In many Pacific Island countries, the delivery of specialised clinical care is limited by a continuing shortage of skilled health care workers, and the cost and challenges of organizing service delivery. Smaller countries are unlikely to become self-sufficient in the provision of many forms of specialised care in the foreseeable future.
These gaps in-country have been historically addressed through visiting specialist teams and individuals, and by off-shore referral for treatment in countries that are able to provide the necessary services and level of care such as Australia, New Zealand, the United States and – increasingly – Fiji, India, the Philippines and Taiwan. These services are funded through a combination of national budget allocations, social and personal health insurance, donor support, and links with non-government organizations (NGOs).
The mechanism by which the Australian Government supports specialist visits to PICs is called the Royal Australasian College of Surgeons (RACS) Pacific Islands Program (PIP). AusAID has funded the RACS PIP since 1995 and the planning and coordination processes for visiting and off-shore referral services are often complex and challenging.
The SSCSiP program was created to address some of these challenges by:
- Supporting PICs to plan for, access, host and evaluate specialised clinical services, and
- Strengthening health worker skills, capacity and capability to meet clinical service needs
The program covers 14 PICs: Cook Islands, Fiji, Federated States of Micronesia, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu.
Fresh & Different Approach
The longer term vision of change to which SSCSiP intends to contribute is:
By 2020, people living in Pacific Island countries, regardless of geographical location and socio-economic status, are accessing and benefitting from timely, good quality clinical care that is appropriately balanced against each country’s primary and preventative care priorities. There are sufficient skilled health workers to provide a defined range of services that are appropriate to the size, location, economy, relationships and culture of particular countries. Where those services are provided by visiting teams, they are country led, well planned, efficiently coordinated and guided by analysis and documented need. Where services are provided through off shore referral or in collaboration with neighbouring PICs, they are cost efficient and consistent with agreed medical and equity guidelines.
The SSCSiP program alone is not sufficient to achieve this vision. However, it will contribute to the achievement of this vision by building the capacity of PIC MOHs to organize and develop their specialised services and influencing how key partners support the provision of those services and the achievement of country-specific goals. The vision acknowledges the minimum longer term time frame necessary to achieve sustainable change in the way specialised clinical services are organized, delivered and maintained in the Pacific, i.e., a period of at least 10 years.
Development Through The Years
The mission of the SSCSiP program, which clarifies its contribution to the vision is:
The SSCSiP program works with PIC MOHs, clinical service providers, academic and health training institutions and with other partners to improve the quality, access and efficiency of specialised clinical services in the Pacific. SSCSiP assists MOH SCSCs to improve the planning, delivery, monitoring and evaluation of specialised clinical services and the systems that support them. It facilitates skill development and career enhancement for health workers by strengthening country level HRH planning and inter-country coordination, and by facilitating and maintaining linkages with academic and health training institutions. It convenes regional and inter-country meetings to stimulate and promote policy dialogue on the organization, delivery and support of clinical services.
This mission statement describes the direct contribution of SSCSiP to the achievement of the vision. Activities supported or implemented by the program are always informed by this mission statement.
The specific objectives of the SSCSiP project are as follows:
- To work with PICs to improve the planning, delivery, monitoring and evaluation of specialised clinical services and the systems that support these at country level.
- To facilitate skill development and career enhancement for health workers by strengthening country level HRH planning and inter-country coordination, and by facilitating and maintaining linkages with academic and health training institutions.
- To promote coordination, alignment and quality of SCS support for the Pacific.