MoHMS continues to be challenged by losing its older and more experienced staff to retirement at age 55. High staff turnover in MoHMS, and also to a certain extent in FHSSP, has meant posts have been vacant and new staff have had to be up to ‘brought speed’. Not surprisingly, the Program has struggled to find traction where the policy environment has been weak. Although progress has been made on the CHW Program, sustainability in this area is questionable and Objective 3 on NCDs has had limited impact partly because the Ministry has been evolving its thinking on but also because the wider policy environment vis a vis NCDs, beyond ‘wellness’” that controlled by MoHMS, means that making an impact on NCDs is challenging. Throughout the Program, interventions dependent on infrastructure have been problematic. Objectives 1 and 3 have suffered from this, and the Program did well to contend effectively with the request to fund a new birthing centre. An ongoing issue is the failure of MoHMS systems to fund the equipment needed for people to do their jobs. Often FHSSP was asked to fund procurement of basic equipment because it was easier than waiting months for the system to provide. This is neither sustainable nor a strategic use of project funds. Recommendations for the next phase of DFAT funding These recommendations have been selected to inform the design of the next phase of DFAT funding for health in Fiji. In depth analysis of the recommendations, their prioritisation and feasibility should be undertaken during the design phase. Strategic framework The United Sustainable Development Goals should help to frame the Nations’ priorities for the Program including Goal 3, Good Health and Well-Being, (reducing maternal mortality, ending preventable deaths of newborns and children under five, reducing premature mortality from NCDs, increasing health financing, building capacity to deal with national and global health risks and addressing HR shortages), Goal 5, Gender Equality (access to sexual and reproductive health and reproductive rights, end discrimination, opportunities for leadership) and Goal 16 Strong Institutions (Effective accountable and transparent institutions). The forthcoming Health National Strategic Plan 2016 2020 should also frame – engagement by the Australian aid Program. Continuity from FHSSP Continued support to health information will be important to underpin any efforts in health systems strengthening. FHSIP and FHSSP have made a very important contribution to helping MoHMS improve its M&E, and the future Program should continue to support a growing results focused culture.
MoHMS continues to be challenged by losing its older and more experienced staff to retirement at age 55. High staff turnover in MoHMS, and also to a certain extent in FHSSP, has meant posts have been vacant and new staff have had to be ‘brought up to speed’. Not surprisingly, the Program has struggled to find traction where the policy environment has been weak. Although progress has been made on the CHW Program, sustainability in this area is questionable and Objective 3 on NCDs has had limited impact partly because the Ministry has been evolving its thinking on ‘wellness’” but also because the wider policy environment vis a vis NCDs, beyond that controlled by MoHMS, means that making an impact on NCDs is challenging. Throughout the Program, interventions dependent on infrastructure have been problematic. Objectives 1 and 3 have suffered from this, and the Program did well to contend effectively with the request to fund a new birthing centre. An ongoing issue is the failure of MoHMS systems to fund the equipment needed for people to do their jobs. Often FHSSP was asked to fund procurement of basic equipment because it was easier than waiting months for the system to provide. This is neither sustainable nor a strategic use of project funds. Recommendations for the next phase of DFAT funding These recommendations have been selected to inform the design of the next phase of DFAT funding for health in Fiji. In depth analysis of the recommendations, their prioritisation and feasibility should be undertaken during the design phase. Strategic framework The United Nations’ Sustainable Development Goals should help to frame the priorities for the Program including Goal 3, Good Health and Well-Being, (reducing maternal mortality, ending preventable deaths of newborns and children under five, reducing premature mortality from NCDs, increasing health financing, building capacity to deal with national and global health risks and addressing HR shortages), Goal 5, Gender Equality (access to sexual and reproductive health and reproductive rights, end discrimination, opportunities for leadership) and Goal 16 Strong Institutions (Effective accountable and transparent institutions). The forthcoming Health National Strategic Plan 2016 – 2020 should also frame engagement by the Australian aid Program. Continuity from FHSSP Continued support to health information will be important to underpin any efforts in health systems strengthening. FHSIP and FHSSP have made a very important contribution to helping MoHMS improve its M&E, and the future Program should continue to support a growing results focused culture.
fiji-health-sector-support-program-final-evaluation.docx