A recent World Bank report has proposed a significant overhaul of Fiji’s healthcare system, suggesting a shift from a hospital-centered model to one that emphasizes preventive care and disease management at the primary care level. This change is deemed necessary as non-communicable diseases (NCDs) have become a major health crisis in Fiji, responsible for 80% of the country’s deaths, with 64% of those fatalities occurring among the working-age population. The economic impact of NCDs in Fiji is substantial, costing the nation approximately $591 million annually.
The report highlights the growing burden of NCDs, which increased from comprising 64.1% of Fiji’s overall disease burden in 1990 to 77.1% by 2019. Among NCD-related deaths in 2019, nearly 64% were individuals aged between 30 and 70. Chronic conditions such as diabetes, ischemic heart disease, stroke, and chronic kidney disease are the leading causes of these fatalities.
The World Bank estimates that transitioning to a more primary healthcare-focused system would require an investment of $320 million to $340 million, translating to about $50 million annually over a seven-year period. However, this investment is viewed as worthwhile since primary healthcare systems are recognized as the most cost-effective and equitable means to enhance public health. An effective primary healthcare system could promote healthy lifestyles, facilitate early disease diagnosis, and ensure better management of chronic conditions, potentially reducing hospitalizations due to complications from diabetes and hypertension.
The report stresses the urgency of implementing policy changes, investments, and improvements in service delivery, stating that maintaining the status quo is not feasible if Fiji is to reverse the current health crisis. It outlines recommendations for reform across four critical areas to aid in achieving this essential healthcare transformation.
This initiative holds promise for enhancing the health and well-being of the Fijian population, particularly as the focus on prevention and early intervention could lead to healthier outcomes and reduced healthcare costs in the long run. By investing in primary healthcare, Fiji may pave the way to a healthier future for its citizens.
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