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The evolution of primary health care in Fiji: Past, present and future

The evolution of primary health care in Fiji: Past, present and future

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Understanding how health policies develop and evolve is an initial step towards improving their effectiveness. This document review and key informant interviews research examines the evolution of primary health care in Fiji from 1975-2009.
Understanding how health policies develop and evolve is an initial step towards improving their effectiveness. This document review and key informant interviews research examines the evolution of primary health care in Fiji from 1975-2009.

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Published by: Nossal Institute for Global Health on Jul 30, 2012
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KNOWLEDGE HUBS FOR HEALTH
Strengthening health systems through evidence in Asia and the Pacic
The Nossal Institutefor Global Health
www.ni.unimelb.edu.au
HEALTH POLICY AND HEALTH FINANCEKNOWLEDGE HUB
 WORKING PAPER SERIES
NUMBER 6 | MAY 2010
The Evolution o Primary Heath Care in Fiji:Past, Present and Future
Joel Negin
Sydney School o Public Health and Menzies Centre or Health Policy, University o Sydney, Australia.
Graham Roberts
Fiji School o Medicine.
Dharam Lingam
Fiji School o Medicine.
 
WORKING PAPER SERIES HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB
The Evolution o Primary Heath Care in Fiji: Past, Present and Future NUMBER 6 | MAY 2010
ABOUT THIS SERIES
This Working Paper is produced by the Nossal Institute or Global Health at the University o Melbourne, Australia.The Australian Agency or International Development (AusAID) has established our Knowledge Hubs orhealth, each addressing dierent dimensions o the health system: Health Policy and Health Finance; HealthInormation Systems; Human Resources or Health; and Women’s and Children’s Health.Based at the Nossal Institute, the Health Policy and Health Finance Knowledge Hub aims to support regional,national and international partners to develop eective evidence-inormed policy making, particularly in the eldo health nance and health systems.The Working Paper series is not a peer-reviewed journal; papers in this series are works-in-progress. The aim isto stimulate discussion and comment among policy makers and researchers.The Nossal Institute invites and encourages eedback. We would like to hear both where correctionsare needed to published papers and where additional work would be useul. We also would like to hearsuggestions or new papers or the investigation o any topics that health planners or policy makers would ndhelpul. To provide comment or get urther inormation about the Working Paper series please contact; ni-ino@unimelb.edu.au with “Working Papers” as the subject.For updated Working Papers, the title page includes the date o the latest revision.
The Evolution o Primary Health care in Fiji: Past, present and Future
First drat – April 2010Corresponding author: Joel Negin Address: Sydney School o Public Health and Menzies Centre or Health Policy, University o Sydney,joel.negin@sydney.edu.auOther Contributors: Graham Roberts, Fiji School o Medicine and Dharam Lingam, Fiji School o Medicine.This Working Paper represents the views o its author/s and does not represent any ocial position o TheUniversity o Melbourne, AusAID or the Australian Government.
ACKNOWLEDGEMENTS
The authors would like to acknowledge the assistance and guidance o Josaia Samuela o the Fijian Ministry oHealth and o Alvaro Alonso-Garbayo o the World Health Organization throughout the research and drating.Erica Mayer provided excellent research support and Anne Marie Thow assisted in the development o thehealth policy analysis ramework. The authors would also like to thank the various interviewees or their timeand candour in contributing to the research.
 
HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB WORKING PAPER SERIES
NUMBER 6 | MAY 2010 The Evolution o Primary Heath Care in Fiji: Past, Present and Future
i
ABSTRACT
Health policy development is under-analysed globally and in the Pacic region. Understanding how healthpolicies develop and evolve is a rst step towards improving the quality and appropriateness o those policies.Through a document review and key inormant interviews, this study examines the evolution o the concepto primary health care in Fiji rom 1975 to 2009, ocusing on priority-setting, unding, implementation, politicaleconomy, the cultural context and interactions between communities, government and donors. Lessons rommore than 30 years o experience with community health are highlighted, revealing high levels o contestationover health policy. The study identies actors or inclusion in any renewed primary health care intervention andcalls or greater government ownership o priority setting, more clarity on the links between policy and unding,greater awareness by development partners o the risks o imposing policy and a deeper analysis o politicaleconomy and culture in relation to health policies.

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