Barriers and enablers to using contraceptives for family planning at Atoifi Hospital, East Kwaio, Solomon Islands

Background: The use of family planning contraceptives helps improve women’s lives and prevent maternal deaths. Globally, maternal mortality has been significantly reduced between 1990 and 2015. However, the gains have not been evenly spread with the majority of deaths still occurring in low- and middle-income countries. Solomon Islands, a low-income nation in the Pacific, faces the continued challenge of low contraceptive use and unmet needs for family planning. There is also still a gap between knowledge about contraceptives and their actual use. This study explores the barriers and enablers to family planning, including contraceptive use at Atoifi Hospital, Solomon Islands and presents strategies that may increase contraceptive use. Methods: In this qualitative study, semi-structured face-to-face interviews were facilitated with family planning nurses, contraceptive users and non-users to explore the barriers and enablers for women and men accessing family planning, including contraceptive use. A total of nine interviews were conducted. Results showed a link between delivery of family planning service with contraceptive use, as represented by four themes: availability and accessibility of contraceptives; knowledge and beliefs; socio-cultural expectation of women; and fear. Conclusion: Context is a key factor to incorporate successful strategies to fulfill unmet family planning needs and increase usage. This small study revealed significant barriers to contraceptive use were linked to where and how family planning service is delivered. The service would benefit from greater attention to the cultural context, gender and privacy issues. Services in Pacific Island countries may also benefit from the lessons learnt in Solomon Islands

Measles outbreak investigation in a remote area of Solomon Islands, 2014

Objective: To describe a measles outbreak and health service response in a remote location in Malaita, Solomon Islands.\ud \ud Methods: Epidemiological review of cases who presented to the Atoifi Adventist Hospital (AAH) during the outbreak period from July to December 2014. Rumour surveillance was used to gather information on unreported cases.\ud \ud Results: A total of 117 cases were reported to AAH. The incidence rate was 123 per 10 000 individuals. Fifty-six per cent (66/117) of cases were hospitalized. Children under 5 years had the highest number of cases (n = 41) with 10 cases below 6 months old. The age-specific incidence rate of children under 5 years was 278.5 per 10 000 individuals. Eighty-two per cent of reported cases were 18 years old or younger. Rumour surveillance revealed about three quarters of children in one area of the East Kwaio Mountains had suspected measles not reported to AAH. There were three unreported deaths from measles outside AAH. During the outbreak, a total of 2453 measles-rubella vaccines were given in the AAH catchment area.\ud \ud Conclusion: A high incidence rate was observed in children and young people aged 18 years or younger, reflecting low childhood vaccination coverage. More than 50­% of cases required hospitalization due to disease severity and challenges of accessing health services. The rumour surveillance discovered many unreported cases in the mountain areas and a few deaths possibly linked to the outbreak. Improvement of registration methods and follow-up systems and setting up satellite clinics are planned to improve measles surveillance and vaccination coverage

Measles outbreak investigation in a remote area of Solomon Islands, 2014

Objective: To describe a measles outbreak and health service response in a remote location in Malaita, Solomon Islands. Methods: Epidemiological review of cases who presented to the Atoifi Adventist Hospital (AAH) during the outbreak period from July to December 2014. Rumour surveillance was used to gather information on unreported cases. Results: A total of 117 cases were reported to AAH. The incidence rate was 123 per 10 000 individuals. Fifty-six per cent (66/117) of cases were hospitalized. Children under 5 years had the highest number of cases (n = 41) with 10 cases below 6 months old. The age-specific incidence rate of children under 5 years was 278.5 per 10 000 individuals. Eighty-two per cent of reported cases were 18 years old or younger. Rumour surveillance revealed about three quarters of children in one area of the East Kwaio Mountains had suspected measles not reported to AAH. There were three unreported deaths from measles outside AAH. During the outbreak, a total of 2453 measles-rubella vaccines were given in the AAH catchment area. Conclusion: A high incidence rate was observed in children and young people aged 18 years or younger, reflecting low childhood vaccination coverage. More than 50% of cases required hospitalization due to disease severity and challenges of accessing health services. The rumour surveillance discovered many unreported cases in the mountain areas and a few deaths possibly linked to the outbreak. Improvement of registration methods and follow-up systems and setting up satellite clinics are planned to improve measles surveillance and vaccination coverage