Pacific Island Nations Research Articles

Community Displacement: How Architectural Adaptations Show Resistance to Assimilation

ABSTRACT The Republic of the Philippines and the Republic of the Marshall Islands are two pacific island nations that have been the site of centuries of colonisation, agricultural exploitation, and wartime decimation forcing marginalised populations to repeatedly resettle and concentrate in and around urban centres. We trace two of these resettled communities to investigate the objectives of cultural assimilation in contrasting top-down versus bottom-up resettlement morphologies. We conclude by suggesting that adaptations in the resettlement architecture show resistance to the traditions of assimilation, and they are an important possible resurgence of cultural patterns.

The global burden of high BMI among adolescents between 1990 and 2021

BackgroundAdolescent high body mass index (BMI) is a growing global health problem. This study analyzes global, regional, and national prevalence and trends of high BMI among adolescents (aged 10–19 years) from 1990 to 2021, investigates disparities by sex, country, and socio-demographic index (SDI), and projects prevalence to 2030.MethodsThis study analyzed Global Burden of Disease (GBD) study 2021 data. Prevalence and trends of high BMI among adolescents were stratified by sex, SDI, and region. Estimated annual percentage change (EAPC), joinpoint regression, and Bayesian age-period-cohort (BAPC) analysis were used to quantify trends and project prevalence to 2030.ResultsGlobal adolescent high BMI prevalence has increased from 8.36% (1990) to 17.64% (2021), with females having a slightly higher prevalence than males. Marked disparities are observed across SDI levels; high SDI countries have the highest prevalence, but middle SDI countries are experiencing the fastest increases. Substantial geographic variations are also evident, with particularly rapid increases in some regions, such as the Pacific Island nations, and slower growth or declines in others, such as parts of East Asia. The BAPC model projects a continued rise in global high BMI prevalence up to 2030, with considerable variation across individual countries.ConclusionsThe global rise of high BMI among adolescents, coupled with projections of continued increases, presents a pressing public health concern. The observed disparities across SDI levels and geographic regions necessitate tailored interventions to address this growing epidemic effectively.

Football on the frontlines: the unjust burden of the climate crisis on Pacific Island nations

ABSTRACT Oceania is a region which contributes little to anthropogenic causes of climate change yet bears many of its most immediate burdens. This can be demonstrated through football in the region as several member associations of the Oceania Football Confederation (OFC) are threatened by rising sea levels, floods, heat and other climate harms while lacking the organisational capacity to adapt to climate change. Using a climate justice lens to understand this disparity, this study provides a climate impact assessment to the OFC and its member associations. Focus groups and interviews with key stakeholders were used to assess organisational climate capacity with a goal of addressing the climate changed future of football in this region. Findings suggest all member associations are at risk of high heat and coastal flooding while others may face heavy rains and wildfires. Member associations are highly aware of their climate risks but lack many of the organisational resources necessary to adapt. This inherently demonstrates the injustice faced by this region as it is an immediate victim of climate change.

Global burden of periodontal diseases among the working-age population from 1990–2021: results from the Global Burden of Disease Study 2021

BackgroundPeriodontal diseases among working-age individuals (15–69 years) represent a significant global health challenge, impacting oral health, quality of life, and economic productivity. Defined according to the 2021 Global Burden of Disease (GBD) framework, periodontal disease in this study encompasses symptoms such as halitosis, altered taste sensation, and occasional gingival bleeding that do not impair daily activities. Despite their prevalence, comprehensive analyses of the global burden of periodontal diseases specifically within this demographic remain limited.MethodsWe analyzed data from the GBD 2021 study, examining periodontal disease burden among individuals aged 15–69 years across 204 countries and territories from 1990 to 2021. Age-standardized rates of prevalence, incidence, and disability-adjusted life years (DALYs) were calculated. We employed joinpoint regression analysis to assess temporal trends, decomposition analysis to examine contributing factors, and frontier analysis to evaluate the relationship between disease burden and sociodemographic development.Findings.In 2021, global periodontal disease cases reached 951.3 million (95% UI: 729.0–1,183.3 million), with an age-standardized prevalence rate (ASPR: 17,011.6 per 100,000 persons) and 80.3 million new cases (ASIR: 1,464.7 per 100,000). The burden accounted for 6.2 million DALYs globally (age-standardized DALY rate: 110.8 per 100,000). Asia demonstrated the highest age-standardized rates across all metrics, while Low-middle SDI regions showed the highest ASPR (20,920.5 per 100,000) and ASIR (1,627.9 per 100,000). At the national level, Sierra Leone, Gambia, and Cabo Verde had the highest disease burden. Males consistently showed higher prevalence rates than females, with peak rates observed in the 50–59 age group. Joinpoint regression analysis revealed an overall increasing trend from 1990 to 2021 (AAPC: 0.04, 95% UI: 0.01–0.06), with notable variations across different time periods. While some countries like Qatar, UAE, and Jordan experienced over 500% increase in prevalence since 1990, Pacific island nations like Tonga and Tokelau achieved reductions exceeding 70%. Decomposition analysis identified population growth (74.56%) and aging (23.00%) as primary drivers of increased disease burden.Interpretation.Our analysis reveals significant global disparities in periodontal disease burden among the working-age population, with concerning increases in many regions from 1990 to 2021. The disproportionate burden in Low-middle SDI regions and South Asia, coupled with the substantial impact of population growth and aging, highlights the urgent need for targeted interventions. While some countries have achieved remarkable reductions in disease burden, the dramatic increases in others underscore the importance of strengthening preventive oral healthcare systems and addressing socioeconomic determinants. These findings emphasize the need for country-specific strategies, particularly in regions with rising burden, and can inform evidence-based policy making to reduce the impact of periodontal diseases on the global workforce.

Enhancing sustainable development through implementation of climate goals in Pacific Island Nations: A call for unified action

Enhancing sustainable development through implementation of climate goals in Pacific Island Nations: A call for unified action

Pacific oral health: a scoping review.

A growing body of literature reports on the oral health of Pacific peoples but a synthesis of the existing knowledge on Pacific oral health epidemiology is absent. This scoping review aims to summarise the evidence on Pacific oral health epidemiology. The findings of this review may help identify knowledge gaps and issues requiring health policy prioritisation. The review followed the PRISMA-ScR guidelines for scoping reviews and included reports published prior to July 2023 on Pacific oral health, regardless of design. Searches were conducted across four databases, and the grey literature. An analysis of 95 sources, primarily from 2000 to 2023 and predominantly New Zealand-based, found that a high proportion of Pacific peoples (including children) were affected by poor oral health and challenges in accessing dental care services. Numerous studies have reported oral health disparities, with poorer oral health among Pacific peoples than other population groups. Epidemiological and health services data from Pacific Island nations show a high prevalence of dental conditions, along with limited healthcare resources and workforce shortages. Studies on the broader social determinants shaping these issues and health promotion strategies to address them were limited. This review revealed significant unmet oral health needs, ethnic disparities in oral health, and barriers preventing care in Pacific populations. The findings emphasise the need for more research to address these gaps to help develop effective, culturally-informed oral health strategies for Pacific communities.

Uncharted Voyages: Tuvaluans’ Narratives and Experiences of Statehood and Survival During Climate Change

Tuvalu is a tiny Pacific Island nation battling the effects of climate change, including rising sea levels, increased ocean temperatures, and more frequent weather events, threatening its existence as an independent state. Regrettably, the narratives of its people are mostly left behind in international literature. This article helps bridge the gap by documenting the viewpoints of 19 adult Tuvaluan nationals and descendants through online qualitative interviews. It adopts posthumanism as a philosophical roadmap to guide the construction of arguments. Outcomes suggest that Tuvaluan policymakers are science-fictional by planning to replicate their country in the metaverse, a virtual and permanently unfinished dimension. The scheme reveals the embodiment and embeddedness of human beings with technology, which, according to the interviewees, allows them to overcome the limits of statehood and personhood. The posthuman category of the cyborg, fusing cables, microchips, and flesh, emerged during the discussions. Furthermore, findings uncover divergent sociological and legal appraisals of climate refugees. While the latter term is frequently used in academic discussions, it is not recognised in international law. Finally, results underscore how environmental degradation triggers the growth of (eco) hierarchies between subjects who can cope with global warming and those who cannot, persons who can afford to travel, and those unable to do so. In this context, overt and covert discrimination takes the form of sub-par jobs offered to disenfranchised individuals, a situation at the forefront of the participants’ memories.

The mental health impact of climate change on Pacific Islanders: A systematic review focused on sea level rise and extreme weather events.

ObjectiveThis systematic review investigates the impact of climate change on the mental health of Pacific Island Nations (PINs), with a focus on identifying culturally tailored interventions and appropriate research methodologies to address these impacts.MethodA systematic review of peer-reviewed literature up to May 18, 2024, was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol and the Population, Interest Area, and Context (PICo) framework. Empirical studies on the impact of climate change on mental health in PINs were evaluated by using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).ResultsSix studies from the Solomon Islands, Cook Islands, and Tuvalu were identified, indicating significant mental health impacts from sea level rise (SLR) and extreme weather events with compounding and mitigating effects across diverse groups. The Skills for Life Adjustment and Resilience (SOLAR) program was highlighted as a promising culturally adapted intervention.ConclusionClimate change significantly impacts mental health, particularly in PIN communities facing SLR and Extreme Weather Events (EWE). Culturally sensitive interventions, local knowledge, and further research are vital to mitigate these effects and support well-being.

Integrating post-validation surveillance of lymphatic filariasis with the WHO STEPwise approach to non-communicable disease risk factor surveillance in Niue, a study protocol.

Lymphatic filariasis (LF), a mosquito-borne parasitic disease caused by three species of filarial worms, was first detected in Niue, a small Pacific Island nation of approximately 1,600 people, in 1954. After extensive efforts involving multiple rounds of Mass Drug Administration, Niue was validated by the World Health Organization (WHO) as having e4liminated LF as a public health problem in 2016. However, no surveillance has been conducted since validation to confirm infection rates have remained below WHO's elimination threshold. WHO has encouraged an integrated approach to disease surveillance and integrating LF post-validation surveillance (PVS) with existing surveys is an anticipated recommendation of the upcoming WHO LF-PVS guidelines. This paper describes a protocol for the implementation of an integrated approach to LF-PVS in Niue as cost-efficient and operationally feasible means of monitoring the disease in the population. The LF-PVS will be implemented as part of a planned national population-based WHO STEPwise approach to non-communicable disease (NCD) risk factor surveillance (STEPS) in Niue. Integration between the LF-PVS and STEPS will occur at multiple points, including during pre-survey community awareness raising and engagement, when obtaining informed consent, during the collection of demographics, risk factor, and location data, and when collecting finger-prick blood samples (for glucose as part of the STEPS survey and LF as part of the LF-PVS). The primary outcome measure for LF transmission will be antigen positivity. Microfilaria slides will be prepared for any antigen-positive cases. Dried blood spots will be prepared for all participants for Multiplex Bead Assays-based analysis to detect anti-filarial antibodies. We estimate a total sample size of 1,062 participants aged 15-69, representing approximately 66% of the population. The results of this study will provide insight into the status of LF in Niue and evaluate the advantages, challenges, and opportunities offered by integrated approaches to disease surveillance.

Indo-Pacific Strategy Under a Second Donald Trump Presidency in the United States: Current Trajectory and Future Path

The Indo-Pacific Strategy (IPS) has been a key US foreign policy goal during the 2010s. The strategy has evolved from a traditional 'Island Chain Strategy' to a more comprehensive approach that is grounded in security and values. Given Trump's explicitly hostile economic and security approach against China, the IPS has become more important than ever. This article examines the concept and development of the IPS under President Barack Obama, Donald Trump, and Joe Biden, and its probable evolution under Trump 2.0. It examines what Indo-Pacific nations expect from this policy and its implications under Trump. The IPS is a strategic asset for the US and its regional allies, including Japan, South Korea, the Philippines, and Australia. The results suggest that the IPS's mission has always been to build strong alliances based on democratic ideals, guarantee freedom of passage, and discourage regional dangers like Chinese and North Korean aggression (Grossman, 2024). The analysis concludes, based on political occurrences and pertinent data, that a second Trump administration may not change the IPS considerably. Trump may escalate his economic policies on China. The study concludes with policy recommendations to improve the IPS under Trump 2.0, including improved economic engagement with South and Southeast Asia, sustaining defense partnerships with Japan and South Korea, and addressing Pacific Island nations' environmental and developmental needs.

Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

Making it real: Actioning the mental health strategy with Pacific Island communities.

ObjectiveThis paper explores the practical implications of the World Health Organization strategy of focussing on community-based mental health and wellbeing ecosystems in the context of the Pacific Island Countries. It draws on the expertise of the participants of a collaborative workshop held during the Creating Futures conference in 2023 to discuss successes, challenges, barriers, opportunities in the implementation of the framework and to examine potential future actions.ConclusionsSome of the significant factors that make for effective and sustained community-based mental health systems include appropriate central coordination and oversight of community-based services, adequate frameworks for quality assurance, meaningful data collection and sustained long-term funding, as well as a range of workforce factors. Flexible and place-based approaches also need to be considered in effective implementation, moving away from Western diagnostic 'labels' to communication that is effective at the local level. Positive community resources as well as the relative youth of the mental health sector in the Pacific Island Nations are huge opportunities to develop affective and appropriate community mental health systems.

Rapid remote volcanic ashfall impact assessment for the 2022 eruption of Hunga volcano, Tonga: a bespoke approach and lessons identified

When disasters occur, rapid impact assessments are required to prioritise response actions, support in-country efforts and inform the mobilisation of aid. The 15 January 2022 eruption of Hunga volcano, Tonga, and the resulting atmospheric shockwave, ashfall, underwater mass disturbance and tsunami, caused substantial impacts across the Kingdom of Tonga. Volcanic impacts on the scale observed after the eruption are rare, necessitating a reliance on international advice and assistance. The situation was complicated by the loss of Tonga’s international submarine fibreoptic cable (causing a complete loss of communications for approximately 20 days) along with border closures due to the COVID-19 pandemic. A need emerged for a rapid remote volcanic impact assessment and provision of specialist advice to help inform the response of international partners. Here we present a novel methodology for conducting rapid remote volcanic ashfall impact assessments, conducted over a 10-day period following the eruption. We used three different hazard models for ashfall thickness across the main island of Tongatapu and available asset information and vulnerability functions for buildings, agriculture, electricity networks, water supply and roads, to provide initial estimates of losses due to ashfall from the 15 January eruption. For buildings, we estimated losses both as total losses and as percentages of the total replacement cost of buildings on Tongatapu. For agriculture, we made probabilistic estimates of production losses for three different crop classes. For ashfall clean-up, we estimated ranges of ashfall volumes requiring clean-up from road surfaces and roofs. For water supply, electricity networks and roads, our analysis was limited to assessing the exposure of important assets to ashfall, as we had insufficient information on system configurations to take the analysis further. Key constraints on our analysis were the limited nature of critical infrastructure asset inventories and the lack of volcanic vulnerability models for tropical regions including Pacific Island nations. Key steps towards iteratively improving rapid remote impact assessments will include developing vulnerability functions for tropical environments as well as ground-truthing estimated losses from remote approaches against in-person impact assessment campaigns.

An examination of Pacific nations’ legislatures’ interactions with Supreme Audit Institutions and the impact on audit quality

PurposeThe purpose of this paper is to report a study of public accountability within the political and economic structures that characterise Pacific nations. The authors examine audit quality with respect to Pacific Island nations’ governmental reporting to investigate ways to improve accountability in a region that is economically and environmentally challenged.Design/methodology/approachThe authors examine whether audit quality in Pacific Island nations is associated with the practical arrangements of Supreme Audit Institutions (SAIs), taking into account external factors. The “practical arrangements” include the independence of a SAI (regarding its staffing and funding) and also the requirement for it to report to the Executive. The financial setting in each jurisdiction has been seen to impact the quality of financial reporting and auditing. The authors examine mediating factors such as income, political stability and education that may also impact audit quality. This study uses publicly available databases as well as jurisdictional annual reports and the associated audit opinions and management letters (where available). Jurisdictional reports on public financial management were also analysed.FindingsThe authors find that public sector audit quality is low in many Pacific countries, concluding that public accountability is impaired. While the authors recommend changes to the practical arrangements that can improve audit quality, the mediating factors also impact audit quality. They argue that a renewed focus on financial capability could enhance public accountability in these nations, but there are limiting factors that are difficult to overcome.Practical implicationsThere are problems in providing accountability for public sector activities in Pacific nations. The authors suggest that improvements to the appointment and funding of SAIs to enhance their independence will help to reduce these issues.Originality/valueThe authors present a framework for analysing SAIs’ practical arrangements and audit quality that includes variables that may mediate the effects of these practical arrangements. They apply the model to 20 Pacific jurisdictions, showing that the practical arrangements of a SAI directly impact audit quality. Nevertheless, there are instances where audit quality is poor despite good practical arrangements, implying that mediating factors also play a substantial role in determining audit quality of a SAI.

Improving the timeliness of birth registration in Fiji through a financial incentive

Improving the timeliness of birth registration in Fiji through a financial incentive

Mental health of the Pacific Island Nation communities: What the rest in the world can contribute to and learn from?

IntroductionCreating Futures initiative has established a network of mental health professionals, researchers, and community members from the Pacific Island Nations (PIN), Australia, and New Zealand to address the growing challenges of mental health conditions compounded by the climate change crisis. The enormous amount of work done in Global Mental Health can be particularly helpful to improve population-level mental health. However, translation of this evidence base into practice poses several challenges.ObjectiveThis perspective paper discusses the role of local culture and health systems context in determining the feasibility and acceptability of implementing and scaling up evidence-based interventions designed in an American-European context. The paper also advocates development (and evaluation) of mental health interventions in the PIN communities particularly and Global South generally and exporting these interventions to the rest of the world.ConclusionsCOVID-19 crisis underlined the role of global cooperation as well as national level 'self-reliance'. In this post COVID-19 world, it will be desirable for the mental health community to cooperate and collaborate to scale up evidence-based interventions through rigorous contextualization and at the same time main-stream mental health interventions developed in the Global South by incorporating them in the Global Mental Health discourse.

The role of animal products in balancing food baskets for Laos and the Pacific islands of Samoa and Vanuatu to minimise caloric and hidden hunger: a review

The ability of farming communities worldwide to provide balanced diets for the growing world population is enunciated clearly in the second of the United Nation’s sustainable development goals, namely ‘End hunger, achieve food security and improved nutrition and promote sustainable agriculture’. Success will be dependent on our ability to preserve the economic sustainability of livestock production in small-holder farming systems which will require regenerative approaches to reverse land degradation and retain biodiversity. Animal products are important components of world food baskets because their nutrient profile most closely resembles the dietary requirements of mankind. Key micronutrients, including iron, vitamin A, vitamin B12, zinc and iodine, are more readily available from animal-sourced foods, which are critical for a balanced diet for those with higher nutrient requirements such as growing children and pregnant and lactating women. The developing Asian economy of Laos, together with that of the Pacific Island nations of Vanuatu and Samoa provide some interesting contrasts in servicing the nutritional needs of their predominantly rural populations as their respective governments address the issues of undernutrition and hidden hunger. The paper explores some of the challenges that governments face in sustaining resilient animal production to supply essential nutrients for food baskets across our region. These include the broader contexts of resource availability, education, cultural traditions, socioeconomic status, gender equality and women’s empowerment.

Coral Sr/Ca-SST reconstruction from Fiji extending to ~1370 CE reveals insights into the Interdecadal Pacific Oscillation.

The southwestern tropical Pacific is a key center for the Interdecadal Pacific Oscillation (IPO), which regulates global climate. This study introduces a groundbreaking 627-year coral Sr/Ca sea surface temperature reconstruction from Fiji, representing the IPO's southwestern pole. Merging this record with other Fiji and central tropical Pacific records, we reconstruct the SST gradient between the southwestern and central Pacific (SWCP), providing a reliable proxy for IPO variability from 1370 to 1997. This reconstruction reveals distinct centennial-scale temperature trends and insights into Pacific-wide climate impacts and teleconnections. Notably, the 20th century conditions, marked by simultaneous basin-scale warming and weak tropical Pacific zonal-meridional gradients, deviate from trends observed during the past six centuries. Combined with model simulations, our findings reveal that a weak SWCP gradient most markedly affects IPO-related rainfall patterns in the equatorial Pacific. Persistent synchronous western and central Pacific warming rates could lead to further drying climate across the Coral Sea region, adversely affecting Pacific Island nations.

Language learning using Pacific picturebooks in an Aotearoa New Zealand kindergarten

Māori and Pacific learners in Aotearoa New Zealand have been identified as ‘priority learners’ by the Ministry of Education. The ‘Pacific picturebook project’ is ongoing research focussed on picturebooks selected to support the languages, cultures, and identities of Pacific learners in keeping with our government, Teaching Council and Ministry of Education expectations. This phase of the research was located in a kindergarten where teachers and children identify as Māori, Pākehā and from several Pacific Island nations. Teachers shared a selection of Pacific picturebooks with the children and recorded their own and the children’s responses to them over a kindergarten term. Thematic analysis of data showed that Pacific picturebooks were significant pedagogical tools for language learning, to support identity, and to contribute to the kindergarten’s emergent and localised curriculum. These findings clearly illustrate what pedagogy looks like when it is entrenched in key documents relevant to early learning in this country.

Assessing the Effectiveness of UNDP’s Climate Action Initiatives at the Local Level: A Thematic Analysis of Implementation Strategies and Outcomes

Sustainable development has been considered as the global phenomena in every field of life. The United Nations developed a program to attain sustainability. This programme is a United Nations agency tasked help countries to eliminate poverty and achieve sustainable economic growth and human development. The UNDP emphasizes in promoting local capacity towards long-term self-sufficiency and prosperity. Therefore, this research aimed to analyse the effectiveness of UNDP climate action initiatives and outcome on local level. The study employs a research design involving the selection of previously published case studies from different regions worldwide, which highlights various climate-related challenges and the effectiveness of UNDP initiatives in addressing them. The data was collected from different sources, such as the World Bank’s official website and UNDP’s official website, and previously published studies were also utilized. Thematic analysis approach was applied to assess the implementation strategies and outcomes across different regions. The findings reveal similarities and differences in the implementation of UNDP climate action plans and the challenges countries face in executing these initiatives. Through thematic analysis and interpretation of results, the study provides valuable information for developing effective policies to address climate-related challenges. Additionally, the research also suggests directions for future studies. The thematic analysis showcases specific case studies, including renewable energy deployment in Pacific Island Nations, ecosystem restoration in the Sahel Region, climate-smart agriculture in Southeast Asia, and climate-resilient urban planning in Latin America. These cases illustrate UNDP’s commitment to promoting climate action and sustainable development through innovative projects and partnerships. This research contributes to understanding the effectiveness of UNDP’s climate action initiatives at the local level and informs future policy and programmatic efforts in this area.