Department of Health

Director of Health, Mrs Silivia Tavite

Tokelau Health Department provides healthcare services and is responsible for resourcing promotion, prevention, preservation and sustainability of the health of Tokelauan people.

The health of the population has over a generation worsened to the point that Non Communicable Diseases (NCDs) has become an urgent priority that needs to be addressed. . Other health issues such as Communicable Diseases, Mental Health, Reproductive Health, Women’s Health, Men’s Health and Child Health have been woven into the overall population health approach we are pursuing and  planning for over the next 5 years.

The population health approaches in the THSP 2009-2015 & TNSP planned for the next five years will help arrest the worsening health status of Tokelauan people

The World Health Organisation (WHO) Steps Survey (2005) provided the baseline regarding NCDs for the Department of Health, Government of Tokelau and population to address.
 
There are also a number of Global and Regional Health strategies that Tokelau is recommended to incorporate into the planning process1 alongside a number of other key funded health strategies related to population health. One such strategy is the ‘Pacific Framework for the Prevention and Control of Non Communicable Diseases’
 
Tokelau has a draft NCD Plan (2008) which has provided the basis for planning and implementation of actions incorporating the recommendations from the Step Survey.

The Department of Health’s draft Strategic plan has 4 key goals:

1. Protect the health of our population
2. Protect our environment
3. Develop an Efficient and Effective health system
4. Develop our Workforce

The objectives we will use to achieve a healthy population are:

1. Improve service delivery through improved Primary Care
2. Improve the health of our population through Public Health programmes.
3. Minimize the incidence and onset of chronic disease
4. Keep our youth safe
5. Improve outcomes associated with chronic disease
6. Build relationships internally and externally, that will enhance commitment to
7. Tokelau 
8. Promote awareness of Public Health 
9. Enable Taupulega/Village/Nuku and families to make informed lifestyle decisions
10. Promote environmental safety
11. Improve food security, sanitation, water and waste hygiene

Addressing the four key goals means we will be addressing public health issues, strengthening our health system so that we can provide good safe primary care.
 

Key Critical success factors are:

1.     Tokelau & Donor agency resourcing
2.     Engagement by Taupulega & Villages
3.     Participation by Communities

We aim to integrate the principles of sustainable development into policy and programmes and work with Department of Economic Development, Natural Resources and Environment to also ensure the health issues associated with such developments are interwoven. Protecting our environment and ensuring robust inter departmental/inter atoll planning regarding climate change and natural disasters are incorporated for national outcomes.

Workforce is key to delivery of the THSP and the Department is committed to developing a workforce that meets the needs of the current and future population.
A number of actions with measurable outcomes supported by a monitoring and evaluation (M&E) framework have been developed for the next five years in each of the key goal areas.  These actions will require a whole of Government and Whole of Community approach for Family Centred outcomes that will encourage ownership, choice and change by each of the communities across the country.

The indicators and targets identify the high level outcomes the department intends to achieve and is closely linked with the Tokelau Health Strategic Plan (2009 - 2010) and Donor agency strategic funded outcomes.

Below are some of our achievements :

Communicable Diseases

• Managed ILI Epidemic – March 2009
• Managed Pandemic – outcome Tokelau was only 1 of 3 countries globally to not have H1N1

 National Programs

• National Cervical Screening programme – 22nd April 2009
• Breast Screening
• Whole of Population Screening
• Immunisation

 Developed a number of key documents:
 Draft National Health Strategic Plan (2009 - 2015)

• International Health Regulation Action Plan
• Non Communicable Diseases Plan
• Reproductive Health Plan
• Mental Health Policy
• Draft Health Policy
• Draft Health Workforce Plan (2009 - 2015)

 Developed population Data base,

• Purchased Patient Management System that will enable better monitoring & collection of data (become operational in 2012 following Vendor  travelling to Tokelau to carry out the training).

 
Strengthened Health Committees – (link to Coop Committees)
 
Strengthened Primary Care

• Base equipment: Lifepak 15, iStat (Biochemistry Point of Care), HbA1c machines, Centrifuges (bloods can be spun & sent to Apia for processing), Cholesterol/Trigylceride testing
• ZOLL AEDs for each Village
• Disability aids (including beds for each hospital)
• Spirometry
• Education and support through access to Hinari Database & training through POLHN
•  International Medical staff visiting Tokelau – Paediatrician, Mental Health, General Practitioner, Breast Specialist/General Surgeon,
• Other medical staff as Visitors to Fakaofo – from Australia “It is Written”

 
Developing Workforce:
Providing training (4 Nursing Trainees,1 Public Health trainee, Rotational training as agreed by each Taupulega for local health staff: received training in Reproductive Health, Pharmaceutical procurement, EPI – Immunisation, general clinical
• 2 Local health staff have graduated as Eye Care technicians (Fakaofo & Nukunonu)
• 1 Nursing graduate – now working in Nukunonu
• 1 Public Health graduate - Atafu
 
 Non-Communicable Diseases (NCD) programs
 Inaugural workshop Nov 2009
 Appointed National NCD Focal point & Public Health Advisor

• 3 Local NCD focal points
• Smoking Cessation workshops – NRT
• Workshops with Fatupaepae on Imports, soft drinks
• Met with Aumaga – topic Alochol consumption

 Worked with other Departments to achieve outcomes:

• EDNRE – Vegetable Gardening projects,
• Sports – Tokelau 7’s Team
• Church activities – provided equipment
• Schools – provided Sports equipment
• Achieved Donor funding outcomes
• Achieved positive outcomes for 99% of TPRS referrals

 Contributed to a number of key documents for Government – business as usual
 
Managed TPRS included Casuals

• 99% of referrals experienced positive outcome/resolution to their health issues (1% died), including social services & Pastoral Care

The Department of Health – Tokelau wishes to provide the following advice to all travellers to Tokelau: