FIJI’S health service structure needs to be ‘flipped’, from a system focused on hospital-based, curative care to one that prioritises preventive care and disease management at the primary level, a review of Fiji’s health sector by the World Bank has recommended in a report released in Suva yesterday.
This, as non-communicable diseases (NCDs) run rampant among the populace, with 80 percent of deaths in Fiji attributed to NCDs, 64 percent of it occurring among working age population and the “crisis” costing Fiji around $591million a year.
“The share of the disease burden resulting from NCDs has been rising over time and the country has one of the highest rates of premature deaths from NCDs globally,” the report noted.
“NCDs rose from a share of 64.1 percent of Fiji’s disease burden in 1990 to 77.1 percent in 2019.
“In 2019, almost 64 percent of all deaths due to NCDs were among Fijians aged between 30 and 70 years.
“This is a high share of all NCD deaths compared to other countries with similar levels of income, and compared to Fiji’s aspirational, structural, and regional peers.
“Diabetes, ischemic heart disease, stroke, and chronic kidney disease are the major causes of death from NCDs among all Fijians.”
The World Bank estimated that “flipping” the system would cost roughly between $320million and $340million or approximately $50million annually over a seven-year period but a worthy investment as “primary healthcare-oriented systems offer the most cost-effective, equitable, and accessible route to improving population health.”
“An effective PHC (Primary Health Care) system promotes healthy lifestyles, diagnoses diseases early, and provides effective disease management,” the World Bank stated.
“Hospitalisations for complications related to diabetes and hypertension can often be avoided if these conditions are managed early and adequately at PHC levels.
“The goal is to reduce the number of patients with chronic conditions and associated complications who end up seeking care in secondary and tertiary facilities.”
The bank has warned that “business as usual is not an option” and that Fiji will require a combination of policy, action, investment and service delivery to achieve a new vision of healthcare to reverse the deadly trend.
It is recommending actions in four key reform areas.
