Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697733589016.pdf (Fiji)
MINISTRY OF HEALTH & MEDICAL SERVICES WRITTEN RESPONSE 162/2021 Hon.

Salote Radrodro to ask the Minister for Health and Medical Services – Can the Minister update Parliament on the planned or proposed activities funded in the allocation for the same in the 2021-2022 Budget.

Parliament Sitting - Tuesday – 17 August, 2021  The Ministry of Health and Medical Services (Ministry) has been allocated a budget of $403.3m in the 2021- 2022 financial year.
Considering the changing demands in service delivery needs and emerging public health issues also largely affect the priorities and outputs of the Ministry.

 The Annual Operational Plan (AOP) outlines the priorities, outputs, indicators and targets under the respective outcome areas.

The annual operational plan is aligned to the Ministry’s Strategic Plan (SP) 2020- 2025.

 The Ministry’s overall focus for 2021-2022 is under 3 Strategic Priority Areas.
It is anticipated that a major focus for this fiscal year will be on responding to the current pandemic and transitioning to the new normal, whilst sustaining the delivery of normative functions through our health facilities.

 Strategic Priority 1 focused on the Reform of public health services to provide a population approach for diseases and the climate crisis and a sum of $34.5m is planned to be utilized.
 Some of the key proposed areas that will be addressed in this Strategic Priority area are: - Reduce communicable and non-communicable disease prevalence, especially for vulnerable groups.
Non-Communicable disease activities of Health promotion activities, oral health promotion, population screening and counselling, and control & elimination of communicable diseases such as Typhoid, Dengue, Leptospirosis, Filariasis are part of this planned activities which Ministry will implement in the 2021- 2022 financial year.

This area also has planned activities under the COVID-19 Emergency Response which I have spoken about in my response to question 149/2021 on Monday 16th during the August sitting.
- Improve the physical and mental well-being of all citizens, with particular focus on women, children and young people through preventive measures.

Strengthening of postnatal clinics, Mental Health, Baby Friendly Hospital Initiative, Management of Rheumatic Heart Disease (RHD), Provide nutritional program/support in Maternal and Child Health Clinics, Adolescent Health Services, cervical cancer screening are some planned activities in this area.
- Safeguard against environmental threats and public health emergencies.

This is where the Water, Sanitation and Hygiene (WASH) program are implemented, conduct surveillance, prevention and control of vector born disease through Integrated Vector Management (IVM) program, Improve food safety control and hygiene through, Good Hygiene Practices, Tobacco free settings established in communities and this area also covers the nationwide conduct of COVID 19 vaccination drive.
 Strategic Priority 2 focused on the increase access to quality, safe and patient-focused clinical services and a sum of $9.3m is planned to be utilized.

 Some of the key proposed areas that will be addressed in this Strategic Priority are: - Improve patient health outcomes, with a particular focus on services for women, children, young people and vulnerable groups.
The activities planned in this area is to ensure that standards in divisional and sub divisional health facilities are safe for maternal and child health services.

- Strengthen and decentralize effective clinical services, including rehabilitation, to meet the needs of the population.
Decentralization of specialist curative services, Utilization of tele-health services, Conduct clinical outreach utilizing FEMAT, Rehabilitation program including outreach for rehabilitation, Strengthen clinical management of priority NCDs and Efficient and effective referral system both locally and overseas are planned activities in this area.

- Continuously improve patient safety, and the quality and value of services.
Strengthen clinical governance, Patient Safety and quality practices in all health facilities, Strengthen infection control practice, Strengthen National Patient Safety Response, Improve customer services and clinical service delivery, Improve waiting time for customers, efficient management of customer complaints through #157 are activities planned in this area.
 Strategic Priority 3 focused on Driving an efficient and effective management of the health system and a sum of $350.7m is planned to be utilized.

 Some of the key proposed areas that will be addressed in this Strategic Priority are: - Cultivate a competent and capable workforce where the contribution of every staff member is recognized and valued.

This area focuse on workforce and working environment of the Ministry.
Some activities planned are to Align existing human resources to support delivery of service, conduct Performance assessment in compliance with Performance Management Guidelines, Timely recruitment and selection of staff to ensure all health facilities are adequately resourced, Posting and transfer of staff effected to address staff shortage and to ensure efficient and effective health service delivery, Orientation and induction for all new appointees and promotes, Awareness on My APA, OMRS, Disciplinary Guideline, Job Evaluation Exercise and Performance Assessment, Facilitate learning and development opportunities for all staff and Monitor compliance to Occupational Health & Safety.
The new positions of nurses, mid-wives, nurse practitioners and medical positions in the 2021-2022 budget are the results of this continuous alignment of human resource program to adequately resource the Ministry.

- Improve the efficiency of supply chain management and procurement systems, and maintenance of equipment.

The Fiji Pharmaceutical and Biomedical Services (FPBS) is solely responsible to ensure that the activities in this area is timely implemented.
Some of the planned activities are to Conduct national quantification exercise for medical consumables and biomedical supplies, Conduct end to end review of supply chain, Conduct review of Essential Medicines List (EML) and revised list published to ensure improved availability and accessibility to medical products.
Other planned activities are Conduct analytical testing of medicines with international quality control laboratory for Quality assurance processes for all medical supplies established and Support the maintenance of existing biomedical and dental equipment for Improved functionality of biomedical & dental equipment in health facilities.
The substantial amount of budget allocated to FPBS is sufficient to achieve the planned activities - Implement more efficient financial processes whilst reducing the financial hardship of the most vulnerable.

This area is more focused on budget execution and its compliance in accordance with the relevant ACTS and Instructions in place to ensure that monitoring mechanisms are in place.

 Ensure infrastructure is maintained to match service needs.
The Ministry has been continuously upgrading and refurbishing divisional and sub-divisional hospitals, health centres and nursing stations through its annual planned major refurbishments and minor works program.

Some of the planned works are:  Construction of New CWM Hospital Maternity Unit - $7.0m  Land Stabilization and Refurbishment of Savusavu Hospital - $1.0m.
There is a growing demand for the expansion of Savusavu Hospital and the Government has given priority to progressively upgrade this facility.

Land stabilization works are necessary before any major investments on the infrastructure are done.

 Upgrade of Labasa Hospital Interior Works - $2.5m.

Labasa Hospital being the major health facility in North which provides a tertiary care to the Fijian people in North was planned for a major facelift.
 Upgrade of Lautoka Hospital Operating Theatre and X-Ray Department - $1.1m.

The completion of the project is nearing and both the operating theatre and X-Ray department should be fully operationalize within this financial year and  Apart from the construction funding, there are some final payment funding that is defects liability perod (DLP) has been allocated for some projects that was completed in the last financial year.
They are: - Defect Liability Payment (DLP) for Completion of Navosa Sub-Divisional Hospital - $3.6m - Defect Liability Payment (DLP) for CWMH Dental Roof - $20K - Defect Liability Payment (DLP) for refurbishment of St. Giles Hospital - $92K - CWMH Operating Theatre (OT) Air- Conditioning Unit Remedial Works - $250K and - Defect Liability Period (DLP) for Nasau Health Centre, Ra - $70K.
 There is a continuous maintenance program planned at the beginning of the year to maintain the health facilities in the Urban, Peri-urban and Rural areas.

A sum of $2.0m is allocated as Minor Works supplementing the major capital maintenance works.

 In addition to the capital construction there is also funding for Capital Purchases mostly for non-medical equipment.
These are: - $500K is allocated for procurement of ICT Infrastructure and Network to support modern technology equipment & support systems - $1.9m has been allocated under Purchase of Equipment for Urban Hospital.

The Ministry plans to - Purchase of new Boiler for CWMH East Wing - $320K.

The boiler is to replace the old one and also to be a support for the existing one.
- Purchase of new Generator for CWMH West Wing - $700K - Incinerator Rehabilitation Works at CWMH, Lautoka and Labasa Hospitals - $500K and - Procurement of replacement/written off Equipment - $100K  $1.2m funding allocated for Purchase of Equipment for Sub-Divisional Hospitals, Health Centres and Nursing Stations.
The funding is earmarked for: - Procurement of Furniture, Fixtures & Equipment (FF&E) for both New Navosa and Rotuma Hopsitals - $180K - Purchase of new Generator for Makoi and Lami Health Centres - $120K - Incinerator Rehabilitation Works at subdivisional health facilities - $700K and - Procurement of replacement/written off Equipment - $200K  It must be noticed that substantial funding has been allocated for Incinerator rehabilitation works in urban and sub divisional hospitals.
Hospital waste is any kind of waste containing infectious materials therefore, to avoid the waste being hazardous the best method of disposal is to incinerate.

The Government is looking at the most effective means of treatment of medical/clinical waste to prevent any harm to the environment and our health in general.

 The allocated funds are sufficient and well planned for timely implementation to ensure that improvements are achieved.
 Harness digital technologies to facilitate better health care for our patients.

This is a key area where the Ministry plans to improve access and completeness of patient information data at most health facilities.

The target is that Patient Information System (PATIS) is rolled out to all targeted health facilities which have GOVNET network platform which can records all data that is from birth, outpatient, inpatient and obviously information on death.
 Continue to strengthen planning and governance throughout the Ministry by continuous review of existing policies, Governance and reporting structures in accordance with standards and requirements and Operational level performance reviews based on respective Business Plans  Widen our collaboration with partners for a more efficient, quality, innovative and productive health system where the Ministry has planned to Strengthened partnerships with external stakeholders by Engagement of CSOs for effective delivery of identified services  The $403.3m also has development partner funding.
As sum of $4.8m from various development partners are reflected as cash grants whilst $5.4m as Direct payments.

 The 2021-2022 budget should be adequate for the Ministry to achieve its planned activities.

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