Strategic Plan 2020-2025

Objectives

Fiji’s 2020–2025 health strategy adopts a one-system approach to achieve universal health coverage: equitable access to effective promotive, preventive, curative, rehabilitative and palliative services without financial hardship, with particular attention to vulnerable and marginalised people, isolated islands, informal settlements, disease hotspots and climate-affected communities.[1][2][3]It aligns with Fiji’s National Development Plan, Sustainable Development Goal 3 and the Healthy Islands vision, seeking high-quality services and ensuring that no one is left behind.[4][2]

• Reform public health through a population-based, life-course approach to communicable diseases, non-communicable diseases, mental health, injuries, environmental threats and the climate crisis.[5][3][6]
• Reduce premature mortality, disease prevalence and complications from cardiovascular diseases, cancers, diabetes and chronic respiratory disease through prevention, screening, early diagnosis, management, rehabilitation and palliative care.[7][8]
• Improve physical and mental well-being, particularly among women, children and young people, by integrating nutrition, physical activity, oral health and mental-health support into reproductive, maternal, newborn, child and adolescent health services.[9]
• Protect communities against environmental risks, outbreaks, disasters and climate-related health impacts, while strengthening resilience and emergency preparedness.[3][9][10]
• Increase access to safe, quality, patient-focused clinical and rehabilitative services, decentralise care, improve patient safety and outcomes, and reduce avoidable inpatient admissions and lengthy hospital stays.[5][11][12]
• Strengthen health-system management through a capable workforce, reliable procurement and supply chains, sound financial and infrastructure management, digital technologies, effective governance and collaboration with partners.[5][12][13][14]

Implementation

Implementation is structured around a rolling five-year Strategic Plan that guides annual operational plans, unit business plans and individual staff work plans.[5][15]The model integrates preventive, community, primary, secondary and tertiary care, connects public-health and clinical services, and brings selected services closer to homes and communities through decentralisation, outreach and digital support.[16][11][14]

• Deliver prevention and health promotion through Wellness Fiji, multidisciplinary teams, seven life-course cohorts and settings including villages, settlements, schools, workplaces, towns and cities, sports settings and faith-based organisations.[6]
• Integrate communicable-disease and non-communicable-disease prevention, screening, case detection and diagnosis from community to hospital level, including the World Health Organization Package of Essential Noncommunicable Disease Interventions in primary care.[6][17]
• Decentralise outpatient, specialist, maternal, rehabilitation and selected clinical services through subdivisional facilities, outreach teams, maritime services, mobile clinics, community health workers and telehealth.[17][10][11]
• Strengthen clinical quality through standardised treatment, referral pathways, clinical governance, practice guidance, audits, patient-safety measures and the draft Patient Charter.[11][12]
• Develop the workforce through recruitment, rapid deployment, retention, competency-based professional development, leadership and management frameworks, workforce analysis and staff-satisfaction monitoring.[12][13]
• Reform supply chains through end-to-end review, improved warehousing, procurement, quality control, equipment planning and maintenance, and measurement of essential-medicine stockouts.[8][13]
• Develop health financing arrangements, improve budget execution and financial controls at cost centres, maintain low-cost services, and assess contracting with civil-society organisations and public-private partnerships where evidence supports efficiency or quality.[13][15]
• Implement a digital-health strategy covering electronic medical records, supply-chain information, patient and workforce systems, telemedicine and information-system training, while modernising existing platforms.[15][14]
• Coordinate action through the Ministry of Health and Medical Services with other government ministries, communities, civil society organisations, private providers, religious institutions, universities, research institutes, donors, United Nations agencies and development partners.[18][19]
• Strengthen governance through standardised planning across national, divisional and facility levels, and consider a Global Health Coordination Unit and Programme Implementation Board.[14][19]
• Monitor implementation through key performance indicators, surveillance, audits, patient feedback, workforce and stockout measures, National Health Accounts and a monitoring, evaluation and learning system; detailed reporting schedules and a consolidated accountability framework are not specified in the supplied extracts.[16][13][14][19]

Monitoring & Evaluation

The Strategic Plan links implementation to a monitoring, evaluation and learning framework, using key performance indicators and outcome measures to inform operational planning, management decisions and progress towards universal health coverage.[16][5][14]

• Measure health outcomes and service provision using Sustainable Development Goal indicators across reproductive, maternal, newborn and child health; infectious diseases; non-communicable diseases and mental health; injuries and violence; universal health coverage and health systems; environmental risks; and disease outbreaks.[2]
• Strengthen surveillance, prevention, detection and response capacities for public-health emergencies, including through the National Notifiable Disease Surveillance System and International Health Regulations capacity covering human resources, surveillance, laboratory and response functions.[20][7][9]
• Monitor communicable and non-communicable disease burden through mortality estimates, case detection, screening and diagnosis across community-to-hospital services.[7][6]
• Track progress towards the 2025 outcome of reduced communicable and non-communicable disease burdens, including work towards eliminating leptospirosis, typhoid and dengue.[6]
• Assess preventive and child-health outcomes through school-based obesity monitoring, immunisation targets, maternal, neonatal, perinatal and child-health audits, and mortality measures.[17][9][10]
• Monitor patient experience and service quality through the 157 complaints hotline, queue-management pilots, patient-satisfaction surveys, a draft Patient Charter, clinical governance, clinical audits and standardised clinical services.[8][12]
• Review workforce needs, staff satisfaction and performance through individual work plans, regular workforce analysis and competency-based professional, leadership and management frameworks.[12][13]
• Establish measurement of essential-medicine and commodity stockouts across nursing stations, health centres, subdivisional hospitals and divisional hospitals.[13]
• Use digital information systems for patient records, service-use returns, human-resource information, inventory management and notifiable-disease surveillance, while improving electronic patient-information completeness and access.[15][14]
• Produce annual National Health Accounts with the World Health Organization to track expenditure flows and out-of-pocket spending for evidence-based planning, financial-protection analysis and universal health coverage monitoring.[18][13]
• Establish functional governance structures at national, divisional and facility levels, connected through standardised planning, by the end of 2025.[19]

The supplied material does not set out a consolidated indicator register, indicator definitions, reporting timetable, evaluation methodology, named reporting responsibilities or detailed formal accountability framework.[16][6][19]

Costing & Financing

Financing priorities centre on improving budget execution, financial controls, expenditure efficiency and financial protection while maintaining services that are free or available at very low cost.[15][13]

• Develop a health financing strategy, strengthen financial controls at cost centres and examine contracting with civil society organisations and public-private partnerships where research demonstrates efficiency or quality benefits.[13]
• Maintain the Free Medicine Policy, which enables the poorest households to reclaim medicine costs, and continue government financing for the free medicine scheme for low-income households.[2][15]
• Allocate substantial health-system resources to clinical services, with primary and secondary clinical care absorbing the majority of the health budget and the workforce forming the largest component of health expenditure.[17][8]
• Address resource constraints affecting medicines, consumables, prosthetics, specialist equipment, storage space, equipment availability and supply-chain efficiency.[8]
• Use development-partner financial and technical assistance to address domestic funding or technical gaps, while improving coordination to reduce ad hoc or duplicative support.[18]
• Reduce overseas-referral costs through expanded specialist services, although no monetary estimate is provided.[11]
• Support investment needs associated with decentralised services, workforce development, digital health, supply-chain reform, infrastructure, surveillance, laboratory capacity, climate resilience and emergency preparedness.[9][10][14]

Reported financing measures include public health spending equivalent to 3.1 per cent of gross domestic product, out-of-pocket spending estimated at 21 per cent of total health expenditure, and hospital services accounting for approximately 43 per cent of government health spending during 2011 to 2015.[15]The supplied material does not provide a total strategy budget, programme-level costings, quantified financing gaps, activity-level allocations, resource-mobilisation targets or economic assumptions.[15][13]