1.Decentralisation of Outpatient Services from Colonial War Memorial Hospital to the Health Centre in the Suva Subdivision
Fiji Journal of Public Health 2012;1(1):1-6
Patient choice forms a key part of health service
improvement and forms a major determinant in
patient health care delivery. At a time when the
population of Fiji has access to 24 hour banking
services and extended supermarket services, the
outpatient services at health centres remained in
the eight hour access, from 8am to 4.30pm.
The Valelevu, Makoi and Raiwaqa health centres
have been providing extension of service hours
from 6.30am to 10pm on weekdays and 8am to
4pm on weekends, from 2nd March and 15th
April, 2009, respectively. Ths concept is to be
extended to all six health centres in the Suva
Sub-division from the 31st of January 2011.
Decentralization is about making services more
accessible to the community, in other words,
bringing the services closer to where people
reside. A study of the health facilities in the Suva
Sub-division are provided with statistical analysis
and needs for future expansion of health facilities
with the necessary infrastructural improvements
or developments, staffi and medical supplies.
The report provides recommendations to
operationalizing the decentralization process by
46.4%. Th average number of patient arrivals
for year 2010 was 7637 patients per month (251
patients/day) and for 2011 it was 4095 patients
per month (135 patients/day). In 2010 the trend
for patient arrivals has been a plateau whereas
in 2011 a gradual decline reaching to a steady
state of patient arrivals from September till the
month of December was seen.
3.An Internal Assessment on the Baby Friendly Hospital
Manisha Shankar ; Timaima B Tuiketei ; Viema L Biaukula
Fiji Journal of Public Health 2012;1(2):1-9
Nausori Maternity Unit was declared a Baby
Friendly Hospital in 2008 and has successfully
maintained its status as such thus far. The
objectives of this qualitative study was to conduct
an internal audit into the BFHI at NMU through
interviews, observation and hospital records, and
secondly to make necessary recommendations to
the Ministry of Health. 51 staf members, 128
mothers and 101 members from the general
public were interviewed. The WHO BFHI internal monitoring tool was utilized in analyzing
the results of the study. NMU met the criteria for
8 of the 10 steps in the breastfeeding policy. Step
2 requires that there be refresher courses for staf
every 2 years; there has not been any refresher
course since 2008. Step 10 requires that mothers
be referred to breastfeeding support groups upon
discharge; again NMU failed to comply. Ths, the
overall compliance aftr the assessment came to
92%.
4.Malnurition in Tavua Subdivision 2012
Maurice Atalifo ; Timaima.B.Tuiketei ; Viema.L.Biaukula
Fiji Journal of Public Health 2012;1(2):15-20
“Reduce Child Mortality” – the fourth
Millennium Developmental Goal acknowledges
the fact that major causes of child deaths globally
is malnutrition and poor access to primary
health care and infrastructure. Ths article aims
to quantify the magnitude of malnutrition
among children 0-5 years of age within the Tavua
Subdivision from January 2010 to April 2012.
5.Patient Waiting Time in GOPD and SOPD at Nadi Hospital 2012
Lirow Eric ; Timaima.B.Tuiketei ; Viema Biaukula
Fiji Journal of Public Health 2012;1(2):27-32
Patient waiting time is a real problem in Fiji and
unfortunately Nadi Sub-divisional hospital is no
exception.
The objective of this study was to determine
patient waiting time in the GOPD and SOPD
clinic in the Nadi Sub-divisional Hospital,
additionally to gauge patient satisfaction.
Time logs were given to patients in order to log
the time as the patient went through the diffrent
management and investigation. Secondly a
questionnaire was given to every 20th patient to
measure their satisfaction with the services they
received in GOPD and SOPD.
The results showed that it took 2 hours and 57
minutes on average for a patient to be attended
by a doctor in the GOPD clinic and 2 hours and
7 minutes in the SOPD clinic. 50% of all patients
sampled believed that there should be more
doctors and 36% complained of the shortage of
drugs at the pharmacy.
Any improvement to the quality of health care
delivery in the Nadi Sub-Divisional hospital
needs to include an increase in doctors as well
as addressing how to prevent common drug
shortages in the pharmacy department.
6.Suicides in Rakiraki
Nisha Nafia ; Timaima.B.Tuiketei ; Viema.K.Biaukula ; Avelina Rokoduru
Fiji Journal of Public Health 2012;1(2):33-38
Suicide is an important public health issue in
Fiji and described as a “chronic epidemic”, only
recently surpassed by automobile fatalities as the
leading cause of death in young people. A total of
1749 people had attempted or completed suicides
with an average of 194 per year between 2002 and
2010 as per police records.5 Fiji has maintained
one of the highest suicide rates in the world in
young Fijian women of Indian descent along the
sugar belt areas of Fiji, at one point being cited
as the second highest in the world behind rural
China8.
Ths is a quantitative descriptive retrospective
study on all cases of suicide and attempted
suicide seen at the Ra Sub divisional Hospital
(RSH) from January 2008 to August 2012.
Data sources were obtained from the Rakiraki sub divisional hospital mortuary record book,
hospital inpatient records and Rakiraki Police
Departments’ records of all cases of deliberate
self harm were also collected in the study period.
Th overall prevalence of suicides and attempted
suicides in Rakiraki of 0.12%. Ths is relatively a
higher prevalence when compared to the national
statistics. Thre is a higher predominance of
suicides and attempted suicides in the IndoFijians, the youths, and in males as compared
to females. Hanging and chemical ingestion
were the commonest methods of suicide and
attempted suicide in Rakiraki and these should
be the main targets for prevention activities.
Indo- Fijian females were reported mainly to
have attempted suicides whilst Indo-Fijian males
predominantly committed suicides in Rakiraki.
9.The New Primary Health Care in Fiji Its Impact and Implications on the Practitioner in an Indigenous Setting – A Case Study in 2001
Fiji Journal of Public Health 2013;2(1):1-26
Health promotion is a process of enabling people to take control and improve their health. The concept was
adopted by the Ministry of Health in Fiji in 1997, and gave birth to what is referred to as the “new primary
health care” – the strengthening of the health promotion capacity of the existing primary health care system.
Ths study aims to describe the impact of new primary health care on existing primary health care practitioners
in Fijian villages, with the purpose of drawing implications on the processes that may be useful in other
indigenous settings in Fiji. A case study was undertaken to reveal the impact of health promotion in a localized
indigenous setting. The case demonstrated that indigenous Fijian settings are communally oriented and are
affcted by three systems – tradition, Christianity and the Westminster systems of governance – all of which are
potential platforms for health promotion. The study depicts that the major impact of the new primary health
care on the practitioner pertains to the need to acquire health promotion knowledge, attitude and practice, and
related understanding of community development and qualitative research. The acquisition of these knowledge
and skills may then enable the practitioner to strengthen the health promotion capacity of his/her primary health
care practice. In this way, an integrated and appropriate practice model has more chance of evolving and health
outcomes will follow.
10.Junk Food Promotion to Children and Adolescents in Fiji
Silvia F. Hope ; Wendy Snowdon ; Lindsay B. Carey ; Priscilla Robinson
Fiji Journal of Public Health 2013;2(1):27-35
Objective: To collect evidence on the exposure, awareness and effct of ‘junk food’ advertising and sponsorship upon
children and adolescents in Fiji.
Method: A questionnaire was developed and used with a sample 88 primary school students and 103 secondary school
students in Suva, Fiji and included questions about participants’ food preferences, nutritional knowledge and
advert recall ability. Two free-to-air television channels were recorded for two weekdays and two weekend days
from 6am-9pm, and the content analysed for advertised content. The amount of street advertisements in three
defied localities was assessed. Sponsorship of events by ‘junk food’ products was assessed over the preceding
twelve month period.
Results: School children were able to identify multiple food products they had seen advertised. 94% reported that
seeing adverts makes them want to try products. Seventy one percent had asked others to buy advertised
products for them. There was evidence that food advertising contributed to incorrect nutrition beliefs. Levels of street and television advertising for ‘junk foods’ were high. Fourteen events sponsored by ‘junk food’ products were found to have taken place within one year of the investigation.
Conclusions: Children in Suva remember but misunderstand the nutritional value of advertised ‘junk foods’.
Their diets are altered detrimentally as a result.
Implications: There is a need for a regulatory approach to limit ‘junk food’ advertising in Fiji.