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EXECUTIVE SUMMARY
INTRODUCTION
Background
In February of 2011 the Pacific Human Resources for Health
Alliance (PHRHA) met in Nadi, Fiji, where representatives
from 13 Pacific Island countries (PICs) discussed current
issues and challenges in human resources for health (HRH),
and identified needs and priorities to address them.
Focussing on participants’ presentations, this paper
documents their perspectives and understandings and
presents policy recommendations arising from discussions.
In addition we present selected country comparative
demographic, socio-economic, health expenditure and
health status indicators to characterise the variable health
service contexts among the participating countries.
Methods
Contributions in the form of PowerPoint presentations from
each of the participating countries were structured according
to pre-arranged format and have been tabulated to identify
common themes. Country comparative indicators have been
compiled from source documents.
Results
Five challenges emerged from the presentations and
discussions:
1. health workforce issues (skills shortages, retention,
recruitment and workforce ageing)
2. the lack of effective HRH policy, management and
information systems;
3. education and training for HRH production;
4. public sector working conditions, and
5. migration of Pacific health personnel, both internally
and internationally.
Participants agreed that education and training, and policy
and management issues, should be given priority. Essential
elements for addressing these needs were seen as national
workforce planning, financial support and technical assistance
from donor countries and other stakeholders. The fulfilment
of needs was also seen to require political commitment and
strong leadership of Ministries of Health (MoHs) capable of
advocating for support from other key stakeholders.
Conclusions
Policy implications emerged for action at three levels:
national governments, regional training institutions, and
donor organisations.
The roles of the PHRHA 1 are to help identify and address
HRH challenges experienced by PICs, to assist in the
implementation of strategic policy and planning, and more
generally, to facilitate the strengthening of national HRH
capacities within the Pacific region. Its supportive activities
include the organisation of forums to facilitate discussion of
HRH issues and concerns amongst stakeholders. This paper
presents the results of one such meeting.
Representatives from 13 PICs (Cook Islands, Federated
States of Micronesia (FSM), Fiji, Kiribati, Nauru, Niue, Palau,
Republic of the Marshall Islands (RMI), Samoa, Solomon
Islands, Tokelau, Tonga and Vanuatu) came together at a
PHRHA meeting held in Fiji in February 2011 2 to present
what they perceived to be the key HRH challenges currently
being faced within their respective health sectors.
This paper considers current HRH issues within PICs from
the perspectives of people who manage HRH within their
country health ministry. The aim of this paper is to document
and highlight their key areas of common concern expressed
at the forum.
Section 1 presents selected key demographic and socioeconomic
indicators for each country, Section 2 focuses on
the methods used for participants to prepare for the meeting
and the methods we have used to identify and synthesise
the themes emerging from the presentations, Section 3
describes issues currently being experienced within each
country, Section 4 focuses on perceived needs and priorities,
Section 5 presents discussions of the key themes emerging from
participants’ contributions and Section 6 presents the policy
implications arising.
1
Membership of PHRHA includes all PICs, key development partners,
representatives of health training institutions, professional associations,
Pacific regional organisations, and WHO. The PHRHA Secretariat is
currently housed at the WHO sub-regional office in Suva, Fiji.
2
The meeting, Draft Framework for Action on HRH 2011-2015: Country
Situation on Human Resources for Health (HRH), was held in Nadi, Fiji,
February, 2011.
HRH issues and challenges in 13 Pacific Islands countries: 2011
Doyle et al.
3