What Fiji's Healthcare Reforms Teach Us

Recently, I sat down with Dr Minali Vasandani of Griffith University to talk about Fiji’s Health Reforms for her podcast series: ‘So What’s That Reform?’

Fiji has made two attempts at reforming its health system. The first attempt, the Fiji Health Management Reform Project, funded by AUSAid, ran from 1999 to 2004 and aimed to devolve the Ministry of Health into geographic divisions, each with legal authority over its own budgets, staffing, and ability to levy fees. However, political instability, government changes during implementation, and resistance from senior officials to what was seen as an externally driven project hampered the achievement of the project’s aims. In 2008, the decentralisation efforts were rolled back.

A second attempt in 2009 focused more narrowly on deconcentrating health services in one geographic division. This attempt targeted adult outpatient services in the Suva Subdivision, roughly home to one-quarter of Fiji’s population. Under this reform, outpatient services moved from the main referral hospital to six local health centres. Although the health centres received more staff, equipment, supplies, and medicines, and were open longer, this did not match the increase in utilisation. This undermined the reform’s aim of improving access to health services.

Listen to the podcast below to learn more about Fiji’s experience and the lessons that can be learnt from Fiji’s two attempts to reform its health system. #Fiji #HealthReforms #HealthSystems #Decentralisation #Devolution #Delegation #Deconcentration #Pacific #Podcast #SoWhatsThatReform