Fiji’s vision of developing a healthy population and sustainable health care is great, says Fiji National University Dean College of Medicine, Nursing and Health Sciences (CMNHS), Dr William May.

But, he adds the biggest challenge that the Fijian health sector faces is the ability to meet the health needs of the Fijian people with its allocated budget. The health needs could be preventative, treatment and rehabilitation.

He explains in detail where the focus could be in the upcoming 2019-2020 National Budget.

What should be the main focus for the Health budget?

Ensuring that all people have access to needed health services. This includes prevention, promotion, treatment, rehabilitation and palliation. The health services should be of sufficient quality to be effective. Strengthening the components of the country’s health systems and provide appropriate qualified, competent health professional staff at all points of health services contacts. The health budget should ensure that the use of these services does not expose Fijians to financial hardship. In short, the budget should focus on addressing Universal health Coverage in Fiji.

What is the biggest challenge the Fijian medical sector faces?

Fiji’s vision of developing a healthy population and sustainable health care is great. The biggest challenge that the Fijian health sector faces is the ability to meet the health needs of the Fijian people with its allocated budget.

The health needs could be preventative, treatment and rehabilitation. Addressing NCDs because it is still the main health challenge – it is the commonest cause of morbidity and mortality in Fiji.

The Fiji NCDs latest statistics are glaring at us: 82 per cent of deaths (and people are dying prematurely) occur are NCDs related, the number of diabetic amputations are three to four every 24 hours, the average length of stay in hospitals have increased, there is increased prevalence of diabetes (particularly now in the younger population), hypertension, heart diseases and cancers. However, one must not forget the prevention, management and control of emerging and re-emerging communicable diseases in relation to climate change such as TB, integrated management of childhood illness, leptospirosis, typhoid, dengue, other sexual and reproductive health issues, HIV and other STIs; and addressing these issues at the points of services levels.

What are the biggest challenges you think our health sector faces? What can be done to overcome that?

Maintaining a healthy population throughout the life course isn’t easy.  Promoting health, changing behaviour, access to healthy and affordable living every day is a big challenge for our country.

It’s not an easy task for a developing country. It requires a multi-sectorial approach. From promoting wellness to  looking at  how our health system can be improved, diverting funds to priority areas based on population health statistics and sustainable health care funding.

One suggestion is developing and implementing evidence-based health policies, programmes and activities.  Perhaps, we may need a paradigm shift of mind-sets to re-look at the health issues affecting the nation to be guided by the health indicators and evidence.

(B) Fiji has varying levels of health facilities that cater for different levels of services across the country.  Maintaining the quality of services all the time can be very challenging. For example the maintenance of radiology, laboratory, pharmacy and medical consumables to ensure services are not disrupted requires tremendous attention to stock management details. The slogan for universal health coverage being “health for all” also requires a health system to be able to periodically understand its needs in all health areas and reliably project with statistical accuracy the total need over a fiscal year. The fact that we hear complaints of shortages in both mainstream and social media, might be pointing to a need for a review of the stock information systems of these health services.

If there was one thing you could add in the national budget, what would it be?

If there is one new thing that I would like to add in the National budget, it would be provision of a Fiji National Health and Medical Research Funding.

This funding can sit with the Ministry of Health and Medical Services (MOHMS) and specifically aligned towards the key national research priorities of the MOHMS.

Educational institutions and health professionals in the country can bid for these funds to carry out research that address our local health priorities and needs.

The outcomes and recommendations from these research projects should be implemented and translated to the development of evidence-based health policies and programmes.

Any comments regarding where Government should focus to better health services in Fiji?

Fiji spends a huge proportion of its health budget on curative health services. The trend will continue to be as such unless we focus on building resilient strategies for health promotion, prevention and treatment. For this to be achieved, Government would need a diversely skilled workforce with collaborators and health facilities that are well equipped to meet the health needs across various levels within the country.

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