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Summary of Fiji Health Sector Review Report

Executive Summary

• Fijians face health outcomes typical of lower middle-income countries despite being an upper middle-income nation.
• Key challenges include a high burden of non-communicable diseases (NCDs), inefficient health spending, and gaps in service delivery, particularly for preventative care.
• A “flipped” health system focusing on primary care and disease prevention is recommended.
• The report proposes costed policy reforms divided into four reform areas: redesigning service delivery, promoting healthy behaviors, building a modern workforce, and strengthening stewardship and data.

Key findings:

1. Health Outcomes: Fiji has one of the highest rates of premature death from NCDs; life expectancy is 68 years compared to UMIC peers.
2. Health Financing: Public spending is low relative to income; private providers are growing but not integrated strategically.
3. Service Delivery: Primary care receives inadequate funding; hospital beds are underutilized in rural/eastern divisions.
4. Human Resources: High vacancy rates in public health positions; uneven distribution within divisions.
5. Economic Value: Investing now could yield high returns (7-10% annually) by 2040.

Recommendations:

• Redesign Health Service Delivery: Shift focus to preventative care, digital infrastructure, and integrated hospital networks.
• Promote Healthy Behaviors: Implement taxes on junk food, SSBs, and trans fats; leverage school policies for healthy lifestyles.
• Build Human Resources: Deploy digital tools for community health workers and strengthen nursing roles.
• Strengthen Stewardship: Improve budget execution, strategic purchasing, and climate-ready health systems.

The reforms require between FJ$320 million and FJ$340 million over seven years, with substantial health and economic returns by mid-century.