School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Humanitarian Programme, International Planned Parenthood Federation (IPPF), Suva, Fiji.
Reprod Health. 2021 Sep 20;18(1):185. doi: 10.1186/s12978-021-01236-2.
Pacific Island countries are vulnerable to disasters, including cyclones and earthquakes. Disaster preparedness is key to a well-coordinated response to preventing sexual violence and assisting survivors, reducing the transmission of HIV and other STIs, and preventing excess maternal and neonatal mortality and morbidity. This study aimed to identify the capacity development activities undertaken as part of the SPRINT program in Fiji and Tonga and how these enabled the sexual and reproductive health (SRH) response to Tropical Cyclones Winston and Gita.
This descriptive qualitative study was informed by a framework designed to assess public health emergency response capacity across various levels (systems, organisational, and individual) and two phases of the disaster management cycle (preparedness and response). Eight key informants were recruited purposively to include diverse individuals from relevant organisations and interviewed by telephone, Zoom, Skype and email. Template analysis was used to examine the data.
Differences in the country contexts were highlighted. The existing program of training in Tonga, investment from the International Planned Parenthood Federation (IPPF) Humanitarian Hub, the status of the Tonga Family Health Association as the key player in the delivery of SRH, together with its long experience of delivering contract work in short time-frames and strong relationship with the Ministry of Health (MoH) facilitated a relatively smooth and rapid response. In contrast, there had been limited capacity development work in Fiji prior to Winston, requiring training to be rapidly delivered during the immediate response to the cyclone with the support of surge staff from IPPF. In Fiji, the response was initially hampered by a lack of clarity concerning stakeholder roles and coordination, but linkages were quickly built to enable a response. Participants highlighted the importance of personal relationships, individuals' and organisations' motivation to respond, and strong rapport with the community to deliver SRH.
This study highlights the need for comprehensive activities at multiple levels within a country and across the Pacific region to build capacity for a SRH response. While the SPRINT initiative has been implemented across several regions to improve organisational and national capacity preparedness, training for communities can be strengthened. This research outlines the importance of formalising partnerships and regular meetings and training to ensure the currency of coordination efforts in readiness for activation. However, work is needed to further institutionalise SRH in emergencies in national policy and accountability mechanisms.
太平洋岛国容易遭受灾害，包括飓风和地震。灾害准备是对预防性暴力和协助幸存者、减少艾滋病毒和其他性传播感染的传播、防止产妇和新生儿过多死亡和发病进行协调一致应对的关键。本研究旨在确定斐济和汤加 SPRINT 项目所开展的能力发展活动，以及这些活动如何使性健康和生殖健康应对热带气旋温斯顿和吉塔。
本描述性定性研究依据一个框架进行，该框架旨在评估各级（系统、组织和个人）公共卫生应急响应能力以及灾害管理周期的两个阶段（备灾和应对）。有目的选择了 8 名主要知情人进行采访，通过电话、Zoom、Skype 和电子邮件进行采访。采用模板分析对数据进行了检验。
突出了国家背景的差异。汤加现有的培训方案、国际计划生育联合会（IPPF）人道主义中心的投资、汤加家庭健康协会作为提供性健康和生殖健康服务的主要机构的地位，以及其在短时间内提供合同工作的长期经验和与卫生部（MoH）的密切关系，促成了相对顺利和迅速的应对。相比之下，在温斯顿飓风之前，斐济的能力发展工作有限，需要在应对飓风的紧急情况期间迅速提供培训，国际计划生育联合会的增援工作人员提供了支持。在斐济，最初由于利益攸关方角色和协调不明确而受到阻碍，但很快建立了联系，以便做出回应。参与者强调了人际关系、个人和组织应对的积极性以及与社区建立关系以提供性健康和生殖健康的重要性。
本研究强调需要在国家一级和整个太平洋区域的多个层面开展全面活动，以建设性健康和生殖健康应对能力。尽管 SPRINT 倡议已在多个区域实施，以提高组织和国家能力准备，但可以加强对社区的培训。本研究强调了正式化伙伴关系和定期会议和培训的重要性，以确保协调工作的及时性，为启动做好准备。然而，需要努力将性健康和生殖健康进一步纳入国家政策和问责机制中的紧急情况。
