June 2014 STRENGTHENING CIVIL REGISTRATION AND VITAL STATISTICS (CRVS) IN FIJI The Minister of Health Dr. Neil Sharma has been an advocate for CRVS in Fiji for over 3 years. His leadership has seen the establishment of the inaugural multi-sectorial National CRVS Committee co-chaired by Director Health Information, Research and Analysis – Mr. Shivnay Naidu and Acting Deputy Government Statistician – Mr. Serevi Baledrokadroka which includes key stakeholders such as Register General, ITC Services, Bureau of Statistics and Health. This initiative looked at the gaps in the current CRVS systems and through support from external stakeholders like Brisbane Accord Group (BAG – WHO, SPC, UQ, QUT, UNICEF etc) in 2012 developed 19 recommendations to improve Fiji’s CRVS systems. These were focused on 5 major areas such as Legal, Registration Practices, ICD Compliance Practice, Data quality, dissemination & use and Coordination. There have been some great milestone achievements such as increased awareness, increased registration, amnesty on fees, increased allocation of resources such as staffing and computers for data entry, audits of coding, training of doctors on completing the medical cause of death certificate, training of medical recorders on best coding practices, investment into maternal and child health for early booking and reduce compilations and deaths, focused interventions on major causes of deaths such as NCDs through Wellness initiative, data sharing between key stakeholders for improved decision making and better collaboration with strategic partners. Recognition of these achievements has been highlighted in both regional and global forums. This has led to Dr Sharma being appointed as the inaugural Chair of the Regional Steering Group for CRVS in Asia and the Pacific. The Regional partners are seeking his leadership and innovation to progress and strengthen systems for people with better investment plans and coverage for all. Fiji is looking towards developing its own National CRVS Strategic Plan 2015-2019 to ensure a structured, coordinated and collaborative partnership that not only convalesces the data but using evidence provides results and developments that is people-oriented, equitable and sustainable in an innovative manner.
WHY CIVIL REGISTRATION AND VITAL STATISTICS (CRVS) SYSTEMS MATTER FOR HEALTH SYSTEMS Civil registration systems are government-administrated systems used to record vital events including live births, deaths, foetal deaths, marriages and divorces. These permanent records have two main uses. First, they are personal legal documents that confer individual rights of identity, property and status. Second, and most importantly from a demographic and epidemiological perspective, they provide data that have the potential to serve as the main source of national vital statistics. Vital statistics are a key input for policymaking and planning in human development, and are essential for the effective operation of health systems. They inform policymakers of the size and characteristics of the population; of the number of live births over
time, classified by various characteristics of the mother; and of deaths, classified by various characteristics of the deceased, especially age and sex. Such knowledge is invaluable for assessing and monitoring the health status of populations and planning interventions (Health Metrics Network 2008). Timely and reliable vital statistics and cause-of-death data are of fundamental strategic importance to health systems. They provide health policymakers and managers with critical information for guiding policy, planning and resourcing of health priorities. The best source of these data is a complete vital registration system, commonly and most effectively established through civil registration (United Nations Statistics Division 2001; AbouZahr et al. 2007).
HEALTH MINISTER CONFIDENT WITH PROGRESS ON ADDRESSING RHEUMATIC HEART DISEASES
COUNTERFEIT MEDICATION PART OF WHA AGENDA
The Health Minister Dr Neil Sharma is confident and determined on the progress and innovative approaches taken to address Rheumatic Heart Diseases (RHD) in Fiji. Work on RHD has been ongoing since 2005 as Fiji being a developing country; addressing such areas in health can be a challenge. However the Health Ministry has been supported by the public private sector collaboration as this has proved to boost and improve the entire spectrum of healthcare. Dr Sharma said, “Health has benefitted from the social corporate responsibility of the private sector which is evident from the collaboration with the Rotary Club of Suva and the Ministry of Education in raising awareness on RHD”. “Public resourcing is often limited. A sustainable partnership in health service delivery assists in improving access to secondary and tertiary levels of care”. RHD is an area of concern as prevalence has been found in children between the ages of 4-19. To address child mortality, the Health Ministry and the Government over the past 5 years has developed programs to address and reduce the rates of child mortality. For instance in primary health care, antenatal nutrition has been focused on, with the provision of food vouchers, iron and folic acid supplementation, addressing child nutrition through the NIMS and Vita-meal program. There is now also a Challenged Child concept evolving, school health and oral health screening and revitalization of Community Health Worker Scheme in place. While in secondary health care, pediatric and medical outreach programs have been further extended. “We have taken a step further in tertiary health care with the availability of surgeries conducted locally and with patients being referred for specialist treatment abroad. Vodafone Foundation has been supportive in sending children for complex surgery to India”, Dr Sharma added. To further strengthen this area of concern, research and training has been ongoing since 2008. Nurses have been trained to conduct cardiac ultrasound in children for early detection of RHD. Meanwhile Dr Sharma undertook a presentation at the World Heart Federation (WHF) held in Melbourne Australia on Fiji’s experience on Private, public Partnership in Rheumatic Heart Disease.
Healthy L iving
The 67th World Health Assembly passed 25 resolutions at its recent meeting with 194 Ministers for Health in Geneva. One of the resolutions centred on a general watchfulness on falsified and counterfeit medication. Fiji has ratified its commitments to the resolution unequivocally. The New Medicine Products Decree which has become operational in 2013 ensures that all medication and medicinal consumables are duly registered and its validity reviewed by the pharmaceutical services. In suspect cases, random testing of medication is undertaken by independent authorities like the Therapeutic Goods Administration (TGA) Australia. Where wholesalers in the past may have indented dubious product lines, the current laws are very clear. “Wholesalers face the full brunt of the law and can loose their license if spurious and falsified items enter Fijian Jurisdiction,” said Minister for Health, Dr Neil Sharma. The Fiji Customs Service has been trained in inspection details by the Pharmaceutical services in 2012-2103. The laws in Fiji remain robust with National Medicines and Therapeutic Committee of clinical consultants to oversee the side-effects, toxicity and adverse reactions which warn the Fiji Pharmaceutical services to act in such matters. Fiji’s responsibilities are regional in nature as the National Bulk Purchase warehouse and distribution network is Suva based. With our current bilateral agreements Fiji supplies its neighbouring countries with high quality generic medication. The warning is not specifically to Fiji but to all governments globally.
GIVE BLOOD – FOR THOSE WHO GIVE LIFE
Saturday 14 June is World Blood Donor Day when we celebrate the contribution of voluntary unpaid blood donors in saving lives and improving health. It also has an essential, life-saving role in maternal care. Around the world, every day about 800 women die from pregnancy or childbirth-related complications. Severe bleeding during delivery and after childbirth is a major cause of mortality, morbidity and longterm disability. Dr James Fong, Head of the Obstetrics and Gynaecology Department, CWM Hospital, supports this year’s campaign theme of Safe Blood for Saving Mothers as he knows first hand just how important safe blood donors are. “I would like to thank all those voluntary blood donors who give blood regularly to keep our Blood Banks topped up so there is blood whenever a mother needs it. These are the true Good Samaritans, whose gift helps save someone they have never met” Dr Fong said. “I hope World Blood Donor Day will create wider awareness about the need for safe blood and encourage many more people to become regular voluntary blood donors” he added. The World Health Organisation goal is for all countries to obtain 100% of their blood supplies from voluntary unpaid donors by 2020, as these donors provide the safest blood. Currently 75% of all blood donated in Fiji is from voluntary donors and the aim is for 100% voluntary donation by 2018.
MOSQUITO BREEDING
Mosquito breeding is an offence under the Public Health Act Cap 111, Part XI (103) – (112). Health Inspectors around Fiji, in rural local authorities or urban centers have the powers to institute legal actions against occupiers, owners of any premises, or the owner or person having charge of any vessel or article in which there is any collection of water and found to contain any of the immature stages of the mosquito. The Ministry of Health in its effort to address the Dengue outbreak created massive awareness through the media and through the public health officials that went door to door and community to community. Public response was affirmative; however, there are individuals, companies and communities that did not adhere to health advices. Dengue situation has not subsided in Western & Northern division Mosquito Larvae Bruteau Indice is still higher than the safe level. Potential resurgence of dengue and prolonged dengue outbreak in the affected areas is very high if the mosquito population is not controlled. The health ministry reminds communities to be more vigilant on destroying mosquito breeding sites as to avoid and isolate the mosquito vector from spreading the disease. People offending in keeping and breeding mosquitoes are liable to fines and the Health Inspectorate staffs are monitoring the communities for such situation and will act immediately. A successful litigation case happened in Savusavu and all other Health offices are continuing with the same procedure starting with the intimation notice so more people will be brought to court. It is important to pay particular attention to rubbish, which includes containers capable of holding water, along with the storage of tyres, water drums, and the overgrowth of grass and shrubs within the compounds. Remember to clean your compounds to be free of empty containers that are capable of storing water so as to protect your families from mosquitoes and dengue.
FIJI MOVES CLOSURE TO ERADICATION OF NEW HIV INFECTIONS The minister for health Dr. Neil Sharma launched three new documents Prevention of Parent to Child Transmission Policy (PPTCT), HIV Treatment and Care Guidelines and PPTCT Participants Manual to help address the prevention of HIV virus transmission from parents to children. Fiji is now launching its Second HIV Treatment and care Guidelines, (the first in 2004) PPTCT Policy which is the 3rd Edition, and for the first time we are introducing our own local adopted training manual for PPTCT also known as prevention of parent to child transmission of HIV. “Fiji has the capacity to move towards zero new HIV Infections amongst the pregnant women by 2015, early booking and compliance Miniistry of Health - Fiji facebook.com/MoHFiji
of women is important to help achieve this”, Dr.Sharma said. It is indeed an opportune time for Fiji to launch these new documents alongside the training of health care workers to strengthen their capacity in the area of HIV. “This I must say is a milestone in the era of Fiji which will not just strengthen the capacity of health care workers but also improve the treatment, care and support for all personals either living with or affected by HIV”, added Dr. Sharma. Dr Sharma thanked its technical and Financial partners such as UNICEF,WHO, SPC,UNFPA Civil Society Organization and Network of Positive People for their support in achieving this milestone.
www.health.gov.fj
COMPILED BY SUNIL.C, MEDIA LIAISON OFFICER MOH HEADQUARTERS. P: 3314988 M: 8905053