Solomon Islands: Rural health services and needs.
Rural health services and particularly rural health facilities are subjects that I regularly return to mentioning, and matters I raise once again.
I believe I am right in saying, but subject to correction, that more than 50 percent of health expenditure in the Solomon Islands comes from donors. Much of that expenditure, however, targets specific diseases, rather than strengthening the country’s overall health system and improving services.
Some 3 years ago, there was talk of a new plan that had been developed by the Ministry of Health and Medical Services (MOHMS) with WHO help. The plan set out a roadmap towards universal health coverage with Sustainable Development Goals
The plan, which I understand was defined as the ‘Role Delineation Policy,’ mapped out the human resources, infrastructure and equipment that would be needed at every level.
Under the plan, 9 provincial hospitals and 34 area health centres would be upgraded, while 202 nurse aid posts would either be closed or upgraded to become rural health centres to ensure resources were used most efficiently to provide health services at strategic locations.
The plan also included staffing area health centres – previously run by nurses – with doctors, ensuring that the health services people need were available closer to where they live.
At the time, there was also a report that a grant from the Republic of Korea would be used to improve infrastructure in at least one province.
In the 3 years since the Role Delineation Policy was launched there have been numerous reports of dilapidated rural health clinics and many sick people in communities going without essential health services, unless travelling great distances, often by canoe and in rough seas, to reach a rural health centre still operational. The situation at Tatamba in Isabell Province comes to mind and it is not an isolated example.
A recent investigative inspection conducted in the Western Province described health services, generally, as being deplorable.
With the threat of coronovirus being a serious and added worry the MOHMS faces a huge burden having to contend with disease: communicable diseases such as dengue and malaria, combined with ever increasing rates of non-communicable diseases and the effects of climate change.
I am inclined to believe the Role Delineation Policy has not yet seen the 2017 proposals implemented and the condition at rural health clinics in particular have gone from bad to worse.
Would it help to have the most dilapidated rural health clinics replaced with steel pre-fabricated type building and with coordination with the Ministry of Health?
If such an option was possible, perhaps traditional donors could assist with funds and then the MOHMS establish fully equipped and functional nurse aid posts in each rural health clinic.