Expert perspectives on priorities for supporting health security in the Pacific region through health systems strengthening

Abstract

The COVID-19 pandemic has reiterated the interdependence of health security and health systems, and the need for resilient health systems to prevent large-scale impacts of infectious disease outbreaks and other acute public health events. Three years into the COVID-19 pandemic has led to discussions on how to “build back better”, making it important to identify lessons to strengthen health systems and prevent future shocks from health security threats. Limited data exist on effective implementable initiatives, especially for the Pacific region. We explored the perceptions of a selection of experts with field experience in the Pacific region to identify and prioritise areas for future health system investments that strengthen health security. We conducted a qualitative cross-sectional study, collecting data using four focus group discussions. We analysed the data using a content analysis of notes recorded from each of the sessions. There were 24 participants, representing 15 research and academic institutions, nongovernment agencies, UN agencies and government as well as independent consultants. All were health sector stakeholders with field experience in the Pacific region and expertise in either health systems or health security. The analysis revealed four areas to prioritise future efforts, namely workforce development, risk communication, public health surveillance and laboratory capacity. A fifth theme, localisation, was identified as a cross cutting theme that should be applied to implementation of other identified priority areas. These findings provide a starting point to apply in practice this relatively new concept, of targeted health systems strengthening for health security development, in the Pacific. Evaluation of these initiatives will strengthen knowledge on the value of integrating these two concepts.

Human resources challenges in global health organizations: Managing a diverse and dispersed workforce

“…However, it is important to note that dispersed supply chains involve trade-offs, such as increased logistics costs and longer response times, which can erode customer service levels and competitiveness (Lorentz et al, 2012). Furthermore, the challenges of delivering healthcare to highly decentralized populations dispersed over islands and atolls have been highlighted, emphasizing the need for innovative logistical solutions in the healthcare sector (Rendell & Sheel, 2022;, Craig et al, 2021).…”

“…Moreover, the skewed distribution of the health workforce geographically poses significant challenges to quality healthcare delivery (Exavery et al, 2013;Kasten et al, 2023). These challenges are further compounded by the limited transport links and connectivity options in such areas (Rendell & Sheel, 2022;Adeniyi et al, 2020).…”

The effectiveness of public health spending in Sub-Saharan Africa.

“…Despite the impact of international and regional health initiatives, including the MDGs and SDGs (Bongaarts, 2016), Global Fund initiatives (Global Fund, n.d.), the 2001 Abuja Declaration (OAU, 2011;Oladosu et al, 2022), global immunisation campaigns (Wolfson et al, 2008), and health system strengthening initiatives (Rendell & Sheel, 2022), the failure to meet health outcome targets despite increased PHS is a significant concern for sub-Saharan governments. Moreover, this raises the question of the effectiveness of PHS in improving a population's health outcomes.…”

“…Moreover, efforts to improve population health outcomes have increased since the 2000s, with sub-Saharan countries and development partners implementing health policies and initiatives to address the problem. These regional health policies included the MDGs implemented in September 2000, Global Fund initiatives (Global Fund, n.d.), the 2001 Abuja Declaration (OAU, 2011;Oladosu et al, 2022), global immunisation campaigns (Wolfson et al, 2008), health system strengthening initiatives (Rendell & Sheel, 2022), and the SDGs implemented on 25 September 2015(WHO, 2016a. As a result of these initiatives, health outcomes in SSA have improved, but more must be achieved because morbidity and mortality in SSA remain high compared with other regions (Ayadi & Lawanson, 2020;WHO, 2018b).…”