The Pacific Islands are vulnerable to climate change and increased risk of disasters not only because of their isolated and often low lying geographical setting but because of their economic status which renders them reliant on donor support. In a qualitative study exploring the adaptive capacity of Pacific Island Countries (PICs) across four countries, Cook Islands, Fiji, Samoa, and Vanuatu, it was clear that traditional coping strategies are consistently being applied as part of response to disasters and climate changes. This paper describes five common strategies employed in PICs as understood through this research: recognition of traditional methods; faith and religious beliefs; traditional governance and leadership; family and community involvement; and agriculture and food security. While this study does not trial the efficacy of these methods, it provides an indication of what methods are being used and therefore a starting point for further research into which of these traditional strategies are beneficial. These findings also provide important impetus for Pacific Island governments to recognise traditional approaches in their disaster preparedness and response processes.

the findings provide insights into how collaboration can be established and maintained and how the contribution collaboration makes to capacity building can be evaluated.

Global aid programs and the recipients of the program would benefit from comparable health strengthening approaches to nursing and midwifery in similar developing countries.

Introduction:The recent policy environment in both Papua New Guinea and Australia for partnering with private entities to address health issues has led to a public-private partnership (PPP) between the National Department of Health in Papua New Guinea, the Australian Government and the Oil Search Foundation. A reproductive health training unit was formed to provide health worker training in essential obstetric care and emergency obstetric care. This article provides a qualitative evaluation of the PPP, looking at facilitating features and barriers to the PPP's target of improving the competence of frontline health workers in obstetric care service provision in Papua New Guinea. Method: A qualitative methodology gathered data since the PPP's inception in 2012. A dataset of 85 interviews with partners and relevant stakeholders from across Papua New Guinea was analysed using thematic analysis. Results: Themes of facilitating features of the PPP were (1) understanding and agreeing with the national plan for PPPs and maternal and child health; (2) having strong champions, strong relationships and a formal decision-making body; and (3) creating autonomy and branding. Themes outlining the barriers to the PPP's effectiveness were (1) lacking governance framework creating confusion in decision making and roles and responsibilities; (2) differing institutional cultures and ownership struggles; and (3) lacking capacity within the institutes themselves, particularly the National Department of Health. Conclusion: The findings of this service provision case study confirm what has been found in other infrastructure-led PPPs.Further research into how to overcome power imbalances between partners in a PPP as well as setting up a governance framework in a dynamic environment could inform this growing area of collaboration between the private and public sectors.

This article explores the evolution of a novel approach designed to advance qualitative methods in cross-cultural health research. This methodology was developed by synthesising several research methods and involved in-depth stakeholder consultation with participants of a Pacific-based nursing and midwifery health leadership program. Many of these participants played a crucial role in creating, exploring and evaluating several research methods and implementing and evaluating this co-designed research methodology. Starting with a Participatory Action Research framework, the research methodology evolved as it was informed by the local Pacific methodologies (in particular Talanoa and Kakala frameworks), where researchers, co-researchers and participants alike, working from within their own collectivist/individualist paradigms, negotiated cultural differences. Finally, a methodological framework of ‘best practice’ for future health research methods was developed for use with capacity building research. The new methodology could provide a foundation for future co-designed cross-cultural research in collectivist cultures.