Digital health and universal health coverage: opportunities and policy considerations for Pacific Island health authorities

The emergence of digital health tools offer opportunities to complement and support the health system in the delivery of health services, especially in resource-constrained settings. Low- and middle-income countries have implemented various digital health interventions to support a range of health functions including patient information collection, diagnostics, supply-chain management, and remote clinical monitoring. The use of digital health in Pacific Island countries and territories (PICTs) is increasing. Effective implementation is hampered by misalignment between system design and contextual realities among other factors. Health service delivery in PICTs are highly resource sensitive, digital health must add demonstrable benefit to justify the expenditure of resources that could otherwise be allocated to facilities, equipment, staff, medicines and other commodities. This policy brief aims to identify health system challenges in the region which digital health interventions may address for decision-makers. It aims to identify policy and implementation factors to increase the likelihood of sustainable and scalable adoption of DHIs, and identify health resources to best capitalize on opportunities that digital health solutions offer. Recommendations suggest the need for each country or territory in the region to assess and determine their own priorities and opportunities, and devise digital health strategies in response. Recommendations outlined in the brief suggest the need to develop national-level digital health strategies to identify timelines and priorities, support mechanisms to strengthen digital health governance, human resource and institutional capacity. The brief aims to provide recommendations to aid relevant stakeholders to strengthen and support the use of ICTs to deliver equitable and integrated person-centered health care in the region

Lessons in change: adapting the World Bank’s ‘Flagship’ training course for the Pacific region

Over the past three years, the Health Policy and Health Finance Hub has collaborated with the World Bank Institute (WBI) and the Harvard School of Public Health to develop a world-class training program to strengthen cohesively health systems and policy making capacities across the Pacific region. Piloted in Fiji in June 2010, the WBI’s Flagship Program on Health Sector Reform and Sustainable Financing aims to give health officials a conceptual framework for analysing the performance of their health systems and for identifying the tools, policies and financing options that best meet their needs

Centers for Disease Control and Prevention fiscal year 2021 grants summary profile report for Hawaii

This profile includes selected CDC grants and cooperative agreements provided to health departments, universities, and other public and private agencies in Hawaii. Refer to the \u201cAbout the Data\u201d section below for important qualifying statements about the data.2021 Population Estimate: 1,441,553Timeframe: 10/01/20 - 09/30/21Publication date from document properties.Hawaii-2021-CDC-Grants-Profile-Report.pd

Centers for Disease Control and Prevention fiscal year 2018 grants summary profile report for Hawaii

This profile includes selected CDC grants and cooperative agreements provided to health departments, universities, and other public and private agencies in Hawaii. Refer to the \u201cAbout the Data\u201d section below for important qualifying statements about the data.2018 Population Estimate: 1,420,491Timeframe: 10/01/17 - 09/30/18Publication date from document properties.Hawaii-2018-CDC-Grants-Profile-Report.pdf2019657

Centers for Disease Control and Prevention fiscal year 2017 grants summary profile report for Hawaii

This profile includes selected CDC grants and cooperative agreements provided to health departments, universities, and other public and private agencies in Hawaii. Refer to the \u201cAbout the Data\u201d section below for important qualifying statements about the data.2017 Population Estimate: 1,427,538Timeframe: 10/01/16 - 09/30/17Publication date from document properties.Hawaii-2017-CDC-Grants-Profile-Report.pdf2018657

Centers for Disease Control and Prevention fiscal year 2019 grants summary profile report for Hawaii

This profile includes selected CDC grants and cooperative agreements provided to health departments, universities, and other public and private agencies in Hawaii. Refer to the \u201cAbout the Data\u201d section below for important qualifying statements about the data.2019 Population Estimate: 1,415,872Timeframe: 10/1/18-9/30/19Publication date from document properties.2020924

Clin Infect Dis

20142015-10-28T00:00:00Z001/World Health Organization/InternationalCC999999/Intramural CDC HHS/United States24627562PMC4624285681

Pacific Islanders and Health in the Print News Media

Pacific Islanders have faced discrimination in New Zealand particularly since the 1960s when members of communities, particularly from the Cook Islands, Samoa, Niue and Tonga began to be transplanted from their home nations to Aotearoa as cheap immigrant labour. Subsequently, the New Zealand vernacular has contained references to Pacific Islanders as 'overstayers', 'coconuts', 'bungas' and 'fresh off the boat' [FOB]. However, the legacy of a domineering relationship between the Palagi1 majority group and Pacific2 minorities that is captured by such derogatory terms is still evident in public forums such as the media. Using a quantitative content and qualitative narrative analysis, this first chapter documents portrayals of Pacific Islanders in New Zealand print media reports (n= 65) published over a three-month period. Findings reveal that Pacific people are predominantly portrayed as unmotivated, unhealthy and criminal others who are overly dependent on Palagi support. Consideration of this offered Pacific identity formation is explored and compared with that implied for Palagi, which is active, independent, competent and caring. Issues in coverage are discussed in relation to how Pacific Islanders are encouraged to see themselves, and the health and social consequences of dominant practices in press coverage. The second part of this thesis will take the findings from the investigation of the characterizations of Pacific Islanders in newspaper coverage and consider audience responses to such coverage. Focus group discussions will be used to explore how different New Zealand audiences view and respond to the portrayals of Pacific Island people and health in news media. The focus on audience responses supports the development of a better understanding of how groups can internalise media portrayals and use these as anchor points for understanding their own situations. Qualitative content from the two groups of Pacific Islanders (P1, P2) and two groups of Palagi (NP1, NP2) enabled a comparative analysis of audience interpretations. Findings propose that health issues are predominantly framed from the perspective of the dominant social group - in the local context Palagi - often at the expense of minority groups such as Māori and Pacific peoples. In appropriating aspects of news coverage, audience members do not engage or regurgitate what they are told or shown through the media. It is a rather complex process with audience members interpreting and using fragments of what they are presented with in making sense of issues of concern in their own lives. All the participants (n= 24) were compensated for their time and travel. We offer some suggestions as to how more equitable representations of Pacific people could be fostered in news media and how changes to a more civilised media will impact Pacific health positively. 1 Palagi (pronounced Palangi) is a term used by Pacific Islanders to refer to people of European decent. 2 We use the terms 'Pacific people' and 'Pacific Islanders' to denote a general social category or minority in Aotearoa used by the media. However, we need to qualify the use of these terms because their use can lead to a glossing over of the diversity in languages and cultures that exists between over 20 different Polynesian, Melanesian and Micronesian communities

Hirschsprung disease in the U.S. associated Pacific Islands: more common than expected.

INTRODUCTION: Tripler Army Medical Center (TAMC) in Honolulu, Hawaii, is uniquely situated to serve patients from the United States Associated Pacific Islands (USAPIs) through the congressionally funded Pacific Island Health Care Project (PIHCP). Because of time differences and distance, a web-based store-and-forward consultation and referral network was established using the internet to more efficiently and economically facilitate patient care. Using both electronic and hard copy records, we sought to establish the incidence of Hirschsprung Disease (HD) in children from the USAPI and contrast it to that of the developed world. METHODS: PIHCP website records as well as all the inpatient and outpatient medical records of patients referred to TAMC fortreatment of HD from 1994 to 2002 were reviewed. A diagnosis of HD was confirmed in all cases with full thickness biopsy. Incidence figures for HD are based on this review and on the birth rates for these islands from the International Data Base of the U.S. Bureau of the Census. RESULTS: There were 14 cases of short-segment HD referred over a nine year study period. Nine patients came from the Federated States of Micronesia (FSM) with an average annual incidence of 1:3190, which is 1.5 to 2 times the reported incidence in Western nations. Remarkably, seven of these nine were from Pohnpei State, capital of the FSM (annual incidence of 1:1370 or3-5 times that in the West). Three patients came from the Republic of the Marshall Islands (RMI), and two came from American Samoa (AS). There were no reported consanguineous marriages, associated syndromes, or complications of surgery. CONCLUSION: HD was found to be up to 2-3 times more common among people from the FSM than has been reported in the developed world. Given the limitations of providing care and obtaining data from all the USAPls with a population that is spread over a massive expanse of ocean larger than the continental United States, this incidence is likely an underestimation of HD among Pacific Islanders. A secure web-based referral network developed in 1998 has been invaluable in collecting epidemiologic data from these islands as well as in providing health care workers in the USAPI with an efficient and inexpensive means to seek consultation from specialists and sub-specialists at a major tertiary care medical facility

Advancing climate change health adaptation through implementation science

To date, there are few examples of implementation science studies that help guide climate-related health adaptation. Implementation science is the study of methods to promote the adoption and integration of evidence-based tools, interventions, and policies into practice to improve population health. These studies can provide the needed empirical evidence to prioritise and inform implementation of health adaptation efforts. This Personal View discusses five case studies that deployed disease early warning systems around the world. These cases studies illustrate challenges to deploying early warning systems and guide recommendations for implementation science approaches to enhance future research. We propose theory-informed approaches to understand multilevel barriers, design strategies to overcome those barriers, and analyse the ability of those strategies to advance the uptake and scale-up of climate-related health interventions. These findings build upon previous theoretical work by grounding implementation science recommendations and guidance in the context of real-world practice, as detailed in the case studies.Peer ReviewedArticle signat per 14 autors/es: Gila Neta, PhD; William Pan, DrPH; Prof Kristie Ebi, PhD; Daniel F Buss, PhD; Trisha Castranio, BS; Prof Rachel Lowe, PhD; Sadie J Ryan, PhD; Anna M Stewart-Ibarra, PhD; Limb K Hapairai, PhD; Meena Sehgal, MPH; Prof Michael C Wimberly, PhD; Leslie Rollock, DrPH; Prof Maureen Lichtveld, MD; John Balbus, MD"Postprint (published version