ABSTRACT
It is not inconceivable that by 2035 the substantial gaps in child health across the Pacific can close significantly. Currently, Australia and New Zealand have child mortality rates of 5 and 6 per 1000 live births, respectively, while Pacific island developing nations have under 5 mortality rates ranging from 13 to 16 (Vanuatu, Fiji and Tonga) to 47 and 58 per 1000 live births (Kiribati and Papua New Guinea, respectively). However, these Pacific child mortality rates are falling, by an average of 1.4% per year since 1990, and more rapidly (1.9% per year) since 2000. Based on progress elsewhere, there is a need to (i) define the specific things needed to close the gaps in child health; (ii) be far more ambitious and hopeful than ever before; and (iii) form a new regional compact based on solidarity and interdependence.
Subject(s)
Child Health Services/trends , Child Mortality/trends , Child Welfare/trends , Developing Countries/statistics & numerical data , Goals , Health Services Needs and Demand/trends , Healthcare Disparities/trends , Australia/epidemiology , Child , Child Health Services/methods , Child Health Services/organization & administration , Child Health Services/supply & distribution , Developed Countries/statistics & numerical data , Health Services Accessibility/trends , Health Status Disparities , Humans , Pacific Islands/epidemiology , Rural Health Services/supply & distribution , Rural Health Services/trendsABSTRACT
AIMS: The Solomon Islands health service, infrastructure and economy were severely affected by the civil conflict that occurred between 1998 and 2003. In 2002 plans to rebuild health services for children, especially those provided in provincial hospitals, were developed by paediatricians, in collaboration with the World Health Organization. We aimed to inform this process by an assessment of the strengths and weaknesses of the child health service, particularly in provincial hospitals. METHODS: A systematic assessment of the quality of hospital care for children in Solomon Islands was conducted in November 2003. The study used a WHO assessment tool, modified for use in the Asia-Pacific region. RESULTS: The assessment highlighted several problems in clinical care, human resources, health financing, referral systems, and training, and has been used as a basis for several interventions for improving the quality of paediatric care. CONCLUSION: This study and the initiatives that have followed it demonstrate the link between such assessments, child health policy and quality improvement activities. Such programs can be implemented even where resources are very limited. Sustaining initiatives based on this assessment will be important for the Solomon Islands if it is to achieve the Millennium Development Goals for child survival by 2015.
