Pacific Island Countries Research Articles

Pacific Island Countries demonstrate the sustained success of a coordinated measles mass vaccination campaign

Pacific Island Countries demonstrate the sustained success of a coordinated measles mass vaccination campaign

One response: Global Outbreak Alert and Response Network supporting the COVID-19 response, Kiribati.

In January 2022, Kiribati experienced widespread community transmission of COVID-19, leading to high rates of infection among health-care workers (HCWs), which reduced essential HCWs during a period of increased hospital admissions. Kiribati, a Pacific island country made up of a remote group of 33 low-lying atolls in the Pacific Ocean, experienced its first surge of COVID-19 cases beginning on 24 January 2022. Reports of increasing numbers of COVID-19 cases in South Tarawa prompted the Kiribati Ministry of Health and Medical Services to request assistance from the international community, including the World Health Organization's Global Outbreak Alert and Response Network (GOARN), to support national COVID-19 response operations. Specialists in infection prevention and control (IPC) were deployed to Kiribati in February 2022 to assist the Ministry's National COVID-19 Taskforce in collaboration with national partners. These specialists helped review and strengthen IPC capacities to accommodate a potential patient surge and consequent demands for medical consumables in health-care facilities in South Tarawa. Strengthened knowledge about and processes for IPC among HCWs prevented health care-associated infections and reduced community disease transmission during the first surge of COVID-19 cases in Kiribati. GOARN has the capacity and ability to rapidly deploy experts to support requests for assistance. Outbreak response activities can be enhanced and sustained by using GOARN's resources and collaborating with all partners, as necessary.

Implementation and use of a national electronic dashboard to guide COVID-19 clinical management in Fiji

From April to September 2021, Fiji experienced a second wave of coronavirus disease (COVID-19) precipitated by the Delta variant of concern, prompting a need to strengthen existing data management of positive COVID-19 cases. With COVID-19 cases peaking at 1405 a day and many hospital admissions, the need to develop a better way to visualize data became clear. The Fiji Ministry of Health and Medical Services, the World Health Organization and the United Nations Office for the Coordination of Humanitarian Affairs collaborated to develop an online clinical dashboard to support better visualization of case management data. The dashboard was used across Fiji at national, divisional and local levels for COVID-19 management. At the national level, it provided real-time reports describing the surge pattern, severity and management of COVID-19 cases across the country during daily incident management team meetings. At the divisional level, it gave the divisional directors access to timely information about hospital and community isolation of cases. At the hospital level, the dashboard allowed managers to monitor trends in isolated cases and use of oxygen resources. The dashboard replaced previous paper-based reporting of statistics with delivery of trends and real-time data. The team that developed the tool were situated in different locations and did not meet physically, demonstrating the ease of implementing this online tool in a resource-constrained setting. The dashboard is easy to use and could be used in other Pacific island countries and areas.

윤석열 정부의 자유·평화·번영의 인도·태평양 전략 추진에 따른 태평양도서국(太平洋島嶼國) 접근 전략 연구

윤석열 정부의 자유·평화·번영의 인도·태평양 전략 추진에 따른 태평양도서국(太平洋島嶼國) 접근 전략 연구

Healthy life expectancy for 202 countries up to 2030: Projections with a Bayesian model ensemble.

Healthy life expectancy (HLE) projections are required for optimising social and health service management in the future. Existing studies on the topic were usually conducted by selecting a single model for analysis. We thus aimed to use an ensembled model to project the future HLE for 202 countries/region. We obtained data on age-sex-specific HLE and the sociodemographic index (SDI) level of 202 countries from 1990 to 2019 from the Global Burden of Disease (GBD) database and used a probabilistic Bayesian model comprised of 21 forecasting models to predict their HLE in 2030. In general, HLE is projected to increase in all 202 countries, with the least probability of 82.4% for women and 81.0% for men. Most of the countries with the lowest projected HLE would be located in Africa. Women in Singapore have the highest projected HLE in 2030, with a 94.5% probability of higher than 75.2 years, which is the highest HLE in 2019 across countries. Maldives, Kuwait, and China are projected to have a probability of 49.3%, 41.2% and 31.6% to be the new entries of the top ten countries with the highest HLE for females compared with 2019. Men in Singapore are projected to have the highest HLE at birth in 2030, with a 93.4% probability of higher than 75.2 years. Peru and Maldives have a probability of 48.7% and 35.3% being new top ten countries in male's HLE. The female advantage in HLE will shrink by 2030 in 117 countries, especially in most of the high SDI and European countries. HLE will likely continue to increase in most countries and regions worldwide in the future. More attention needs to be paid to combatting obesity, chronic diseases, and specific infectious diseases, especially in African and some Pacific Island countries. Although gender gaps may not be fully bridged, HLE could partially mitigate and even eliminate them through economic development and improvements in health care.

Ordering the Islands? Pacific Responses to China’s Strategic Narratives

Abstract Metropolitan powers are concerned that China is seeking to influence Pacific Island countries and reshape Pacific Islands’ regional order in its favour. But there is a risk that the effectiveness of China’s efforts has been overinterpreted by metropolitan powers. In this article we analyse the effectiveness of one element of China’s activities: the deployment of narrative power. We do this by examining the reception and role of China’s strategic narratives in the Pacific Islands. We analyse how China’s strategic narratives have been interpreted, adopted, and/or instrumentalised by Pacific Island countries and leaders using case studies of three key regional states: Fiji, Solomon Islands, and Samoa. We conclude that while Fijian, Solomon Islands, and Samoan leaders have incorporated elements of China’s strategic narratives into their discourse, they have done so using their own interpretations and, at times, instrumentalised those narratives for their own purposes. We conclude that this suggests that narrative power is more limited than it is often assumed. However, we acknowledge that narrative power may have indirect effects, with China’s narratives in the Pacific Islands region, as well as their instrumental adoption by Pacific Island countries, motivating changes in the policies and narratives of metropolitan powers.

Food tax policies in Pacific Island Countries and Territories: systematic policy review.

To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs). Food taxation polices, regarding excise taxes and tariffs applied from 2000 to 2020 in twenty-two PICTs, and their key characteristics were reviewed. The search was conducted using databases, government legal repositories and broad-based search engines. Identified documents for screening included legislation, reports, academic literature, news articles and grey literature. Key informants were contacted from each PICT to retrieve further data and confirm results. Results were analysed by narrative synthesis. Noncommunicable diseases (NCD) are the leading cause of premature death in PICTs and in many jurisdictions globally. An NCD crisis has been declared in the Pacific, and food taxation policy has been recommended to address the dietary risk factors associated with. Progress is unclear. Of the twenty-two PICTs included in the study, fourteen had food taxation policies and five introduced excise taxes. Processed foods, sugar and salt were the main target of excise taxes. A total of eighty-four food taxation policy changes were identified across all food groups. There was a total of 279 taxes identified by food group, of which 85 % were tariffs and 15 % were excise taxes. Individual tax rates varied substantially. The predominant tax design was ad valorem, and this was followed by volumetric. A quarter of PICTs have introduced food excise taxes from 2000 to 2020. Further excise taxes, specifically tiered or nutrient-specific designs, could be introduced and more systematically applied to a broader range of unhealthy foods.

Prevalence and correlates of psychological distress among national community-based adult populations in Nauru, Tukelau and Tuvalu.

The aim of the study was to estimate the prevalence and correlates of psychological distress (PD) in three small Pacific Island countries. National cross-sectional data (pooled sample N = 3,088, 18-69 years) of participants from the STEPS surveys in Nauru (2015/16; N = 1382), Tukelau (2014; N = 554) and Tuvalu (2015; N = 1152) were analysed. In the pooled sample 30.4% participants had PD (⩾20 scores), 18.1% mild (20-24 scores), 7.8% moderate (25-29 scores) and 4.4% severe (30-50 scores) PD. The prevalence of PD in Nauru was 41.5%, in Tukelau 5.0% and in Tuvalu 22.7%. In the adjusted logistic regression analysis with the pooled sample, younger age (18-39 years), alcohol family problems, heart attack/stroke, current smoking, high salt intake and high sedentary behaviour were positively associated with PD, while male sex and being from Tukelau and Tuvalu were negatively associated with PD. Almost one in three participants reported PD and several associated factors were found that can be targeted in population interventions.

“Want to help someone? Shut up and listen”: Foreign aid, maladaptation, and community development practices in the Pacific

AbstractMotivationThrough a Fiji case analysis, this article elaborates on how well‐intentioned foreign aid initiatives can result in maladaptation for local communities. When most well‐intentioned foreign aid institutions become aware of development problems in the Pacific Island Countries, they start planning development interventions. However, maladaptation can occur where there is insufficient community input, creating conditions that worsen situations and make communities more vulnerable.PurposeThe study highlights a way to improve the sustainability and effectiveness of development projects with local communities by analysing two case studies. One is a community project driven by a civil society organization (CSO) and the other is community‐driven development (CDD) project in Fiji.Approach and methodsThe researcher engaged in community field studies while working as a civil servant in Fiji for 12 years and has continued these studies as a researcher for five years. The data used in this article are both experiential and research‐based. Action research took place when the author supported CDD programmes based on traditional farming. This study provides a longitudinal view that includes critical auto‐ethnography and talanoa.FindingsThis study finds that the CSO did not appreciate community aspirations and local knowledge, leading to community maladaptation in response to their programme intervention. By contrast, CDD in the same locale saw community members take control of strategizing, carrying out development activities, and monitoring. This directly contributed to community resilience and collective well‐being, in addition to making the CDD activities more sustainable than those dependent on donor funding.Policy implicationsThis article showcases the value of CDD for Pacific communities and the importance of accounting for local aspirations and worldviews. Thus, policies in Pacific Island Countries should ensure that any community development programmes respect people's culture and understand their notions of well‐being and resilience, and so contribute to more self‐determined development.

How co‐design can localize development programmes and reduce dependency: Examples from Pacific Island Countries

AbstractMotivationInternational donors commit around USD 2 billion every year to Pacific Island Countries (PICs). While the donors intend to help develop the Pacific, few of the projects they fund involve any more local involvement in their selection and planning beyond consultation with selected, often elite, or small groups of locals. It is even rarer to find projects that are localized or locally‐led.PurposeWe ask whether it is possible to do more to localize donor‐funded development in the Pacific. We ask if co‐design between foreign and local specialists can localize development, by giving locals more agency, and by prioritizing indigenous knowledge.Specifically, we review the Pacific eLearning Programme (PeP), funded by New Zealand and implemented in the Cook Islands, Samoa, Solomon Islands and Vanuatu. The programme works with Ministries of Education to design science content that reflects the country context for some ten or so schools in each nation. Co‐design includes use of indigenous dialogue [talanoa / tok stori / storian] to share, debate and learn between foreign and local specialists, and between specialists across the four countries.Methods and approachEvidence was gathered from pre‐ and post‐programme surveys. Further data was collected from comments written by the local co‐designers.FindingsWe found that kinship formed between locals and foreigners, based on mutual respect for the knowledge each group brought. This process empowered locals, valued their expertize and knowledge, and reduced dependency by prioritizing indigenous and local knowledge. Localization led to mutually beneficial outcomes.Policy implicationsCreation and implementation of policies that mandate localization through recruitment, use of indigenous methodologies, co‐design and recognition of local skills, knowledge and culture will help create trust with development partners, empower locals, exchange skills and knowledge between locals and foreigners, and reduce dependency.

The Role of the Banking Sector in Economic Resurgence and Resilience: Evidence from Pacific Island Countries

The Role of the Banking Sector in Economic Resurgence and Resilience: Evidence from Pacific Island Countries

Towards a Holistic Definition of Post-pandemic Resilience: The Pacific Context

AbstractPost-pandemic resilience in the Pacific region presents some unique, context-specific, economic, social, environmental, and political challenges as well as opportunities. This study aims at developing a holistic definition of post-pandemic resilience in the Pacific context, based on the interconnected aspects and factors that contribute. As there is a gap in the literature for a holistic definition of post-pandemic resilience based on empirical studies from the Pacific Island countries, this study tries to plug that gap. Using a qualitative systems thinking approach, data was collected from primary and secondary sources including semi-structured interviews with ten senior leaders in the Pacific. This study first captures the multiple levels and different interconnected aspects of post-pandemic resilience in the Pacific and then presents a holistic definition. An analysis of the different papers published in this special issue based on this holistic definition and their contexts is also provided in this article. Overall, this study contributes to the literature and practice on post-pandemic resilience by developing a holistic definition using an empirical study based in the Pacific.

Australia’s Pacific Step-Up Foreign Policy as a Response to the Increase of China’s Influence in the Pacific

Abstract
 The Pacific region has become highly geopolitical due to its economic, strategic, and military significance. Pacific Island countries face several challenges that they are striving to address because many Pacific Island nations have limited resources in terms of finances and skilled human resources, lack of access to technology, capacity building, and economic development, on the other side is prone to natural disasters such as cyclones, tsunamis, and earthquakes, also face challenges in providing adequate healthcare and education services, and are especially vulnerable to climate change whose impact may vary. The issue then becomes the reason for regional and global powers like Australia and China to exercise their capability and aim to fulfill their respective national interests to extent their influence in the region through their foreign policy. Influence pertains to a country’s ability to affect other nations' or international entities' decisions, actions, and behaviors. This research uses qualitative methods and foreign policy theory to address the issue further. In this research, Australia emphasizes its foreign policy to the Pacific using The Pacific Step-Up programme to pursue their interest as a long-standing partner and its neighborhood’s guardians and counter China’s growing presence and influence in the region.
 Keywords: Australia, China, Foreign Policy, Pacific

Does structural form matter? A comparative analysis of pooled procurement mechanisms for health commodities

IntroductionPooled procurement can be seen as a collaboration initiative of buyers. Such mechanisms have received increased attention during the Covid-19 pandemic to improve access to affordable and quality-assured health commodities. The structural form of pooled procurement mechanisms ranges from a third-party organization that procures on behalf of its buyers to a buyer’s owned mechanism in which buyers operate more collaboratively. However, little is known about how these types of pooled procurement mechanisms differ in terms of characteristics, implementation and developmental process. To fill this gap, we compared four pooled procurement mechanisms. Two buyer’s owned mechanisms: the Organisation of the Eastern Caribbean States (OECS) and the Pacific Island Countries (PIC). And two third-party mechanisms: the Global Drug Facility (GDF) and the Asthma Drug Facility (ADF).MethodsFor this qualitative study, we used a multiple case-study design. The cases were purposefully selected, based on a most-similar case study design. We used the Pooled Procurement Guidance to collect data on individual cases and compared our findings between the case studies. For our analysis, we drew upon peer-reviewed academic articles, grey literature documents and 9 semi-structured interviews with procurement experts.ResultsBuyers within a buyer’s owned mechanisms differ in procurement systems, financing structures, product needs and regulatory and legal frameworks. Therefore, buyers within such mechanisms require relative alignment on motivations, goals and operations of the mechanism. Our study showed that buyers’ relative homogeneity of characteristics and their perceived urgency of the problems was particularly relevant for achieving that alignment.Third-party organization mechanisms require less alignment and consensus-building between buyers. To participate, buyers need to align with the operations of the third-party organization, instead of other buyers. Elements that were essential for the successful implementation and operation of such mechanisms included the procurement secretariat’s ability to create local and global awareness around the problem, to induce political will to act upon the problem, to mobilize sufficient funding and to attract qualified staff.ConclusionTo successfully sustain pooled procurement mechanisms over time, key actors should drive the mechanism through continuous and reflexive work on stakeholder engagement, mobilization of funding and alignment of interests and needs.

Taking the “UN Decade of Ocean Science for Sustainable Development” as an opportunity to help build a “Community with a Shared Future between China and Pacific Island Countries”

A deep heritage of cooperation and a growing convergence of interests have driven relations between China and Pacific Island countries forward. These nations are closely linked by water, and the ocean has become an important frontier of common concern for both sides. The “United Nations Decade of Ocean Science for Sustainable Development”(the UN Ocean Decade) and the “Building a Community with a Shared Future Between China and Pacific Island Countries” were born during the era of globalization and have a high degree of compatibility in their development visions. China should seize the opportunities brought by the UN Ocean Decade to promote science and technology diplomacy with Pacific Island countries through building science and technology innovation cooperation platforms, participating deeply in global ocean governance, and conducting civil science and technology exchanges. This will help build a closer “Community with a Shared Future between China and Pacific Island countries”.

A “forgotten” disease entity? Scabies with secondary infection in a housewife: case report

Background: In 2017, scabies was classified by WHO into the neglected tropical disease list , with an estimated 455 million annual incident cases. This disease has a high prevalence in many tropical environments with low income sources, especially in the Pacific Island countries. Scabies transmission occurs as a result of skin-to-skin contact and spreads easily in crowded living conditions. Objective: This case report aims to describe the risk factor, clinical features, and management of scabies patient with secondary infection. Case: A 17-year-old female presented with nocturnal itching on her hands and feet. She rarely washed sheets or dried mattresses. Physical examination revealed multiple erythematous papules, pustules, crusts, and skin erosions in the antebrachii and manus regions. Papules and pustules were also observed in the dorsum pedis regions. The patient was diagnosed with scabies and a secondary bacterial infection. Treatment included topical antiparasitic (Ointment 2-4) and sedating antihistamines (CTM) to alleviate itching, along with systemic antibiotics (Amoxicillin) to address the bacterial infection.Conclusion: The internal and external risk factors that underlie the development of scabies in this case are the patient's residence in densely populated environment, low level of personal hygiene, knowledge level patients who are less about scabies, and low socioeconomic level. The success of scabies management depends on effective therapy and health education about PHBS (Perilaku hidup Bersih dan Sehat).

Should foreign aid consider inter‐Pacific Islands migration in the context of climate change? Evidence from Fiji

AbstractMotivationThis research brings a Pacific Islands‐centred perspective into the discussion of foreign aid and climate mobility. Climate‐related migration is a crucial issue in Oceania as climate change is increasingly affecting Pacific Islanders. In this context, the Pacific Islands are typically seen as migrant‐sending countries to places outside the region. Inter‐Pacific Islands migration (IPIM) is barely recognized.PurposeShould foreign aid consider climate‐related IPIM? This article focuses on Fiji to: (1) assess current knowledge on migration between the Pacific Island Countries and Territories (PICTs) and Fiji's role therein; (2) maps aid‐funded climate mobility initiatives in the Pacific Islands; and (3) explores Fiji's national polices and local Fijian perspectives on regional climate‐related immigration to Fiji.Methods and approachThis study draws on a combination of statistical analysis, policy document analysis, expert interviews, and semi‐structured interviews and an in‐depth online survey involving local Fijians. Additionally, it incorporates the author's personal work experience as a Pacific Islander and a Fijian traversing climate mobility aid and policy spaces relating to Oceania.FindingsCurrent aid policies and initiatives addressing climate mobility have insufficiently considered IPIM. Migration from other PICTs to Fiji is significant, both in terms of numbers and in its current and potential impacts on local Fijians. Neither research, nor Fiji's national policies, nor donors have sufficiently considered this issue to date.Policy implicationsAid policies and initiatives targeting climate‐related migration in PICTs need to be refocused to give more attention to IPIM. Donors must expand their support to migrant‐receiving communities in PICTs such as Fiji. By recognizing and investing in IPIM, donors can foster mutual benefits for Fiji, other PICTs, and donor countries.

Using social network analysis to track the evolution of Pacific food system research collaborations over time

Climate change undermines the foundations of food and nutrition security, making it crucial to understand and improve the current research collaborations striving to fill knowledge gaps about the impacts on food systems. This study focuses on the network of research actors working on food systems and climate change in Pacific Island Countries and Territories (PICTs), a region particularly vulnerable to climate change, and actively integrating knowledge about climate impacts to inform adaptation planning. Specifically, this study looks at co-publication as a form of research collaboration and co-production, using network analysis to understand who are the prominent organizational actors driving knowledge development in the region. Overall, we found a distinct core of these organizations engaged in the research space, dominated in number by academic institutions largely based in Australia, the USA, and New Zealand, but knit together through the interactions of the regional government agencies of the Pacific Islands. Over time, the network of research collaboration on climate change and food systems in the region has grown and diversified. While regional Pacific institutions have remained central actors throughout, national and subnational actors are still in the minority, raising questions about efforts to decolonize research in the region. Furthermore, greater interaction between peripheral actors and the core (especially Pacific actors) could help integrate new research into Pacific knowledge bases and decision-making. Ultimately, when facing the novel conditions that climate change brings, combining the infusion of new knowledge and innovation with local expertise and ownership is critical.

‘Sometimes, men cannot do what women can’: Pacific labour mobility, gender norms and social reproduction

AbstractAustralia's 2018 introduction of the Pacific Labour Scheme (PLS) broadened the scope and duration of labour mobility pathways available to Pacific Island countries. Although longer term temporary migration schemes like the PLS expand livelihood opportunities for migrant households, they also create challenges related to the maintenance of personal relationships and care practices during transnational family separation. Though pressing concerns for Pacific Island governments, these issues have received little scholarly attention. Drawing on in‐depth interviews with migrants and their households in Kiribati, Tonga and Vanuatu, this article offers some preliminary insights into the way gender norms intersect with the reorganization of socially reproductive labour during migration. Findings indicate that women were disproportionately involved in the performance of additional unpaid care work within migrant households adjusting to transnational family life, but also suggest that women's participation in labour mobility may offer nascent opportunities to increase financial autonomy and social standing through the act of ‘remitting care’.

Effectiveness of NCD-Related Fiscal Policies: Evidence from the Pacific.

Obesity in Pacific Island countries (PICs) has hit crisis levels, and the consequent high non-communicable disease (NCD) burden is devastating for their developing economies. Nutrition transitions from traditional, plant and seafood diets to a dependence on processed foods are at the core of the obesity and NCD epidemic in PICs. Fiscal policies are widely promoted as an effective mechanism to reduce consumption of unhealthy foods and increase consumption of fruits and vegetables. However, there are little data to evaluate the effectiveness of these policies as rates of NCDs and obesity in PICs continue to rise. This study used an online survey to recruit 4116 adults from six PICs: Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu. The study measured the consumption of and household access to sugar-sweetened beverages, ultra-processed packaged snacks, fruits and vegetables and attitudes on food prices and unhealthy eating. The study also assessed the relationship between consumption of these foods and drink and (1) household access, (2) price as a food choice motive, and (3) unhealthy eating attitudes. This study provides novel data on food-related behaviours in PICs, offers insights into the potential impact of NCD-related fiscal policies on food consumption and identifies other variables of interest.