Solomon Islands health system review
Overview
The Solomon Islands HiT determines that the country’s health system has significant weaknesses but also considerable strengths. Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date.
The demographic profile exacerbates these challenges. Increasing numbers of young women reaching reproductive age increase the need for maternal, newborn and child health services. At the same time, more people are living longer or reaching old age; this change, combined with the high prevalence of risk factors, is causing growth in noncommunicable diseases and related disabilities, as well as an increase in premature deaths.
The physical health network in the Solomon Islands is made up of a National Referral Hospital, provincial hospitals, area health centres, rural health clinics and nurse aide posts. Most of the provinces have access to at least one level of health facility, based on the size and distribution of their population. However, these area health centres and rural health clinics are in urgent need for upgrade, repair or renovation. Many facilities have serious shortages of clinical equipment and medical supplies, with hospitals often relying on old and poorly maintained medical, diagnostic and surgical equipment. The availability of medicines in rural areas is improving.
Solomon Islands is served by a well-trained nursing workforce that provides the backbone of service delivery in rural areas. However, weak strategic workforce planning has led to potential oversupply of some cadres (such as doctors) and workforce deficits in other areas such as medical laboratory staff, radiologists and other allied health professionals. High staff turnover is another issue, largely due to financing constraints, along with the migration of some specialized health workers to other countries for better salary and working conditions.
Overall, Solomon Islands health system can be characterised as conceptually fit for purpose but needing ongoing maintenance and development in some key areas such as management and service administration. There is a high degree of financial risk protection with low out-of-pocket payments. Possibly, for this reason, health service contact rates are high by regional comparison and have been resilient to the service disruptions caused by political instability and unrest.