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Table 1 Summary of key regional health-care capacity issues for disaster response

From: A qualitative examination of the health workforce needs during climate change disaster response in Pacific Island Countries

  Cook Islands Fiji Samoa Vanuatu
Health workforce governance, management and policy
Health-care governance No clear guidelines for the coordination of in-coming health personnel. Mechanisms being developed to deal with this. In-coming health personnel were usually coordinated through the UNOCHA/PHT system. Existing guidelines for registration of in-coming health professionals, but not always followed. No clear guidelines for the coordination of in-coming health personnel. Policies were needed to govern this process during disasters.
Health-care management systems Health sector is a key stakeholder in the DRS and well organized and has seen improvements since the clarification of roles and responsibilities. Health sector is a key stakeholder in the DRS and actively involved in disaster coordination. Health sector coordination functioning well. Health sector is a key stakeholder in the DRS however internal issues may be affecting the strength of their coordination and involvement. Health sector is a key stakeholder in the DRS however lacks coordination within the sector and with external partners needs to be improved.
Health-care policy environment Policy in place to guide health workforce. Knowledge of policies affected by high staff turnover rates. Generic policies and processes in place but need to be more clearly defined for specific disasters. Clearly defined policies and processes in place, supported by National Development Strategy. Lack of clear policies and guidelines for health workforce coordination.
Health-care capacity and skills
Human resources for health capacity Clear leadership and strong partnerships with NGOs and donors; health workforce and capacity inadequate particularly in times of disaster. Strong leadership and external support systems from government and donors; health workforce capacity is stretched especially in times of disaster. Strong leadership and external support systems from government and donors. Lack of cohesion within health sector limits effective utilisation of resources. Internal leadership needs strengthening and relies heavily on external support. Limited capacity to respond to disasters against limited HRH and resources.
Health workforce capacity and skills Inadequate capacity to address psychosocial needs. Inadequate capacity to address psychosocial needs. Inadequate capacity to address psychosocial needs. Inadequate capacity to address psychosocial needs.
Human resources for health training, competencies and workforce development
Health workforce education, training and development Some level of disaster training available for health workforce. Desktop and field simulations or training programs annually. Access to training for some levels of staff is an issue. Need for a nursing education Institution in-country. Disaster training available and included in nursing curriculum. Access to training for some levels of staff an issue. Nursing and allied health staff actively involved. Task-shifting and multi-tasking encouraged. Low intakes in nursing and medical programs undermining workforce development. Triage and emergency medical care, post-trauma counselling were critical areas for training. Health workforce actively involved, but needs to improve skills to deal with climate sensitive diseases. Disaster training available and included in nursing curriculum. Additional training for village health workers and traditional birth attendants needed.
  1. DRS = disaster response system; HRH = human resources for health; NGO = non-governmental organization; UNOCHA/PHT = United Nations Office for the Coordination of Humanitarian Affairs/Pacific Humanitarian Team.