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.

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.

In the Pacifi Health Ministers meeting in Yanuca Island Fiji in 1995, the Health Ministers agreed on formulating a framework to adapt the 1987 healthy city initiatives for the pacifi island countries, and the adaptation process resulted in the formulation and endorsement of the healthy islands initiatives under the ‘Yanuca Island Declaration’.Th strategy for implementing the healthy islands initiative was discussed in the ministers bi-yearly meeting two years later in Rarotonga Cook Islands, which saw the introduction of the settings approach. Foiled in that meeting as well is the healthy islands working defiitions, the visions and the core elements of healthy islands. In the urge to see that Fiji realigns herself to the global and regional changes, much has come through in Fiji’s effrt to implement the healthy islands initiative through the settings approach as a national program, and that has resulted in the establishments of settings in workplaces, schools, villages and settlements around Fiji. While the strategy might be workable in some context, the Lomaiviti Provincial Council saw the need of amending that to an “ISLAND APPROACH”, one which is much suited to their locality, considering the distributions of the islands within the Lomaiviti group. Moturiki island was chosen as a pilot and a model for the approach, and this report discusses the processes taken and captures a few highlights in the course of implementation. The approach is workable, and has seen a general increase and entire uplift of the island people’s expectations on what the initiatives has to offr. The development of social projects like community halls, water projects, flsh toilets and etc had a signifiant impact on the community, and has to an extent act as a catalyst in bringing people together for this course. While this report focuses specifially in addressing the immediate impacts on the entire island, a thorough and precise assessment should be done fie to seven years down the line to evaluate the island approach’s fial outcome on the reduction in communicable diseases, reduction in drowning incidents, effctiveness of the Oral Health 5:20 campaign and whether physical activity and local food consumption has increased that should subsequently result in a much controlled NCD rate in Moturiki Island. The report highlights a few areas of improvements if the approach is to be perfected, and it humbly draws the readers attention to the few recommendations listed down at the end of this report.

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.