The individual, the government and the global community: sharing responsibility for health post-2015 in Vanuatu, a small island developing state

International Journal for Equity in Health

Jean-Jacques Rory¹  Marie-France Maleb³  John Tasserei¹  Peter S. Hill²  Simon A. Sheridan²  Claire Ibell² 

[1] Health Promotion Unit, Public Health Department, Private Mail Bag 9009, Port Vila, Efate, Vanuatu;School of Public Health, Public Health Building, University of Queensland, Herston Road, Herston 4006, QLD, Australia;Sanma Provincial Health Office, Luganville, Espiritu Santo, Vanuatu

关键词: Small island developing states;    Pacific Island Countries;    Post-2015 health agenda;    Sustainable development goals;   

Others  :  1231375
DOI  :  10.1186/s12939-015-0244-1

 received in 2015-04-02, accepted in 2015-10-14,  发布年份 2015

【 摘 要 】

Introduction

The end of 2015 will see the creation of the sustainable development goals – the new global framework for development. The process of creating universally relevant goals has involved community consultation throughout the world. Within this process it is vital that Pacific Island countries are included as they face particular development challenges due to their size and geographical location. As small island developing states, many Pacific Island countries struggle to overcome high rates of poverty and poor health outcomes. In order to include Pacific voices in the new health related sustainable development goals, Vanuatu was selected as a representative of the Pacific for this qualitative study. This paper presents the perspectives of communities throughout Vanuatu on their essential health needs and how best to meet them.

Methods

This paper examines the perspectives of 102 individuals from throughout Vanuatu. Ten focus group discussions and 2 individual interviews were conducted within communities in September 2013. Discussions focused on community perceptions of health, essential health needs, and responsibility in achieving health needs. Discussions were audio recorded and transcribed. The transcripts were then analysed using a theoretical thematic approach in order to identify central themes and subthemes.

Results

Individuals in this study demonstrated a comprehensive understanding of health, defining health in a holistic manner. Participants identified clear environmental and societal factors that impact upon health, and emphasized failures within the current health system as important barriers to attaining good health. Participants described the challenges faced in taking responsibility for one’s health, and pointed to both the government and the international community as key players in meeting the essential health needs of communities.

Conclusions

As a small island developing state, Vanuatu faces accentuated development challenges – particularly as globalisation and climate change progress. The individuals and communities in this study demonstrate a clear understanding of their needs, and show a strong desire for change. They point to both the government and the international community to assist in meeting health needs, and stress that respect for traditional governance and community involvement in decision-making are vital in this process. In order to ensure that the new health goals effectively meet local needs in Vanuatu such factors must be incorporated into policy and implementation decision-making.

【 授权许可】

   
2015 Ibell et al.

【 参考文献 】

• [1]United Nations Secretary General. The road to dignity by 2030: ending poverty, transforming all lives and protecting the planet. Synthesis report of the Secretary-General on the post-2015 sustainable development agenda. 2014. http://www.un.org/en/ga/search/view_doc.asp?symbol=A/69/700&referer=http://www.un.org/en/documents/&Lang=E. Accessed 15 Feb 2015.
• [2]Beyond2015, World we want 2015 http://www.beyond2015.org/world-we-want-2015. Accessed 15 Feb 2015.
• [3]United Nations Regional Commissions New York Office. Post-2015 Pacific Consultation Outcome Document. 2012. http://www.regionalcommissions.org/AP_MDGs_Nadi_Consultation_Pacific_Final%20Outcomes%20Doc.pdf. Accessed 15 Feb 2015.
• [4]United Nations Conference on Trade and Development. The Least Developed Countries Report 2013. 2013. http://unctad.org/en/PublicationsLibrary/ldc2013_en.pdf. Accessed 21 Feb 2015.
• [5]United Nations. SIDS Accelerated Modalities of Action (S.A.M.O.A) Pathway. 2014. http://www.sids2014.org/index.php?menu=1537. Accessed 15 Jan 2015.
• [6]Small Island Developing States Network (SIDSnet): About SIDS [http://www.sidsnet.org/about-sids]. Accessed 15 Jan 2015.
• [7]Hoy D, Roth A, Viney K, Souares Y, Lopez AD. Findings and Implications of the Global Burden of Disease 2010 Study for the Pacific Islands. Prev Chronic Dis 2014; doi: http://dx.doi.org/10.5888/pcd11.130344.
• [8]World Health Organisation Western Pacific Region. Honiara Communiqué on the Pacific Non-communicable Disease Crisis. 2011. http://www.wpro.who.int/noncommunicable_diseases/honiara_communique.pdf. Accessed 14 Feb 2015.
• [9]Go4Health http://www.go4health.eu/. Accessed 1 Dec 2014.
• [10]Go4Health. The post-2015 international health agenda: universal health coverage and healthy environment, both anchored in the right to health. 2012. http://www.go4health.eu/publications/. Accessed 17 Feb 2015.
• [11]Sheridan S, Brolan C, Fitzgerald L, Tasserei J, Maleb M, Rory J et al.. Facilitating health and wellbeing is “everybody’s role”: youth perspectives from Vanuatu on health and the post-2015 sustainable development goal agenda. Int J Equity Health. 2014; 13:80. BioMed Central Full Text
• [12]Vanuatu National Statistics Office: Live Population of Vanuatu. http://www.vnso.gov.vu/ . 2014. Accessed 10 Feb 2015.
• [13]Vanuatu National Statistics Office. 2009 National Population and Housing Census, Analytical Report Volume 2. 2009. http://www.vnso.gov.vu/index.php/document-library?view=download&fileId=2009. Accessed 10 Feb 2015.
• [14]Vanuatu National Statistics Office. Vanuatu Statistics Pocketbook. 2012. http://www.vnso.gov.vu/index.php/document-library?view=download&fileId=853. Accessed 10 Feb 2015.
• [15]Asian Development Bank. Asian Development Bank and Vanuatu Factsheet. 2015. http://www.adb.org/sites/default/files/publication/27812/van.pdf. Accessed 21 Oct 2015.
• [16]The World Databank. World Development Indicators: GDP per capita. 2015. http://databank.worldbank.org/data/reports.aspx?source=world-development-indicators#selectedDimension_WDI_Ctry. Accessed 10 Feb 2015.
• [17]Central Intelligence Agency. The World Factbook: Vanuatu. 2014. https://www.cia.gov/library/publications/the-world-factbook/geos/nh.html. Accessed 10 Feb 2015.
• [18]Pacific Islands Forum Secretariat. 2013 Pacific Regional MDGs Tracking Report. 2013. http://www.forumsec.org/resources/uploads/attachments/documents/2013_Pac_Regional_MDGs_Tracking_Report_FINAL.pdf. Accessed 21 Jan 2015.
• [19]UN Millennium Development Goals Indicators: Vanuatu. 2014. http://mdgs.un.org/unsd/mdg/Data.aspx. Accessed 11 Feb 2015.
• [20]Government of Vanuatu Prime Minister’s Office. Millennium Development Goals 2010 Report for Vanuatu. 2010. http://www.vnso.gov.vu/images/Special_Report/Vanuatu_Demographic_and_Health_Survey_Report/2013_VDHS_FINAL_Report.pdf. Accessed 21 Jan 2015.
• [21]Vanuatu Ministry of Health, Vanuatu National Statistics Office and the Secretariat of the Pacific Community. Vanuatu Demographic and Health Survey – MICS 2013. http://www.vnso.gov.vu/images/Special_Report/Vanuatu_Demographic_and_Health_Survey_Report/2013_VDHS-MICS_FINAL.pdf. Accessed 11 Feb 2015.
• [22]Institute for Health Metrics and Evaluation, and the World Bank Human Development Network. The Global Burden of Disease: Generating Evidence, Guiding Policy, East Asia and Pacific Regional Edition. 2010. http://www.healthdata.org/policy-report/global-burden-disease-generating-evidence-guiding-policy-%E2%80%93-east-asia-and-pacific. Accessed 25 Jan 2015.
• [23]World Health Organisation. Vanuatu Health Profile. 2012. http://www.who.int/gho/countries/vut/country_profiles/en/. Accessed 4 Feb 2015.
• [24]UNAIDS. Global AIDS Response Progress Report: Vanuatu. 2014. http://www.unaids.org/sites/default/files/en/dataanalysis/knowyourresponse/countryprogressreports/2014countries/VUT_narrative_report_2014.pdf. Accessed 14 Feb 2015.
• [25]Dancause K, Vilar M, Wilson M, Soloway L, DeHuff C, Chan C, et al. Behavioural Risk Factors for Obesity During Health Transition in Vanuatu, South Pacific. 2013; doi:10.1002/oby.20082.
• [26]Phongsavan P, Olatunbosun-Alakija A, Havea D, Bauman A, Smith B, Galea G et al.. Health behaviour and lifestyle of Pacific youth surveys: a resource for capacity building. Health Promot Int. 2005.
• [27]Government of the Republic of Vanuatu. Priorities and Action Agenda 2006 – 2015. 2006. http://www.dfat.gov.au/about-us/publications/Documents/government-of-vanuatu-priorities-action-agenda-2006-15.pdf. Accessed 15 Feb 2015.
• [28]World Health Organisation Western Pacific Region. Vanuatu NCD Risk Factors STEPS Report. 2013. http://www.who.int/chp/steps/Vanuatu_STEPS_Report_2013.pdf?ua=1. Accessed 15 Feb 2015.
• [29]Bani, E. Vanuatu’s National Assessment Report for the implementation of the Barbados Programme of Action (BPoA) and the Mauritius Strategy for Implementation (MSI). 2013. http://www.sids2014.org/content/documents/221Vanuatu.pdf. Accessed 1 Dec 2014.
• [30]United Nations Development Group. The World We Want, Dialogues on the implementation of the post-2015 development agenda. 2014. http://www.un.org/millenniumgoals/pdf/UNDG%202nd%20dialogues.pdf. Accessed 10 Sept 2015.
• [31]Commonwealth Local Government Forum of the Pacific. Localising the Post 2015 Development Agenda: Findings of the Vanuatu Dialogues. 2014. https://www.worldwewant2015.org/localising2015. Accessed 25 Nov 2014.
• [32]Friedman E, Akakimpa D, Baba J, Brolan C, Chew A, Eggermont N, et al. Go4Health community consultations on the post-2015 global health agenda: A demand for dignity, respect, participation and accountability. 2013. http://www.go4health.eu/wp-content/uploads/WP2-August-2013-FINAL-Light.pdf. Accessed 16 Feb 2015.
• [33]Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:77-101.
• [34]World Health Organisation and Vanuatu Ministry of Health. Health Service Delivery Profile – Vanuatu. 2012. http://www.wpro.who.int/health_services/service_delivery_profile_vanuatu.pdf. Accessed 17 Feb 2015.
• [35]Government of Vanuatu and NZaid. Vanuatu National Water Strategy. 2008. http://nab.vu/vanuatu-national-water-strategy. Accessed 25 Jan 2015.
• [36]Vanuatu Ministry of Health. Health Sector Strategy 2010-2016, moving health forward. 2010. http://www.wpro.who.int/health_services/vanuatu_nationalhealthplan.pdf. Accessed 4 Feb 2010.
• [37]Vanuatu Ministry of Health. National Policy and Strategy for Healthy Islands: A vision for Primary Health Care Revitalisation through Health Promotion 2011-2015. https://healthyislandsvanuatu.wordpress.com/policy/. Accessed 24 Feb 2015.
• [38]World Health Organisation. Vanuatu Country Cooperation Strategy at a glance. 2014. https://extranet.who.int/iris/restricted/handle/10665/136982. Accessed 4 Feb 2015.