Better Health Services Needed in Honiara.

Honiara City Council, Director of Health, Dr Sarah Habu Hopkins

IMPROVING the quality of health services in Honiara’s health system and the community could save lives, says the Honiara City Council, Director of Health, Dr Sarah Hopkins.
“Honiara’s quality of health services provided in our health care system is still falling behind,” said Dr. Hopkins, who took up her post earlier this year.
“The health services and resources available are still inadequate compared to the trend of the Honiara’s growing population, therefore, we are not moving forward as we want and expect,” she said. Dr Hopkins has previously worked as Resident Doctor in Charge of Buala Hospital, Isabel Province from 2010-2017. “With my leadership and my colleagues, we are optimistic that we can manage the urban health of a population of around 86,529 in the City of Honiara. I hope that we will do whatever it takes to help the urban population of Honiara achieve better healthcare services. “We want to be sure everyone receives better health care and all public health centres are well managed and organised,” she said.
Honiara and other neighbouring provinces in the country face a burden of diseases, such as
increasing rates of non-communicable diseases and the effects of climate change.
In a nation of only 620,000 people dispersed over more than 600 islands only about 30% of all births in the country happen at the National Referral Hospital, even though the capital accounts for just 13% of the population. Of the nation’s 157 doctors, 126 are based in Honiara.
According to an Asia Pacific Observatory on Health Systems and Policies (APO) review of Solomon Islands Health System, in 2015, the country’s health system has significant weaknesses but also considerable strengths.
“Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date,” the review said. “The demographic profile exacerbates these challenges. Increasing numbers of young women reaching reproductive age increases the need for maternal, newborn and child health services. At the same time, more people are living longer or reaching old age; this change, combined with the high prevalence of risk factors, is causing growth in non-communicable diseases and related disabilities, as well as an increase in premature deaths.
“Solomon Islands is served by a well-trained nursing workforce that provides the backbone of service delivery in rural areas. However, weak strategic workforce planning has led to potential oversupply of some cadres (such as doctors) and workforce deficits in other areas such as medical laboratory staff, radiologists and other allied health professionals. High staff turnover is another issue, largely due to financing constraints, along with the migration of some specialized health workers to other countries for better salary and working conditions.
“Overall, Solomon Islands health system can be characterised as conceptually fit for purpose but needing ongoing maintenance and development in some key areas such as management and service administration. There is a high degree of financial risk protection with low out-of-pocket payments. Possibly for this reason, health service contact rates are high by regional comparison and have been resilient to the service disruptions caused by political instability and unrest,” according to the review.
Most of the provinces have access to at least one level of health facility, based on the size and distribution of their population. However, these area health centres and rural health clinics are in urgent need for upgrade, repair or renovation. Many facilities have serious shortages of clinical equipment and medical supplies; with hospitals often relying on old and poorly maintained medical, diagnostic and surgical equipment. The availability of medicines in rural areas is improving.
“Almost half of all health expenditure in the Solomon Islands comes from donors. But much of that funding has targeted specific diseases, rather than strengthening the country’s health system and improving overall services,” the report said.
The APO is a collaborative partnership of interested governments, international agencies,
foundations, and researchers that promotes evidence-informed health system policy regionally and in all countries in the Asia Pacific region. It is hosted by the World Health Organisation (WHO).