When women and girls are able to stay in school longer, access health services and empowered to plan for responsible motherhood, they can improve their social and economic opportunities, and ultimately transform their futures.
Although 70% of the health workforce is made up of women, this is often not reflected in leadership roles. It is important that more women join the ranks of health leadership where decisions are made about the health of women and girls
On the occasion of International Women’s Day on 8^th March we reflect on the universal theme of “press for progress” through actions to advocate for gender equality and women’s empowerment. This annual event is a global day celebrating the social, economic, cultural and political achievements of women. The day also marks a call to action for accelerating gender equality and acts as a catalyst for facilitating change for progress.
For health professionals, the theme is focused around women in health leadership. As health advocates, we try to make this theme meaningful and valuable so that it inspires us in our everyday work. For many, the theme maybe just one of those catch-phrases for global attention to support a global health agenda. On a positive side, we can usefully apply the theme for our own purpose and advantage. If organisations, groups or individuals analyse the theme and unfold its meaning, we can gain better understanding of what it means for different settings, and how we may be able to advocate for women leaders in the health sector.
In some parts of the Pacific region, women are indeed already taking up positions of health leadership in many fronts and at all levels. Statistics indicate that at least 70% of the health workforce comprises women at various levels of professional responsibilities. A fairly large proportion of them are assigned to mid-level management, while the larger proportion are frontliners for service delivery working as clinical doctors, nurses, midwives and paramedics at all levels of health care.
Pacific women have reached leadership roles as health ministers, executive directors, clinical managers, consultants, heads of sections, health facility managers, supervisors and so forth. While we are making progress in senior leadership, it is important that we recognise that any health professional is a leader in his/her area of work, regardless of hierarchy. But often times, the role of leadership is not strongly embedded in job descriptions and remains a weak component of the recruitment and orientation process. As such, our current workforce systems often fall short in bringing about the essence of leadership functions, appropriate and relevant for different positions.
How do we address this shortfall? Often times the leadership roles are not well articulated in job descriptions; a missed opportunity. Therefore, we need to recognise its importance, provide an enabling environment to allow women to exercise leadership roles, and empower them so they can develop, expand their horizons and ultimately maximise their contribution to health outcomes.
Advocating for women in health leadership can impact on the way we work and the approaches we take for bringing about maximum health outcomes. The theme portrays the critical role of women as catalysts for change in health sector development.
“Women in health leadership” reminds us that as health professionals, we can influence health outcomes by supporting, advocating and investing in women to become stronger leaders in the health sector. There is ample evidence that investing in women is the most effective way to lift communities, organisations, and even countries to better socio-economic gains. Women’s participation makes strategic directions for health care stronger, societies more resilient and economies more vigorous. Women’s empowerment and leadership is critical to ensuring success across all 17 Sustainable Development Goals.

Empower nurses to improve global health: lifting the profile of Nurses and Midwives

Nursing Now is a three-year global nursing campaign run in collaboration with the International Council of Nurses and the World Health Organization. It aims to improve health globally by raising the profile and status of nursing, worldwide – influencing policy makers and supporting nurses to lead and build a global movement. Nursing Now was launched on 28^th Feb 2018 by HRH the Duchess of Cambridge with nurses and health leaders across the world. The Pacific was represented by Ms Elizabeth Iro who recently joined WHO headquarters as Chief Nursing Officer.

Nursing Now is based on the findings of the “Triple Impact” report. The report concluded that as well as improving health globally, empowering nurses would contribute to improved gender equality – as the vast majority of nurses are still women – and build stronger economies. The campaign focuses on five strategic areas:

• Ensuring that nurses and midwives have a more prominent voice in health policy-making;

• Encouraging greater investment in the nursing workforce;

• Recruiting more nurses into leadership positions;

• Conducting research that helps determine where nurses can have the greatest impact; and

• Sharing best nursing practices.

Nurses are at the heart of most health teams, playing a crucial role in health promotion, disease prevention and treatment. As the health professionals who are closest to the community they have a particular role in developing new models of community based care, community engagement and support local efforts to promote health and prevent disease.

The Nursing Now global campaign wants to make sure that all nurses and midwives across the globe, in every role at every level, are skilled and supported to develop and strengthen nursing and midwifery practice, mobilise others and really make change happen. The campaign can be adapted to suit the Pacific environment – an opportunity to raise the profile of Pacific nurses.

For more information, please download background paper

On the early morning of 26^th February a massive earthquake of magnitude 7.5 struck PNG affecting the provinces of Southern Highlands, Hela and Western Highlands. The affected areas are largely mountainous and remote. The earthquake has claimed many lives with more than 50 deaths reported one week after the disaster. The exact numbers of deaths of those buried alive in landslides and rumbles are not known but estimated to have exceed hundreds.
An estimated 275,000 people live within 50km of the epicentre and experience frightening landslides and falling shelter and buildings. Approximately 325,000 people are estimated to have been displaced due to loss of basic needs for shelter, food and water. Immediate needs for survival include shelter, food and water, sanitation and life-saving health services. At least half of health facilities were damaged and became non-functional. Women, infants and children were the most affected as they struggled to get food, water and sanitation. More than 50% of rural health facilities and staffing homes have been flattened and buried under landslides. Some health workers are reported to be suffering from psychological trauma and post disaster depression.
The massive earthquake and destructive landslides caused severe destruction to homes, plantations, infrastructure, buildings, roads and bridges and cut off water and electricity. People were devastated while numerous strong aftershocks continued for at least a further week. Destroyed mining sites and gas plants posed the risks of potential toxic spills.

The government declared PNG in a state of emergency two days later. The last few weeks saw international aid flowing into the two most severely damaged provinces. Emergency responses to save lives were established but many deaths occurred unnoticed. Choppers are the main only means of transport to reach these remote communities. Villagers and communities are frustrated at the slowness of accessing food, water and essential health services. It will take a long time for people to sustain adequate food supplies and return to their usual routines. Outbreaks of food and water-borne diseases are likely to occur, while malnutrition from lack of food will surely affect small children.

Australia and New Zealand sent helicopters and planes to help deliver food, water and medicine to the remote region, where the government and aid agencies have been scrambling to reach villages stranded by landslides and collapsed roads.

A ferocious Tropical Cyclone Gita crashing with fierce winds of up to 260 km/h was the most intense tropical cyclone to impact Tonga since reliable records began.

After experiencing a fearful night, Tonga woke up to see massive destruction to their homes and belongings following Cyclone Gita’s merciless journey. Winds were forceful and roared angrily for many hours overnight. Many described the event as the most frightening experience they have come across. Some families cramped themselves up in small bathrooms as heavy rain and fearless winds bulldozed into their homes. In the middle of the night, brave doctors and nurses transferred patients to safe rooms as water sipped into the wards.

Severe Tropical Cyclone Gita left a trail of destruction – ripped roofs off houses, uprooted large trees, destroyed buildings and homes. Thousands of residents faced prolonged cut off of electricity and water supplies.
In responding to the aftermath of Gita, Tongans have been resilient to pick themselves up and immediately start clean-up operation and restoration within 24hours post cyclone.
There have been no confirmed deaths from the storm, although there were reports of injuries, a few major but mostly minor injuries.

PSRH offers ten Research Awards per annum to assist research capacity building in reproductive health in the Pacific region. Each award is to the value of NZ$500 and can be used to develop a larger research proposal or for paying expenses in performing a clinical audit. Where the awards are over-subscribed, priority will be given to projects that have part-funding from another source.
The criteria are:

1. The Principal Investigator (PI) is a financial member of PSRH
2. The PI has ready access to the internet and a computer
3. The project addresses a priority area/service
4. Have the support of the Head of Unit/Ward/Service/Hospital
5. Sound research/audit application and methods
6. A research team (2-7 members) will perform the project with one member having performed research before
7. Take no more than two years to complete
8. Findings to be published in the Pacific Journal of Reproductive Health
9. The application must be typed with referencing where appropriate

Applications on the linked form close 30th March 2018.
 

Pacific Associate Members are invited to apply for the following scholarships offered to Associate Members participating in the RANZCOG Pacific CPD.

• CPD Program ASM Scholarship 2018 to be held in Adelaide, 15-19 September 2018
• Brian Spurrett Fellowship to attend the Anatomy of Complication Workshop, Perth, 19-20 October 2018

Applications close 31 January 2018.
For more information contact Ms Carmel Walker on email:  cwalker@ranzcog.edu.au

Recommendation 1
Establish a Comprehensive Cervical Cancer Prevention and Control Programme

• Cervical Cancer is the most common female cancer in the Pacific, contributing to disease burden and causing more than 1,500 premature deaths per year in the region. These deaths can be prevented if pre-cancer status is detected and treated early. Primary and secondary prevention that are effective and practical for Pacific island settings should be pursued.
• The Society made strong commitments to develop a Pacific-oriented guideline on Comprehensive Cervical Cancer Prevention to help countries address this problem. PSRH will embark on collaborating with governments and key partners in the region to pursue this agenda.
• A multi-country Technical Working Group on Cervical Cancer Prevention will be coordinated by PSRH to oversee the development of this programme and facilitate its progress.

 
Recommendation 2
Support Health Workforce Development in Obstetrics and Gynaecology

• The shortage of health workforce in midwifery and obstetrics is a long-standing problem in the Pacific and affects the quality of service delivery in maternal-newborn care. The issue needs to be positioned high in the agenda of development and in the discussions among governments and development partners.
• PSRH is well-positioned to engage in advocacy dialogue with donors and development partners to leverage resources and sponsorship for strengthening health institutions (midwifery schools, Fiji National University and UPNG) to produce adequate health workforce for the region.

 
Recommendation 3
Strengthen the Capacity of Midwifery Training Institutions to produce increased numbers of Midwives to meet national targets
3.1 Shortage of midwives has been a long-standing problem that hinder the provision of essential maternal-newborn care at all levels of the health care system. Increasing the numbers of midwives to fill in the large numbers of vacancies is critical to make progress in quality of care especially at primary care level.
3.2 The Midwifery segment of PSRH Board will work with governments and development partners to reassess the situation in the Pacific and develop strategic plans that are practical and affordable in addressing the issues.
Recommendation 4
Increase Contraceptive uptake and Reduce the Unmet Need for family planning in the Region
4.1 Family planning is an effective intervention for reducing maternal deaths and should be strongly promoted to couples and individuals as an essential component of essential maternal health package.
4.2 PSRH will collaborate with countries, donors and development partners on innovative ways to reach more people with effective contraception, with a focus on long-acting methods of contraception.
 
Other important Recommendations
In addition to the above, the conference discussed other recommendations relevant to the needs of the region. The PSRH Secretariat will endeavor to mobilise partnerships with relevant institutions to partner in these areas. These include:

1. Mainstream the prevention of gender-based violence as part of existing services for women and children. More specifically, screening for GBV using simple practical screening tools can be introduced in clinical settings at all levels of the health care system.
2. Strengthen the practice of functional and effective maternal death reviews as an effective intervention for improving quality of care. PSRH can work with other partners to expand the application of standard methods and templates that can be modified, as appropriate.
3. Explore the establishment of a “surgical skills laboratory” at the two main medical training institutions – Fiji National University and University of Papua New Guinea. The aim is to ensure that graduating doctors are well skilled in conducting operations and perineal repairs.
4. Work in partnership with Ministries of Education in selected countries to support the development of a position statement on the need to incorporate Adolescent Sexual and Reproductive Health Education as a compulsory subject in the school system.

A new Board was elected at the recent Biennial General Meeting for the years 2017-2019.