EVERY INNOVATION NEEDS A STORY

We are an enduring community in the Pacific that have several stories to tell on digital health and innovation

FIELD STORIES

We are proud to share our stories and innovations across thematic areas and countries from this Region.  This section includes sharing our collective experiences on how we have adapted global best practices and best actions, how we introduced innovations that could be adapted for COVID-19 responses, or simply expressing our inspirations in finding new digital solutions to keep our populations healthy. Here are some highlights from PHIN member countries and partner agencies.

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PROGRESS IN CONNECTIVITY IN PACIFIC ISLAND COUNTRIES
For over two decades, slow and expensive satellite technology provided the connectivity backbone between the main islands and the rest of the world. But with submarine fiber-optic cables, satellites will become the secondary connection serving other parts of the countries. It was just less than a decade ago that it was conceivable only a handful and mainly larger Pacific Island countries would have submarine fiber-optic cable connections. Today, due to political will, innovation and donor support, 15 PICTs - both big and small have high speed internet via submarine communications cable. Future plans are currently underway for nearly all Pacific countries to have its main islands be connected to high speed internet by 2022. Countries like Tuvalu, Kiribati and the Solomon Islands are forging ahead to have high speed internet. Plans are also underway for smaller island nations to be connected such as the Cook Islands, Nauru, Niue and Tokelau.
Picture: Grandmother receives a visit from the social worker in the suburb of Noumea while the mother is still studying.
SETTING THE COUNTRY VISION AND DIRECTION FOR DIGITAL HEALTH
We believe digital innovation is transforming healthcare. In 2005 the World Health Assembly through its resolution on eHealth (WHA58.28) urged Member States “to consider drawing up a long-term strategic plan for developing and implementing eHealth services to promote equitable, affordable and universal access to their benefits”. This includes a roadmap to reform policies and practices to enable scarce strategic investments and resources to support digitalization of healthcare. By developing a Country Digital Health Strategy, Pacific nations will have a blueprint on how to transform their healthcare system using technology to improve coordination across health systems and towards an integrated system of care. A national strategy that sets out agreed priority areas and is underpinned by standards, can encourage investment in both the public and private or donor funded health systems in the same direction. There is wide disparity in progress in this area among PICs, with several countries still having no formal national plans or roadmaps. Digital technologies will not achieve anywhere near their full potential absent a plan that provides the necessary resources, coordination, cooperation, and leadership.
Picture: HIS Hub Manager Dr. Audrey Aumua, Professor Maxine Whittake and HIN members Jeffrey Langati and Lester Dingley from Vanuatu in 2011.
PUBLIC HEALTH REPORTING IN THE PACIFIC
Many Pacific countries still rely heavily upon paper tools for recording and monitoring health information. Paper systems have been often the only feasible solution in areas with limited resources and infrastructure. Absent enabling infrastructure for digital systems (computers, electricity, mobile phone coverage), paper systems can fulfill all the necessary functions of a well-performing health information system. However, digitalization is being touted as providing several potential benefits and advantages and many countries have been gradually moving using electronic tools. For example, In the Pacific, DHIS2 is used for data warehousing, public health reporting and analysis in Tonga, Solomon Islands, and Vanuatu. DHIS2 has also released a digital data package to accelerate case detection, situation reporting, active surveillance and response for COVID-19. The DHIS2 tracker function is used by the malaria program in Vanuatu
Picture: Nicola Hodge (PHIN Secretariat, the University of Queensland's School of Public Health) and Teanibuaka Tebunga (PHIN member, Kiribati Health Information unit) checking the data, 2012.
STRENGTHENING EHR ADOPTION IN THE PACIFIC
Electronic Health Records (EHRs) are digitized versions of paper charts found in health care settings such as hospitals and clinics. The digital tool is primarily used by providers for diagnosis and treatment. EHRs are much more valuable than paper records as they enable providers to track health information over time, identify at-risk populations for preventive visits, monitor patients, and improve the overall health care quality and safety.

The Pacific region is one of the most remote, least populated, infrastructure challenged and geographically dispersed group of nations in the world. Therefore, Pacific countries and territories are at different stages of readiness and maturity regarding their adoption of an EHR. WHO has commissioned a study to understand localized needs, resource and technology challenges, and the prioritized requirements specific to the Pacific setting to assist the health sectors choose an EHR that is suitable and sustainable for its purpose.
Picture: Shivnay facilitating the group work. Mr. Shivnay Naidu, Director of the Health Information at the Ministry of Health and Medical Services was acting PHIN President until 2018.
A ROLE FOR DRONES IN HEALTHCARE
Using drones to support healthcare is a relatively new digital health application. In the future, drones may be a feasible method of transporting medications and promoting healthcare and health-related services in difficult-to-reach areas. With so much potential for drone use in healthcare, considerable work is required to fully understand its possibility, its costs to healthcare organizations and its value to communities they serve. For emergency situations such as COVID-19, drones are being deployed in innovative ways to minimize the local authorities’ risk of infection while trying to contain the virus.
CLIMATE CHANGE AND DIGITAL SURVEILLANCE OF CLIMATE-SENSITIVE INFECTIOUS DISEASES
Climate change is the greatest health challenge of the 21st century and threatens all aspects of society - especially in the Pacific islands. Direct health impacts include physiological effects of exposure to higher temperatures, increasing incidences of respiratory and cardiovascular disease and injuries, and in some cases death due to extreme weather events such as droughts, floods, heatwaves, storms and wildfires. One of the most significant repercussions of the changing weather conditions is the spread of climate-sensitive infectious diseases such as malaria and dengue through mosquitos. Digital tools have been used against mosquito-borne diseases through electronic maps (with GIS) and to monitor epidemics or the spread of diseases among others. Digital health has a demonstrable track record in playing a key role in achieving malaria elimination in Vanuatu by implementing a malaria information system that surveils, track cases and is integrated into its national public health information systems.
Picture: Palau and American Samoa participants with HIS consultant, Miriam Lum Om, PHIN meeting in 2013. Miriam is currently Head, Cardiovascular, Diabetes and Kidney Unit at Australian Institute of Health and Welfare.
ONLINE TRAINING AS A WEAPON TO FIGHT THE NEW CORONAVIRUS IN PNG
New online training on practical and important COVID-19 practices is now available in response to the outbreak in PNG. The online platform, accessible on a smartphone, tablet or computer, provides practical resources and scenarios to help health workers in Papua New Guinea in responding to the pandemic at the community level. CoHELP is supported by the Australian Partnership and developed by JID in consultation with Papua New Guinea National Department of Health and WHO Papua New Guinea and WHO. This training is developed for all health care staff, students, volunteers, it contains practical resources and scenario training. To access the training all you have to do is register by clicking on the link below! cohelp.learnbook.com.au
Picture: Mark Landry from WHO providing his concluding remarks on the workshop in 2011. Mark was the Health Information Technical Officer and eHealth Focal Point for the WHO Western Pacific Regional Office (WPRO). Currently he is the regional advisor for Health Situation and Trend Assessment in the Health Systems Development Department in the WHO South-East Asia.
COVID-19 RESPONSE: PROXIMITY TRACKING TOOLS
There are several initiatives that use smartphones as “sensors” to detect proximity and exposure to individuals who may have COVID-19. Blue-tooth enabled proximity-tracking tools have been introduced in few Pacific countries to supplement the traditional case investigation and contact tracing tools, such as SORMAS and Go.data. To date, there are currently limited evidence on the performance of proximity tracking applications. Most often, reviews are mixed particularly the sensitivity, specificity and effectiveness of these methods as it pertains to identifying true close contacts. Proximity tracking technologies have been deployed in Fiji, Guam, Cook Islands and the Northern Marianas.
CONTACT TRACING PIONEERS AGAINST COVID-19
As early as February 2020, Fiji took decisive action to strengthen the country’s preparedness against COVID-19. This included putting in place an outbreak management response digital tool called contact tracing. Designed by German state epidemiologists from the Helmholtz Centre for Infection Research, SORMAS went live on March 31, 2020. Fiji was one of the last countries (165th) to report its first case, but it was also one of the first countries in the world to implement a contact tracing system. France and Switzerland followed soon after. Effectively used in Africa against the Ebola outbreak, SORMAS is an active surveillance and contact tracing system that handle multiple communicable diseases such as dengue, malaria and tuberculosis.
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STORIES

We want to share our experiences, best practices and innovations that have been adapted for COVID-19 responses or simply inspire solutions for improving health services delivery and strengthening our countries’ health systems.

COUNTRY PROFILES

The interactive map represents the digital health profiles of Pacific countries and territories. The map contains indispensable information and statistics on health and the use of information and communication technologies (ICT). It also includes official country documents relevant to digital health projects, country-led programs, national laws and policies, and country-specific documents and reports from WHO and partners.

Cook Islands
Micronesia
Solomon Islands
CNMI
Niue
Tonga
Guam
New Caledonia
Tokelau
Fiji
Palau
Tuvalu
Kiribati
Papua New Guinea
Vanuatu
Marshall Islands
Samoa
Palau