Rumsey Michele, Fletcher Stephanie M, Thiessen Jodi, Gero Anna, Kuruppu Natasha, Daly John, Buchan James, Willetts Juliet
World Health Organization (WHO) Collaborating Centre for Nursing, Midwifery and Health, University of Technology Sydney, P,O, Box 123, Broadway, NSW 2007, Australia.
Hum Resour Health. 2014 Feb 12;12:9. doi: 10.1186/1478-4491-12-9.
There is a growing body of evidence that the impacts of climate change are affecting population health negatively. The Pacific region is particularly vulnerable to climate change; a strong health-care system is required to respond during times of disaster. This paper examines the capacity of the health sector in Pacific Island Countries to adapt to changing disaster response needs, in terms of: (i) health workforce governance, management, policy and involvement; (ii) health-care capacity and skills; and (iii) human resources for health training and workforce development.
Key stakeholder interviews informed the assessment of the capacity of the health sector and disaster response organizations in Pacific Island Countries to adapt to disaster response needs under a changing climate. The research specifically drew upon and examined the adaptive capacity of individual organizations and the broader system of disaster response in four case study countries (Fiji, Cook Islands, Vanuatu and Samoa).
'Capacity' including health-care capacity was one of the objective determinants identified as most significant in influencing the adaptive capacity of disaster response systems in the Pacific. The research identified several elements that could support the adaptive capacity of the health sector such as: inclusive involvement in disaster coordination; policies in place for health workforce coordination; belief in their abilities; and strong donor support. Factors constraining adaptive capacity included: weak coordination of international health personnel; lack of policies to address health worker welfare; limited human resources and material resources; shortages of personnel to deal with psychosocial needs; inadequate skills in field triage and counselling; and limited capacity for training.
Findings from this study can be used to inform the development of human resources for health policies and strategic plans, and to support the development of a coordinated and collaborative approach to disaster response training across the Pacific and other developing contexts. This study also provides an overview of health-care capacity and some of the challenges and strengths that can inform future development work by humanitarian organizations, regional and international donors involved in climate change adaptation, and disaster risk reduction in the Pacific region.
越来越多的证据表明，气候变化的影响正在对人口健康产生负面影响。太平洋地区尤其容易受到气候变化的影响；在灾难时期需要强大的医疗保健系统来应对。本文从以下几个方面考察了太平洋岛国卫生部门适应不断变化的灾难应对需求的能力：（i）卫生人力治理、管理、政策及参与情况；（ii）医疗保健能力与技能；（iii）卫生人力资源培训及劳动力发展。
通过与关键利益相关者进行访谈，对太平洋岛国卫生部门及灾难应对组织适应气候变化背景下灾难应对需求的能力进行评估。该研究特别借鉴并考察了四个案例研究国家（斐济、库克群岛、瓦努阿图和萨摩亚）中各个组织以及更广泛的灾难应对系统的适应能力。
“能力”，包括医疗保健能力，是被确定为对太平洋地区灾难应对系统适应能力影响最为显著的客观决定因素之一。该研究确定了几个可以支持卫生部门适应能力的要素，例如：全面参与灾难协调；制定卫生人力协调政策；对自身能力的信心；以及强大的捐助方支持。限制适应能力的因素包括：国际卫生人员协调不力；缺乏解决卫生工作者福利问题的政策；人力资源和物质资源有限；处理心理社会需求的人员短缺；现场分诊和咨询技能不足；以及培训能力有限。
本研究的结果可用于为卫生人力资源政策和战略计划的制定提供参考，并支持在整个太平洋地区及其他发展中背景下制定协调一致的灾难应对培训协作方法。本研究还概述了医疗保健能力以及一些挑战和优势，可为参与太平洋地区气候变化适应和减少灾害风险的人道主义组织、区域和国际捐助方未来的发展工作提供参考。
