (15-18 years old) In Suva: A Qualitative Study
No full textIntegrating echo screening into the school nurse health visits in primary schools in Fiji Island
No full textThe Lived Experiences of Fijian Male Student Nurses- School of Nursing- Fiji National University: A mixed method study
No full text
Implementation and use of a national electronic dashboard to guide COVID-19 clinical management in Fiji
No full textProblem: From April to September 2021, Fiji experienced a second wave of coronavirus disease (COVID-19) precipitated by
the Delta variant of concern, prompting a need to strengthen existing data management of positive COVID-19 cases.
Context: With COVID-19 cases peaking at 1405 a day and many hospital admissions, the need to develop a better way to
visualize data became clear.
Action: The Fiji Ministry of Health and Medical Services, the World Health Organization and the United Nations Office for
the Coordination of Humanitarian Affairs collaborated to develop an online clinical dashboard to support better visualization
of case management data.
Outcome: The dashboard was used across Fiji at national, divisional and local levels for COVID-19 management. At the
national level, it provided real-time reports describing the surge pattern, severity and management of COVID-19 cases across
the country during daily incident management team meetings. At the divisional level, it gave the divisional directors access to
timely information about hospital and community isolation of cases. At the hospital level, the dashboard allowed managers
to monitor trends in isolated cases and the use of oxygen resources.
Discussion: The dashboard replaced previous paper-based reporting of statistics with the delivery of trends and real-time data.
The team that developed the tool were situated in different locations and did not meet physically, demonstrating the ease
of implementing this online tool in a resource-constrained setting. The dashboard is easy to use and could be used in other
Pacific island countries and area
Antimicrobial susceptibility of bacterial isolates from clinical specimens in four Pacific Island countries, 2017–2021
No full textBackground There are limited antimicrobial resistance (AMR) surveillance data from low- and middle-income countries, especially from the Pacific Islands region. AMR surveillance data is essential to inform strategies for AMR pathogen control.
Methods: We performed a retrospective analysis of antimicrobial susceptibility results from the national microbiology
laboratories of four Pacific Island countries – the Cook Islands, Kiribati, Samoa and Tonga – between 2017 and 2021.
We focused on four bacteria that have been identified as ‘Priority Pathogens’ by the World Health Organization: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa.
Findings Following deduplication, a total of 20,902 bacterial isolates was included in the analysis. The most common organism was E. coli (n = 8455) followed by S. aureus (n = 7830), K. pneumoniae (n = 2689) and P. aeruginosa (n = 1928). The prevalence of methicillin resistance among S. aureus isolates varied between countries, ranging from8% to 26% in the Cook Islands and Kiribati, to 43% in both Samoa and Tonga. Ceftriaxone susceptibility remained high to moderate among E. coli (87%–94%) and K. pneumoniae (72%–90%), whereas amoxicillin + clavulanate susceptibility was low against these two organisms (50%–54% and 43%–61%, respectively). High susceptibility was observed for all anti-pseudomonal agents (83%–99%).
Interpretation: Despite challenges, these Pacific Island laboratories were able to conduct AMR surveillance. These data
provide valuable contemporary estimates of AMR prevalence, which will inform local antibiotic formularies, treatment guidelines, and national priorities for AMR policy
Lessons for strengthening policymaking for obesity and diet related noncommunicable disease prevention: A narrative synthesis of policy literature from the Western Pacific Region
No full textObesity and diet-related noncommunicable diseases (NCDs) have a profound impact on individuals, households, health care systems, and economies in low- and middle- income countries (LMICs), with the Western Pacific Region experiencing some of the highest impacts. Governments have committed to improving population diets; however, implementation challenges limit effective policy action. We undertook meta-narrative synthesis of the academic literature and used theories of policymaking and implementation to synthesize current knowledge of issues affecting the adoption and implementation of policies to
prevent obesity and diet-related NCDs in LMICs in the Western Pacific Region. We found that political leadership and management of food and nutrition policies often diluted following policy adoption, and that nutrition and health advocates find it difficult to enforce policy compliance from actors outside their sectors. Opportunities for strengthening implementation of food and nutrition policies in the Western Pacific include
(1) improved and
earlier engagement between health policymakers and implementing agencies.
(2) focusing on the need for increased accountability from governments, including through effective engagement and organization of actor networks, knowledge sharing, and in highlighting where stronger action is required; and
(3) identifying and building the strategic capacities of policy actors in framing, advocacy, coalition-building, knowledge translation, and leadership