Delegates from the following countries and organisations met in Suva, Fiji on 5-6
December 2019 and agreed the Call to Action below:
Delegates from Papua New Guinea, Vanuatu, Solomon Islands, Kiribati, Federated States
of Micronesia, Fiji and Samoa together with representatives of the Pacific Society for
Reproductive Health, Papua New Guinea Obstetrics and Gynaecology Society, Fiji
Obstetrics and Gynaecology Society, Papua New Guinea Institute of Medical Research,
Cervical Cancer Prevention in the Pacific, The Pacific Community (SPC), VCS Foundation,
Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Kirby
Institute at the University of New South Wales, Family Planning Australia, Australian
Cervical Cancer Foundation, Fiji Cancer Society, Fiji National University, University of
Otago, National University of Samoa and Victoria University. Also present were
representatives of the United Nations Population Fund and the United Nations Children’s
Fund.
We agreed to the following principles:

1. We support the global target to achieve elimination of cervical cancer as a public
   health problem, noting the current high burden of cervical cancer in the Pacific
   and the current lack of adequate vaccination, screening and treatment.
2. In line with the World Health Organization (WHO) draft targets for 2030, in the
   Pacific our targets are:
   1. a. 90% of girls are fully vaccinated against human papillomavirus (HPV) by
      15 years of age.
   2. b. 70% of women have had an HPV screening test between 30 – 39 years of
      age and a second HPV test between 40 – 49 years of age1.
   3. c. 90% of women identified with cervical pre-cancer and cancer have
      received appropriate treatment and care
3. We support the principles of equity in striving for the elimination of cervical
   cancer in the Pacific so that no woman or community is left behind.
4. We support the principle of meaningful collaboration between Pacific Island
   nations in planning, procurement and knowledge sharing.

We are committed to the following actions:

1. Raising awareness of cervical cancer in the Pacific and its impact on families and
   communities and strengthening advocacy for elimination.
2. Vaccination
   Exploring funding options including public-private partnerships for ongoing HPV
   vaccination in the Pacific.
   These two tests should be 10 years apart. Clinically validated PCR based tests should be used.
3. Urging Pacific Island governments to include HPV vaccination against HPV onto
   existing immunization schedules.
4. Screening
   Urging Pacific Island governments to transition to the delivery of effective cervical
   cancer screening with HPV testing and pre-cancer treatment services.
   Consideration should be given to self-collection of vaginal samples in order to
   facilitate scale up and acceptability.
5. Treatment:
   Urging cooperation between Pacific Island Governments to establish a treatment
   centre for cervical cancer, including radiotherapy, to act as a referral hub within
   the Pacific.
6. Workforce:
   Assisting Pacific Island governments and training agencies to develop an essential
   workforce for the delivery of HPV vaccination, cervical cancer screening and the
   management of cervical cancer.
7. Registry establishment:
   Assisting in establishing an adequate registry to record information about
   vaccination, screening and treatment for the prevention of cervical cancer; and
   with potential linkage to a cancer registry. This will facilitate follow-up of the
   young with incomplete vaccination and women through the screening pathway. It
   will also enable robust monitoring and evaluation of vaccination and screening
   program performance.

For more information, please email/call any of the following:
Professor Alec Ekeroma, HOD, Department of Obstetrics and Gynaecology,
University of Otago, Wellington, New Zealand. E: alec.ekeroma@otago.ac.nz; M:
+64212767975.
Professor Diana Sarfati, Head of Department, Public Health, University of Otago,
Wellington, New Zealand. diana.sarfati@otago.ac.nz
Professor Marion Saville, Executive Director, VCS Foundation, Melbourne, Australia.
E: msaville@vcs.org.au

The PSRH Focal Points (FPs) in each participating Pacific Island country act as eyes and ears for PSRH at country level. Therefore, PSRH regards their roles as critically important to providing relevant information to the Secretariat, especially in sharing PSRH-supported maternal and newborn activities at country level. Focal Points also contribute to collating country news articles that can be featured in the PRSH quarterly newsletter. This way, we are connected across the Pacific Ocean and made aware of important events taking place in the countries.
 
The current FPs were appointed at the last PSRH Biennial General Meeting in Vanuatu (July 17, purely on voluntary basis. The PSRH Executive has decreed that the FPs roles are:
 

• To liaise between PSRH Executive and appropriate authorities in countries on matters relating to PSRH.
• To coordinate functions and activities of PSRH at country level.
• To feed relevant country information and updates to Executive, and coordinate country contribution to the PSRH newsletter
• To facilitate the implementation of PSRH Action Plans agreed to at each biennial meeting.
• To facilitate membership drive among RH professionals and advocates.
• To communicate & hold regular PSRH meeting (at least 2-3 times a year) with local PSRH members in respective countries.
• To facilitate selection of country delegates to attend the PSRH biennial meeting in line with the official procedures of each country.
• To coordinate fund-raising activities to support country delegation to BGM meetings.
• To prepare a country presentation for each BGM meeting, as appropriate and to lead the country delegation

For list of Country Focal Points, please visit PSRH website:  www.psrh.org

During 2018, a number of workshops and meetings have been delivered in many of the Pacific Island Countries. These include PEMNeT, Family Planning, Ultrasound, Colposcopy and Research in Reproductive Health. More workshops are being are planned for delivery. Workshops are funded by the Royal Australasian College of Surgeons Pacific Islands Programme, Secretariat of the Pacific Commission (SPC) and United Nations Population Fund. PSRH would like to acknowledge our funders and partners who have supported the delivery of these workshops.  A list of workshops completed and being planned appears in the table below.
 
The second edition of the PEMNET Manual and Guideline is under review and this work has been led by Professor Alec Ekeroma and Dr Sharron Bolitho. The review is needed so that the manual remains relevant for Pacific island settings. The new edition will be launched as soon as it is ready.

Professor Aiono Dr Alec Ekeroma and the team have continued their regional work on Cervical Cancer screening, prevention and treatment that started in Samoa in May this year. The meeting which was held recently (Sep) in Sydney.
A call was made by WHO and meeting partners to eliminate cervical cancer in the region. There was general agreement to build on the Sydney call for action and discussions are already underway among a number of collaborating groups including PSRH, RANZCOG, Victoria Screening Lab and the Universities of Otago and Victoria.  It is possible to eliminate cervical cancer in Pacific Islands if joint efforts are sustained and national buy-in is secured. Pacific nations need to be in the driver’s seat in this agenda to prevent unnecessary deaths in young mothers across the region. Comprehensive interventions are needed including HPV vaccination, screening and early detection, and robust treatment programs. To facilitate the drive, actions for research, political will and activism are needed in this area.

During the FOGS week, the PSRH hosted a regional symposium at the Grand Pacific Hotel in Suva, Fiji. The function was officiated by Hon. Rosy Akbar, Minister for Medical and Health Services in Fiji. Minister Akbar deliberated on the continued need for advocacy on sexual and reproductive health including a focus on cervical cancer prevention, screening and treatment in the Pacific. She also emphasized on the role of multisectoral collaboration and networking among organisations and partners in jointly responding to major health challenges. She highlighted that the PSRH Symposium is an example of regional collaboration to generate discussions, mobilize capacity building, negotiate for resources and strengthen health program development. The function was supported by UNFPA Pacific Sub-regional office, Ministry of Health and Medical Services Fiji and the Secretariat of the Pacific Commission.

The 13th Biennial General Meeting (BGM) for PSRH is being planned to take place at The Stanley Hotel, Port Moresby in Papua New Guinea (PNG).  The dates are confirmed for 6-11 July 2019 and hundreds of health professionals are expected to attend. The PNG LOC is chaired by Dr. Mary Bagita, currently the President of the PNG O&G Society. The local organisation is being jointly coordinated with the PNG Midwifery Society.
The theme for the conference is “Pacific Experience for Pacific Solutions in Reproductive Health.” Prior to the conference a number of technical workshops will be conducted in parallel sessions organised by the Local Team in consultation with visiting experts. Details of the workshops will be posted in the PSRH website by January 2019.

The Secretariat’s role in contributing to regional oversight, advocacy work and up skilling of clinicians has been crucial. The CEO, Mrs Ireen Manuel represented PSRH at the recent UNFPA meeting held in Nadi Fiji in September.
The workshop discussed issues related to health workforce development for Reproductive, Maternal, Newborn, Adolescent and Child in the Pacific. PSRH shared its work in the Pacific on how it is contributing to this agenda. Together with other RMNCAH partners and stakeholders, we anticipate that PSRH’s role in capacity development is of critical importance to further strengthen RMNCAH services in the Pacific. A number of NGOs and other partners were present at this meeting to support the UNFPA workshop. PSRH is keen to collaborate with UNFPA in this area and continues to collaborate with other RMNCAH colleagues at regional and national levels so that our efforts and initiatives are appropriately aligned and harmonized, and respond to local needs.

Recent WHO work and important documents by partners in the area of Reproductive Health, Maternal-Newborn, Child and Adolescent Health (RMNCAH) and health through the life-course (April 2018)

Protecting, promoting, and supp
1．Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018 Implementation Guidance.

WHO and UNICEF issued new ten-step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. The updated guidance is intended for all those who set policy for, or offer care to, pregnant women, families and infants: governments; national managers of maternal and child health programmes in general, and of breastfeeding- and Baby-friendly Hospital Initiative (BFHI)-related programmes in particular; and health-facility managers at different levels (facility directors, medical directors, chiefs of maternity and neonatal wards). The document presents the first revision of the Ten Steps since 1989. The topic of each step is unchanged, but wording has been updated in line with evidence-based guidelines and global health policy. http://www.who.int/nutrition/publications/infantfeeding/bfhi-implementation/en/

Related documents Health topic page – Breastfeeding Fact sheets –  Infant and young child feeding Facts in pictures-  Breastfeeding Infographics  Baby-friendly hospitals initiative

2 .Standards for improving the quality of care for children and young adolescents in health facilities

3. Civil Registration and Vital Statistics (CRVS)

 
4. Factsheets

 
5. WHO publications/information

• Universal Health Coverage and Sustainable Development Goal country profiles for the Western Pacific Region 
• 71st World Health Assembly site
• World Health Day Site  – 7 April 2018
• Revised SAGE recommendation on use of dengue vaccine
• World Immunization Week, 24-30 April 2018
• The Global Early Adolescent Study (GEAS) Tool Kit
• HRP annual report 2017
• Classification of digital health interventions v1.0

PSRH wishes to announce its Biennial Conference scheduled for July 2019 to be held in Port Moresby, Papua New Guinea

• Host Country: Papua New Guinea
• Dates: July 6 – 11^th July
• Pre-conference workshops: 6-8^th July (Medical School, University of PNG)
• Conference: 9 – 11^th July
• Venue: Stanley Hotel, Port Moresby
• Theme: “Pacific Experience for Pacific Solutions in Reproductive Health”

Please check PSRH website for more information.

 Professor Alec Ekeroma, the Hon CEO of PSRH, has from last September, become the Chair of the Department of Obstetrics and Gynaecology at the Wellington School of the University of Otago (UoO). The UoO position is an academic promotion for Alec and he will be the first Pacific academic to reach a professorial role in any area of medicine in either Australia or NZ. Alec feels privileged that his long academic service and leadership work in the Pacific is recognized and revels in the potential importance of the role “to lead the department of obstetrics and gynaecology in the nation’s capital, further my research collaborations in NZ and the Pacific and innovate in training future O&G leaders in NZ and the region”. The second appointment is a call to assist Samoa strengthen the new School of Medicine at the National University of Samoa. He will divide his time between Wellington and Samoa.