HON. MINISTER AKBAR'S SPEECH AT THE PACIFIC SOCIETY OF REPRODUCTIVE HEALTH SYMPOISUM

The trained personals, who are doctors, midwives, nurses, researchers and health planners, will be deemed trained champions and will be given resources, so they can train other health professionals in Fiji and the region.

Due to the challenges of geography, lack or resources, and changes in weather pattern, amongst many other challenges in Fiji and in many other Pacific island countries, these workshops add value to the workforce who usually practice in remote and isolated acute care and community settings.

Ladies and gentlemen, the Ministry of Health and Medical Services is indeed very appreciative of the efforts of Pacific Society for Reproductive Health for its ongoing partnership and commitment to building capacity on reproductive health in Fiji and indeed in the region.

I am pleased to know that the purpose of Pacific Society for Reproductive Health has been to:
> Foster education and assistance between members in Pacific island countries through the provision of educational workshops and development of distance education approaches.
> Improve the opportunity for networking and the provision of mentorship and support within the region
> Provide more continuing education opportunities in the Pacific and neighboring countries.
> Mitigate the challenges of geography and provide support for isolated heath care workers.
> Provide direction and support to members in discussions of improvements to obstetric and gynecological services in Pacific island countries.

Indeed, ladies and gentlemen, all these objectives greatly complement the Health Ministry’s overarching vision for A Healthy population by:
• Empowering people to take ownership of their health
• Assisting people to achieve their full health potential by providing quality preventative, curative and rehabilitative services through a caring sustainable health care system.

I am pleased to say that the Reproductive Health indicators in Fiji have indicated a general trend of progress and improvements over the years and having said that the contraceptive prevalence rate has increased over the years from 30% to 44% for women of child bearing age however there is still high unmet need among youths.

Country Developments
The Ministry in partnership with UNFPA has also developed a comprehensive training package for health workers on family planning method and counseling for women which has seen an increased offer of family planning options.

Our Scope of practice for Nurses has been reviewed and modified to allow nurses to insert and remove jadelle in their facility provided they have been trained and certified under the new training package, most health centre’s can provide up to four modern contraceptive services. Modern contraceptive are also available up to nursing station level in Fiji which ensures universal access to women of child bearing age.

Just last week, our local Sexual health & HIV specialists with the support of WHO and UNAIDS were working on the review of two of our key documents in the field of Sexual health namely the Antiretroviral Treatment Guideline and the Sexually Transmitted Infection Management Guideline. Having updated guidelines, policies, practice manuals aligned to acceptable international standards are also key to the delivery of our reproductive health services.

Ladies and gentlemen, the Reproductive Health Services is an important component of all maternal health services and public health services such as Maternal Child Health, Family planning clinics and outreach services for the health ministry.

The Ministry allocates funding of two hundred thousand each year for maternal and reproductive health capacity building programs for the staffs. Apart from this, there are other allocations made available through other public health programmes that will also directly benefit women and children in the country. Reproductive health is a major component of care since it is interlinked with many health indicators.
At this point I would like to thank UNFPA for providing free contraceptive to the Health Ministry for the benefit of women and girls in the ‘child bearing age’. I also thank donors such DFAT, WHO, UNICEF, UNAIDS and other NGO such as the Pacific Society for Reproductive Health for providing support in terms of Finance, capacity building programs and technical experts in achieving universal access and providing quality care to our people.

Investment in sexual and reproductive health is fundamental to many and in which Pacific island countries have set for themselves to achieve equitable development. Its importance is reflected in objectives set out in the Pacific Healthy Islands Strategy, signed in Yanuca Island, Fiji, initially in 1995 and again re-endorsed in 2015, by the Pacific Health Ministers.

We are thankful to the Australian Government for injecting in $46.5 million dollars which is one of the largest investment in our region specifically to strengthen access to sexual and reproductive health. The newly launched Transformative Agenda that has been designed to respond to key needs of the six priority Pacific countries (Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu).

This will mainly focus on:
-Increasing and improving the supply of quality integrated sexual and reproductive health information services, particularly for family planning.
-Strengthening the enabling environment for sexual and reproductive health.

Men and women should be informed about and have access to safe, effective, affordable and acceptable methods of family planning of their choice.

Providing access to these critical services will ensure that people can make informed decisions about their own lives and achieve the goals they set for themselves.

When they have these services, they enjoy better health, can achieve higher levels of education, expand their workforce opportunities, and generate more income for themselves and their families.

Access to quality sexual and reproductive health, particularly family planning, is essential to improving an individual’s health, education and economic wellbeing, particularly for women and girls. It can also play a pivotal role in strengthening national economic performance by reducing health and education costs, increasing household wealth and enabling women to contribute equally to social and economic development.

However, we appreciate that like many of our fellow islanders there is scope for improvement and progress.

We continue to aspire to right size our workforce and ensure they can provide quality work in Fiji and the region. I would hope that with our regional and international partners the Ministry of Health and Medical team can also learn valuable lessons that will prove useful to our women.

Recommendations for Action
Some of the challenges that I would like you to consider in your deliberations are:
> lack of health literacy among our people, they need information to be able to make informed choices, therefore reaching the hard to reach population and raising awareness on reproductive health services is critical.
> Competing priorities among our target population, therefore we need to improve our health promotion and social mobilization strategies, to improve uptake of reproductive health services.
> Sometimes we think of the ‘hard-to-reach’ as only the ones who are isolated and far from us, but the reality is there are also the ‘hard-to-reach’ who are very close to us, who need information, direction and options to make healthy choices, therefore we need to be more accessible and user-friendly to our clients.
> Let us be agents of change also and prevent Violence against women and children, and any form of sexual violence and abuse.
> The need for clinical research and audit in the Pacific needs to be highlighted. We need to make sure that all our actions will bring about good clinical outcomes and are in line with best practice. As such the focus on audit and research is timely and very beneficial.

Concluding remarks
Finally, I commend your society for having a membership that represents a broad range of health workers involved in reproductive or neonatal health care in the Pacific.

Cervical and Breast Cancer is the main cause of cancer death in Fiji and I appreciate the focus that you have in this symposium and in the workshops on cervix cancer. We need a regional approach that allows us to collaborate and support each other to reduce the burden of suffering incurred to our women.

This type of collaboration and networking needs to be encouraged. Our island family need to remain strong and united in our endeavor to secure a healthy future for the people that we are mandated to serve. This symposium will strengthen the collaboration for the aspiration of building capacity and development of reproductive health program empowerment in Fiji and the region.

I am pleased to know that the participants will have the opportunity to dialogue, network and identify catalysts for accelerating improvements in maternal health and reproductive health in the region. Upon their return home, action ideas and innovative plans shared at the workshop can be implemented for positive developments and change.

With that ladies and gentlemen, I would also like to wish you all the very best for the workshop and looking forward to learn about the outcomes of your discussions through this much awaited symposium.

Thank you all.