A shortage of clinical skills among frontline health workers, rather than a lack of equipment, is undermining efforts to detect tuberculosis cases early in Fiji, Assistant Minister for Health and Medical Services Penioni Ravunawa has warned. Ravunawa said the inability of nurses and other clinic staff to recognise and appropriately manage TB symptoms is contributing to missed diagnoses and delayed care.
In response, the Ministry of Health has launched the Fiji National TB Management Guideline 2025, the fifth edition of the national manual aimed at strengthening diagnosis and improving patient care. Ravunawa said the updated guideline is intended to help frontline clinicians “understand the signs and symptoms that are presented to the clinic and how to manage them,” stressing the emphasis on clinical recognition rather than focusing solely on diagnostic equipment.
The guideline, the ministry said, provides updated and standardised directions for prevention, diagnosis and treatment of tuberculosis. Officials described it as offering clear, practical and evidence-based guidance for health care workers — a resource designed to bring consistency to clinical decision-making across primary health clinics and other frontline facilities where patients first present.
Health workers at the first point of contact play a pivotal role in identifying possible TB cases, initiating diagnostic pathways and ensuring timely treatment. According to Ravunawa’s remarks at the launch, gaps in these core clinical skills are a major barrier to early detection. By consolidating best-practice recommendations into an accessible national reference, the guideline aims to reduce variation in practice that can result in delayed testing or referral.
The 2025 edition builds on previous versions of the national TB management manual, updating recommendations to reflect current evidence and to align prevention, diagnosis and treatment protocols. The Ministry framed the launch as part of broader efforts to strengthen the health system’s response to TB by equipping clinicians with clearer, more standardised instruction on recognising symptoms, interpreting clinical findings and managing cases at the clinic level.
While the ministry highlighted the guideline as a key tool, Ravunawa’s comments underscore that improved case detection will also depend on the capacity of frontline nurses and clinicians to apply the guidance in everyday practice. The launch signals a shift toward emphasising clinical training and decision support as complements to diagnostic technology in Fiji’s ongoing fight against tuberculosis.
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