Concurrent speakers
Session 2A: Gender based violence: impacting patients and providers
Strengthening health sector response to sexual and gender based violence across the Pacific
Sexual and Gender Based Violence (SGBV) which refers to any act of violence and coercion that is committed against a person’s will because of gender norms and power inequalities can be physical, sexual emotional and psychological in nature, and is made up of intimate and non-partner violence.
On the average, 39% to 51% of women in the Pacific have experienced intimate partner violence across their life course; compared to less than 30% globally.
As the likely 1st point of contact for most women and girl survivors of SGBV, the health sector is in a unique position to identify, prevent and respond to cases of violence, and facilitate referral for other support services including legal and social protection services.
However, Health Facility Readiness and Service Availability Assessments (HFRSAA) across 8 PICs reveal that less than 4% of facilities in any country meet the quality requirements of health workforce capacity and numbers, job Aids and tools, medicines and supplies and conducive facility environment to provide SGBV services.
According to SDG target 5.2 and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), which most PICs have ratified, zero tolerance to SGBV is a goal, and the most opportune place to start in achieving it, is by accelerating the health sector response to it.
In 2022-23, with the support of UNFPA, GBV clinical SOPs were developed for 8 PICs (Fiji, Kiribati, Marshalls Islands, Micronesia (Yap and Kosrae), Samoa, Solomon Islands, Tonga, Vanuatu). This initiative provided the foundation for health systems strengthening for GBV Services and strengthening of GBV referral pathways across the Pacific. Furthermore, UNFPA supported Training of Trainers at regional level to build the capacity of 22 master trainers from Samoa, Solomons, Fiji and Vanuatu on health sector response to Gender Based Violence. Subsequently, in-country rollout of these trainings on health sector response to GBV resulted in capacity building of 143 clinicians (19 from Samoa, 35 from Solomons, 22 from Fiji, 13 from Vanuatu, 20 from Palau and 34 from FSM). These trainings had a positive impact on participant’s understanding of gender-based violence, as they helped change their stereotypical views about gender roles and expectations, beliefs, attitudes, and values which impacted their understanding and role as service providers in providing care for survivors.
Dr Titilola Duro-Aina
Chief of health and Technical Advisor SRHR, UNFPA PSRO, Suva, Fiji
Dr. Titilola Duro-Aina is Chief of Health and Technical Advisor SRHR with UNFPA Pacific SRO. Prior to joining UNFPA Pacific SRO, she was working for UNFPA’S PNG Country Office as the Technical Specialist FP/MH/RHCS and has over 18 years of national and international work experience in the design, implementation, and management of innovative SRH, maternal health, humanitarian, family planning, RHCS, adolescent, youth, and condom programming. She’s been instrumental in the development and roll-out of health sector response to GBV, cervical cancer elimination strategies and establishment of maternal and perinatal death surveillance and response systems across the pacific
Prior to joining UNFPA, Dr Titilola worked on and provided leadership on several BMGF; USAID and MacArthur Foundation projects including the development of the Non-pneumatic Anti-shock Garment as a temporizing device for obstetric hemorrhage in collaboration with the University of California, San Francisco. She also facilitated the roll out of strategic SRH capacity building activities on FP/LARC, EMONC, Supply Chain Management; provided strategic guidance to SRH humanitarian preparedness for MISP; the establishment of SRH and PSEA coordination platforms; and supported policy dialogue and the development of National and sub-national SRH strategic documents.
Dr Titilola holds a Medicine and Surgery degree, Masters in Population and RH, and a Postgraduate degree in Logistics and Supply Chain Management.
She is a passionate advocate of women’s rights and the advancement of sustainable health systems.
Gender based violence in the health workforce - are we looking away?
GBV is a life-threatening global health and human rights issue, and the Pacific Island countries have some of the highest rates in the world. Globally, women account for 70% of health and social care workforce delivering care to around 5 billion people.
Despite some progress, women remain largely segregated into lower status, lower paid jobs. They are often subject to discrimination and some live under constant threat of violence while being carers; struggling to cope with their own reality as victims of GBV, be it at home, workplace or elsewhere. Is this a hidden problem or are we looking away?Dr Swaran Naidu
Gynaecologist
Adjunct Associate Professor, Fiji National University
Dr Swaran Naidu is a Gynaecologist, who is an Adjunct
Associate Professor at the Fiji National University. She has been the Medical
Director and founding trustee of Viseisei Sai Health Centre in Lautoka.
She is
a graduate of Fiji School of Medicine who then completed her specialist training
in NZ and Australia to become a Fellow of the Royal Australian and NZ College
of Obstetrician and Gynaecologists. She was a Senior Consultant in Obstetrics &
Gynaecology at Royal Hospital for Women in Sydney and a lecturer with University
of New South Wales before returning to Fiji in 2011.
Most her 40 years of professional life have been dedicated to Women’s health and she has led many rural outreach services for the empowerment of women and girls.
Violence in labour. Is it a problem? How do we address it?
Women being shouted at, belittled and even slapped during labour is not a new phenomenon nor is it confined to poorer less resourced settings. World-wide women routinely receive examinations and procedures without proper consent or explanation. In studies from countries as diverse as Australia and Niger, Holland and Brazil, Iran and the Philippines a similar story emerges, it is not unusual for women to leave the birthing unit feeling traumatised. The practice of disrespecting women in labour is so wide spread it has been normalised, but that doesn’t make it right. A patient who has been traumatised in a health setting is less likely to return for help, thus increasing her risk for post-natal complications. Women suffering from PTSD don’t bond as well with their baby and are less likely to breast feed. However, how do we as doctors and midwives change a culture?
Dr Mairi Wallace
Specialist Gynaecologist, Urogynaecologist, Northland, Aotearoa New Zealand
Health Specialist Programme, Cook Islands
Mairi works as a specialist gynaecologist in private practice in Northland, Aotearoa New Zealand. She is also a Urogynaecologist for the Health Specialist Programme in the Cook Islands and the Director of Putiputi Charitable Trust. Mairi is a member of RANZCOG and UGSA.
Dr Wallace was born in South Africa, which is where she completed her medical training in 1989. She completed her MMed (O&G) and FCOG (SA) in 1999. Prior to moving to New Zealand in 2003, she had worked mostly in poorer rural hospitals.
Mairi has published on domestic violence, she was instrumental in establishing units for the examination and treatment of rape survivors, and in New Zealand was involved with treating rape survivors.
She now divides her time between her private practice in Northland New Zealand, and women’s health projects in the Pacific.
Session 2B: Contraception updates
Review of postpartum contraception guidelines and practice in nine Pacific Island countries
Postpartum family planning (PPFP) ensures healthy birth spacing and can potentially have a positive impact on maternal and neonatal morbidity and mortality as well as on gender equity, women’s empowerment and sustainable development. However, unmet need for family planning (62%), is highest in the postpartum period. Kirsten will share findings from this study which explored the current situation regarding PFPP service provision, uptake and guidelines in Pacific Island countries.
Professor Kirsten Black
Professor of Sexual and Reproductive Health, University of Sydney, Australia
Kirsten Black is professor of Sexual and Reproductive Health at the University of Sydney. She is an academic gynaecologist working clinically in the fields of preconception care, contraception and menopause.
Prevalence of pregnancy termination and associated factors among married women in Papua New Guinea: a nationally representative cross-sectional survey
McKenzie Maviso
Public Health Lecturer, School of Medicine and Health Sciences
University of Papua New Guinea
McKenzie Maviso is a public health lecturer in the School of Medicine and Health Sciences at the University of Papua New Guinea.
McKenzie also has maternal and child health qualifications and has contributed to training midwives in Papua New Guinea for more than a decade. He has been actively involved in the community to address social determinants of health among young people, as well as promoting the inclusion of indigenous perspectives in health promotion, research and practice.
Family planning service provision in Solomon Islands: a case study approach
Family planning (FP) services and contraceptives are available in most health clinics in Solomon Islands, however there is a significant gap between contraceptive access, knowledge and use. This study aims to explore the availability, accessibility and acceptability of FP services, including contraceptives in Solomon Islands to inform future family planning service provision.
A mixed methods case study design is used to closely examine FP services and contraceptives within specific contexts (urban, peri-urban and rural) to understand the gap in FP service provision.
Relmah Harrington
Midwife and Senior Lecturer, James Cook University
Relmah is a midwife and senior lecturer from the Solomon Islands. She has been practicing as a nurse-midwife for more than 10 years and teaching for more than 15 years and has great passion for midwifery practice. She is also involved in community-based research in sexual and reproductive health and women’s health.
Her recent PhD research focuses on family planning service provision in Solomon Islands, exploring the availability, accessibility and acceptability of family planning contraceptives in three health clinic settings in Solomon Islands.
Jenny Cao
Maternal, Child and Adolescent Health Program,
Burnet Institute, Australia
Jenny is a public health professional with a background in health promotion, research and advocacy across the government, academic, and not-for-profit sectors. Jenny’s research interests are in maternal and newborn health, and sexual and reproductive health and rights.
At Burnet, her research has focused on abortion access and clinical interventions to reduce maternal and newborn morbidity and mortality including systematic reviews, and qualitative studies. Jenny is committed to addressing health inequities for women and girls, particularly those from marginalised communities.
Session 3A: Adolescent health and wellbeing
Adolescent Gynaecology 101
Saman will discuss common and complex presentations in paediatric and adolescent gynaecology, focusing on diagnosis and initial management.
Dr Saman Moeed
Obstetrician and Gynaecologist, Te Toka Tumai, Auckland
Aotearoa, New Zealand
Institutionalizing
ASRHR in the Pacific: Fiji's experience
For Pacific countries to achieve universal health coverage through health systems strengthening, they must go beyond piecemeal approaches to institutionalize adolescent sexual reproductive health service delivery across all the six (6) building blocks of health systems. This systems approach acknowledges adolescents as distinct from other age groups and holistically addresses the barriers that limit their access to quality and friendly SRH information and services. A systems approach refers to incorporating evidence-based elements/strategies of ASRHR throughout all components of the health system, rather than implementing isolated interventions that usually and mainly target service delivery.
UNFPA in the Pacific has over the last few years undertaken this approach to increase availability of and ensure access to adolescent and youth SRH information and services by supporting eight (8) countries including Fiji to develop & implement individual roadmaps guided by national AYFHS guidelines. In Fiji, this process evinced a programmatic aspiration of the comprehensive nature of adolescent health services beyond SRH. This indicated a vested commitment by the government to meet the health priorities of their adolescents and youth and helped build new partnerships for the sustainability of this endeavor.
Dr Titilola Duro-Aina
Chief of health and Technical Advisor SRHR, UNFPA PSRO, Suva, Fiji
Dr. Titilola Duro-Aina is Chief of Health and Technical Advisor SRHR with UNFPA Pacific SRO. Prior to joining UNFPA Pacific SRO, she was working for UNFPA’S PNG Country Office as the Technical Specialist FP/MH/RHCS and has over 18 years of national and international work experience in the design, implementation, and management of innovative SRH, maternal health, humanitarian, family planning, RHCS, adolescent, youth, and condom programming. She’s been instrumental in the development and roll-out of health sector response to GBV, cervical cancer elimination strategies and establishment of maternal and perinatal death surveillance and response systems across the pacific
Prior to joining UNFPA, Dr Titilola worked on and provided leadership on several BMGF; USAID and MacArthur Foundation projects including the development of the Non-pneumatic Anti-shock Garment as a temporizing device for obstetric hemorrhage in collaboration with the University of California, San Francisco. She also facilitated the roll out of strategic SRH capacity building activities on FP/LARC, EMONC, Supply Chain Management; provided strategic guidance to SRH humanitarian preparedness for MISP; the establishment of SRH and PSEA coordination platforms; and supported policy dialogue and the development of National and sub-national SRH strategic documents.
Dr Titilola holds a Medicine and Surgery degree, Masters in Population and RH, and a Postgraduate degree in Logistics and Supply Chain Management.
She is a passionate advocate of women’s rights and the advancement of sustainable health systems.
Exploring preconception health education for adolescents in the Solomon Islands
Rebecca Manehanitai
National Coordinator for Adolescents Health and Development Programme, Solomon Islands
Rebecca is a midwife from Solomon Islands.
Rebecca works with the RMNCAH department, MHMS and Coordinates various programs including the Maternal and Safe motherhood. Currently, she the National Coordinator for Adolescents Health and Development Program.
Rebecca has a Master of Philosophy from the University of Queensland. Her thesis was on Preconception Health.
Sexual health issues facing Pacific young people in Aotearoa, New Zealand - what we know and how we can respond
This presentation highlights:
- The prevalence of sexual activity, sexual attraction, condom and contraceptive use, and unwanted sexual touching amongst Pacific secondary school students in Aotearoa, and
- Community views on central concepts, ideas and values when developing relationship and sexuality education for Pacific youth.
These findings, from two HRC funded projects: Youth19 and Nesian Narratives, signal the persistent sexual health disparities for Pacific youth that must be addressed through consistent, comprehensive, and evidence-based approaches and amplifies the ongoing appeals made by Pacific communities to:
1. ensure Pacific students’ basic needs and rights are met;
2. partner with Pacific young people, their families and communities to realise an equitable future; and
3. invest in more quality research with and for Pacific young people, their families, and communities.
Dr Analosa Veukiso-Uluiga
Senior Lecturer, HRC Pacific Post-doctoral Research Fellow
School of Curriculum and Pedagogy, Faculty of Education and Social Work
The University of Auckland, Aotearoa New Zealand
Dr Analosa Veukiso-Ulugia is a senior lecturer and an HRC Pacific postdoctoral research fellow based at Moana Connect and the University of Auckland in the Faculty of Education and Social Work. An allied health professional specialising in youth health, Analosa is committed to the empowerment of Pacific communities, specifically in the area of sexual health and youth health and wellbeing.
Session 3B: Communicable and non-communicable diseases in reproductive health
Maternal and childhood oral health and NCDs
Te Marae Ora (TMO), in collaboration with the United Nations International Children's Emergency Fund (UNICEF), has recently put together an integrated nutrition program for young children and mothers. TMO aspires for a ‘Healthy Island’ by the year 2030 and beyond. Along with providing a strategic opportunity to include nutrition programs in primary care, the partnership with UNICEF Pacific strengthens the Healthy Islands Initiative campaign. It gives a possible paradigm for addressing existing challenges of childhood obesity, early childhood caries (ECC), and future risk for NCDS. Suggesting a potential model not only in the Cook Islands but also in the wider Western Pacific Region.
Dr Seema Lal-Kumar
Dental Specialist,
Te Marae Ora, Rarotonga, Cook Islands
Dr Seema Lal-Kumar completed her Bachelor of Dental Surgery from the University of the South Pacific in 1997 and a Master of Paediatric Dentistry from the Eastman Dental Institute of the University College London in the United Kingdom. She received post-graduate training in medical education, tertiary teaching, and orthodontics in Fiji.
Seema is currently employed as a dental specialist at Te Marae Ora in Rarotonga, Cook Islands. Dr Kumar has previously held positions at Fiji National University as an academic and as a dentist in both public and private practice. She is pursuing her doctorate at the University of South Pacific in Fiji. Seema is dedicated to promoting maternal and child oral health, reducing early childhood caries in the Cook Islands and the Pacific region at large, and enhancing oral health literacy. Her research and clinical interests are in the fields of oral health of children including those with special needs and managing fear and anxiety in children.
Increasing hope and enhancing reproductive justice: hearing from women living with HIV who have undergone point-of-care HIV viral load testing in Papua New Guinea
Papua New Guinea has the largest HIV epidemic in the Pacific, with a higher prevalence among women. The increasing numbers of women living with HIV (WLHIV) giving birth, coupled with persistently high vertical transmission rates, emphasise the need for point-of-care viral load testing, treatment and counselling support to support WLHIV in making informed and autonomous reproductive decisions. This presentation explores the impact of point-of-care HIV viral load (POC HIV VL) testing for WLHIV in PNG.
Ruthy Boli
Senior Social Researcher,
Papua New Guinea Institute of Medical Research
Ruthy Boli is a senior social researcher at the Papua New Guinea (PNG) Institute of Medical Research. She has been involved in implementing and coordinating social and public health projects in PNG for 12 years, especially qualitative research focused on sexual and reproductive health including HIV/STI, gender and sexual diversity, human rights and gender-based violence. Ms Boli is currently assessing the acceptability of point-of-care HIV viral load testing and infant diagnosis in PNG, as part of the ACT UP-PNG project.
Challenges
in managing STIs and HIV/AIDs in primary health care in Fiji: a focus on maritime
islands in the Eastern Division, Fiji
This presentation highlights the challenges primary health care workers face and acts as barriers when addressing sexual and reproductive health in the primary health care sector in Fiji. In particular, the focus will be on experiences and challenges shared by primary care physicians when managing sexually transmitted infections and HIV/AIDS in the maritime islands of the Eastern Division.
The range of challenges include but not limited to access to latest developments in STI and HIV management, stigma, health-seeking behaviours and resource constrained environment, lack of support for research in this field and geography were highlighted as barriers to service delivery. One of the biggest challenge highlighted was the limited capacity to perform diagnostic tests in health centres, especially in antenatal clinics leading to many expectant mothers going through ANC undetected for STIs. The presentation will also highlight the lack of reporting system that exists for reporting of STI cases from PHC facilities affecting data at national level.
Dr Malakai
Sovaki Ranuve
Principal Medical Officer, Levuka Subdivisional Hospital
Fiji
Dr Ranuve graduated from Fiji School of Medicine in 2013 with MBBS, PGDipPH in 2021 and Master of Public Health in 2022 from Fiji National University. He has published two research studies in BMJ in diabetes and foot care. Malakai is the national trainer on STIs and HIV/AIDs.
Session 6A: Strengthening midwifery across the Pacific
A
collaborative approach to teaching professional issues in Midwifery to
midwifery students in Samoa
To meet the International Confederation of Midwives (ICM) global standards, midwifery education programs must include modules of learning on professional and global issues in midwifery. This is often a new topic for recently ICM-aligned midwifery programs. Samoa is one of six Pacific nations to undertake a UNFPA supported process of review and renewal of the midwifery curricula to align with international standards. Samoa is the first of these nations to implement the renewed curriculum.
Supported by UNFPA, the midwifery team at the Burnet Institute collaborated with midwifery faculty at NUS to develop content for the module Midwifery as a Profession. A hybrid learning format was introduced to co-deliver the module and support the NUS midwifery faculty. The learning module is currently undergoing post-delivery evaluation from NUS students. Mele and Boe will share the process and outcomes of this work.
Mele Tofaeono
Registered Nurse and Midwife, Lecturer, Undergraduate Nursing and Postgraduate Midwifery, National University of Samoa
Mele Tofaeono
Registered Nurse and Midwife, Lecturer, Undergraduate Nursing and Postgraduate Midwifery, National University of Samoa
Mele is an experienced Registered Nurse and Registered Midwife who lectures in undergraduate nursing and postgraduate midwifery at the National University of Samoa, and is a course coordinator for the Postgraduate Diploma in Midwifery program. Mele is also a clinical midwifery preceptor who works clinically with students as well as teaching theory in the classroom.
Boe Calvert
Research Midwife, Global Women's and Newborn's Health International Development, Burnet Institute, Australia
Boe is a research midwife at the Burnet Institute who works in strengthening midwifery across the Asia Pacific region in the Global Women’s and Newborn's Health group. Boe is a registered midwife in Australia who has experience working clinically in urban, regional and remote areas. Boe has a Masters degree in Global Development, majoring in global public health.
Midwifery network in the Pacific: the experience of networking with Tongan Midwives
Networking amongst midwives in the Pacific provides access to countless opportunities and allow them to communicate, interact and collaborate with each other to enhance midwifery care and improve health. The experience of networking amongst midwives in Tonga is an example of one of the many networking opportunities currently happening amongst Pacific Midwives.
This presentation highlights the importance of networking amongst Pacific Midwives as was initially initiated amongst the Team of Midwives in Tonga. Midwives amongst the Pacific have common issues which could be discussed and facilitated through midwifery networking.
Regular webinars such as those delivered monthly, provide midwives the opportunity to debate and discuss issues with leading midwives and others involved in childbirth, an opportunity unlikely to be offered in any other environment. Despite the many challenges faced by the team in Tonga they continue to smile.
We believe that our experience makes us strong and that we can learn from each other and take little steps one at a time. Make time for yourself and be lonely, re-evaluate, focus, look out for each other and continue to communicate and be part of the team.
Tagiyaco
Vakaloloma
Deputy Director Nursing, Maternity Unit,
Colonial
War Memorial Hospital, Fiji
Tagiyaco Vakaloloma is the Deputy Director Nursing, Maternity Unit at the Colonial War Memorial Hospital in Suva, Fiji.
She holds a Diploma in Nursing, Certificate in Midwifery, bachelor’s in Nursing Science and Post Graduate Diploma in Leadership and Management in Nursing. She was one of the pioneering Clinical Midwifery Nurse Educators at CWMH.
Tagiyaco was a recipient of the 2009 Brian Spurrett fellowship to Sydney, Australia. President of the Fiji Midwifery Society (current), Fiji Nursing Council Member (Midwifery), Midwifery Representative of the Fiji Midwifery Society to the International Confederation for Midwives (ICM).
Akesa
Halatanu
Matron, Vaiola Hospital Curative-Clinical Services Tonga
Akesa Halatanu is the Matron of the Vaiola Hospital Curative-Clinical Services Tonga. She holds a Diploma and Bachelor in Nursing, Bachelor and Master in Midwifery. Akesa has also been a Senior Midwife in North Shore/Waitakere Hospital and Former President for Nurses/Midwifery Association Tonga.
Perceptions
of midwives on the use of the partograph for labouring women from the rural
health facilities in Papua New Guinea
The purpose of this study was to explore the perceptions of midwives on the use of the partograph when referring labouring women in rural health facilities in Papua New Guinea.
Nancy
Geregl Kerenga
Midwifery Lecturer and Course Coordinator,
Pacific Adventist University, Papua New Guinea
Nancy, who has a Bachelor and Masters in Midwifery and a Bachelor of Nursing, has been a clinical Midwife for 10 years. She is Midwifery Chairperson for Simbu-Sub Association, Young Midwifery Leadership in ACM/PNGMS Buddying Leadership Initiative, Midwifery Lecturer and Course Coordinator at Pacific Adventist University, Papua New Guinea.
Lessons from midwifery led point of care quality improvement adapted to a provincial maternity service in Papua New Guinea
Between June 2022 and June 2023, a group of ten midwives undertook Point of Care Quality Improvement (2 POCQI, WHO 2020) training, adapted to their Provincial maternity service in PNG where over 9,000 babies were born each year. Despite several ‘disabling’ health infrastructure challenges, they led changes resulting in small but important quality improvements in different aspects of care provision across antenatal, Birth Suite and postnatal wards. They self-reported and anecdotal and observational data indicated that the outcomes of their efforts not only improved the quality of care women and babies received, but the midwives reflected on their achievements enabling them and others to better withstand the difficult conditions in which they worked.
Evelyn Mondo
Senior Clinical Midwife,
Angau Memorial Provincial Hospital
Session 6B: Strengthening Obstetrics and Gynaecology, and new born health across the Pacific
Introduction of hysteroscopy to low resourced area – Lambasa, Fiji
Hysteroscopy is a minimal invasive surgical technique that can be used to assess and manage gynaecological conditions. Access to adequate skilled operators and equipment is limited in many low resourced areas, and was not available in Fiji prior to this training. Menstrual disorders have a higher impact on women’s quality of life in low resources areas and is associated with a delay to seeking treatment.
Sunil will share the design, process and outcomes of this training.
Dr Sunil Pillay
Endoscopic Specialist, Fertility Associates,
Auckland, New Zealand
Dr Sunil Pillay is an accomplished endoscopic surgeon, gynaecologist and fertility specialist. He was medically trained in Fiji and completed his FRANZCOG in New Zealand. He has run over 4 similar missions to Fiji over the past 5 years. He is a member of Friends of Fiji Health (FOFH) which is a New Zealand-based charitable organisation that has supported these missions. His aim is to improve the overall health and well being of women in Fiji.
Strengthening Pacific urogynaecology training
Understandably, when medical resources have to be carefully allocated, urogynaecology and pelvic floor medicine may not be seen as a priority. However, without a working understanding in this area, everyday obstetric and gynaecological procedures can adversely impact future pelvic floor function. This presentation looks at how we can incorporate some of the practical aspects of urogynaecology into training and practice.
Dr Jenny King
Urogynaecologist, Director of the Pelvic Floor Unit
Westmead Hospital, Sydney, Australia
Dr Jenny King is a urogynaecologist and Director of the Pelvic Floor Unit at Westmead Hospital, Sydney. Jenny is also Secretary of the International Urogynecology Association. Dr King was awarded the Order of Australia Medal in 2017 for services to urogynaecology.
Development of a sustainable Pacific GTD Registry: the issues, barriers & benefits
This presentation will cover the advantages of a registry, provide options for models of care, how to set up a registry and explore specific issues related to the Pacific.
Dr Andrea Garrett
Gynaecologic Oncologist
Wesley Hospital and Royal Brisbane Women's Hospital
Dr Andrea Garrett is a University of Queensland Medical School graduate and was granted Fellowship of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in 2006. In 2008 she completed her Certificate of Gynaecologic Oncology, having trained in Brisbane, Melbourne and Perth. She also completed a Graduate Diploma in Palliative Care (Flinders University). Her practice includes the management of gynaecological malignancy of the female genital tract as well as pre-invasive disease, hereditary conditions and complex benign gynaecology. She has a special interest in the management of Gestational Trophoblastic Disease and runs the Queensland Trophoblast Centre.
Strengthening O&G emergency training
Come and hear about PSRH’s own Pacific Emergency Maternal and Neonatal Training (PEMNeT) Programme, presented by Dr Sharron Bolitho with assistance from the Pacific faculty. What is PEMNeT’s purpose? What does a course look like? Where is it having an impact?
Dr Sharron Bolitho
Obstetrician and Gynaecologist
Christchurch Women's Hospital
Aotearoa New Zealand
Sharron is a full time Obstetrician and Gynaecologist (FRANZCOG) at Christchurch Women’s Hospital. Her passion is preventing maternal and perinatal mortality and serious morbidity through multi professional ‘hands on’ skills and teamwork training, particularly in remote and low resource settings. In Aotearoa- NZ, this is through the PROMPT course, and in the Pacific via PSRH’s Programme ‘PEMNeT’ - Pacific Maternal and Neonatal Emergency Training. Dr Bolitho is currently the leader for, the PEMNeT Facilitator training and the project team revising the PEMNeT Course Manual and Facilitator Guide.
Session 7A: Obstetrics and Gynaecology updates
Improving the post-discharge care of women with hypertensive disorders of pregnancy - review of clinical practice guidelines and stakeholder consultations at Labasa, CWM and Aspen Lautoka Hospitals between May to July 2023
Hypertensive disorders of pregnancy (2) affect 5-10% of pregnant women worldwide. Women with a history of HDP have been found to have a 4-fold increased risk of developing cardiovascular disease (CVD) much earlier in life as compared to those who were normotensive. Fiji has one of the highest mortality rates from CVD. However, there is no standardized discharge plan that would mitigate the risk these women face.
Bevlin will share the method and conclusions of this prospective, multi-centre, mixed method study which was performed by reviewing latest clinical practice guidelines published in the last 10 years. Patient questionnaire with an audit of their folders was carried out at Aspen Medical Lautoka and a doctors/midwives’ survey was carried out at the 3 divisional hospitals (CWM Hospital, Labasa Hospital and Aspen Medical Lautoka Hospital between May to July 2023.
Dr Bevlin Shen Ming
Obstetrics and Gynaecology Unit, Aspen Medical, Fiji
Bevlin has worked in the Obstetrics and Gynaecology department for at least 7 years, having started as a service registrar at Labasa Hospital in 2017.
Bevlin re-located to Lautoka hospital in 2019 to pursue specialist training. Currently in the final year of the Masters program and will be graduating in December, 2023.
Bevlin was awarded the international fellowship program by RANZCOG in 2022 which included attachment at Mercy Women's hospital in Melbourne and attendance at the ASM in Gold coast
Severe Perineal Trauma (SPT) and Obstetric and Anal Sphincter Injuries (OASIs) – A qualitative Study on Women with SPT and OASIs and how the Government of Kiribati through its Ministries advocate for these women’s voices and empowerment
The study objectives are:
1. To review current international literatures on evidence based practices to protect perineal integrity during childbirth.
2. To advocate for Carers of women to follow evidence-based Guidelines on SPT and OASIs, in alignment with the ‘Te Maneaba’, the Kiribati Health Care Model’ and ‘Duty of Care’ in the prevention and management of repair.
Tareti and Monica will discuss the study.
Tareti Ruaia
Deputy Director, School of Nursing and Midwifery, Kiribati
Monica Tarabo
Midwifery Lecturer, School of Nursing and Midwifery, Kiribati
Retrospective study of incidence, associated factors, and maternal and neonatal outcomes of fetal macrosomia at Lautoka hospital in 2018
Macrosomia, is an obstetric term that describes a baby born weighing 4000 grams or more than 4500 grams at birth, regardless of gestation age. As birth weight increases, so does the likelihood of labor and delivery complications to both mother and newborn.
The aim of this study was to determine the incidence of macrosomia, ascertain the associated risk factors and its maternal and fetal outcomes in a year.
Prerna will share the method, results and conclusions from this study.
Dr Prerna Prakash
Obstetrics and Gynaecology Registrar,
Health Care Fiji
Prerna is an Obstetrics and Gynaecology Registrar at Health Care Fiji, providing service to the women of West for over10 years. She completed Masters of Medicine in O&G in 2022 from Fiji National University and received the RANZCOG Award for best candidate in Master of Medicine Program (O&G), 2020.
Prerna is the daughter of school teachers, wife of a bank officer and mother of a two-year-old naughty boy, who are her inspiration and support system.
Her goal in life: stay happy and spread happiness.
Missed opportunities for meeting the data needs of reproductive health programs
Routine health facility data are essential for effective healthcare decision-making, but many Pacific Island countries face challenges in generating and accessing indicators that address decision-making needs.
The Burnet Institute and UNFPA undertook a review of the health management information systems (HMIS) related to sexual and reproductive health in 6 countries in 2022, and is now providing technical support to implement recommendations.
Zeshi Fisher
Global Women's and Newborn's Health
Burnet Institute, Australia
Zeshi Fisher works with the Global Women’s and Newborns’ Health group at the Burnet Institute in Australia. She is a midwife with professional experience in clinical care, midwifery education, public health, program management, information systems, and organisational governance in Australia and internationally. Her interests include global health contexts, measurement, quality improvement, and systems change.
Global platform for strengthening maternal and newborn health – Asia-Pacific region
Good-quality care in the intrapartum and early postnatal period are critical to ensuring maternal, fetal and newborn survival and well-being.
Minh will share this study to evaluate the quality of intrapartum and early postnatal care provided to women and newborns in participating health facilities.
Dr Minh Pham
Senior Research Fellow
Burnet Institute, Australia
Dr Pham is a Senior Research Fellow at the Burnet Institute, Melbourne, Australia. He has more than 15 years of experience conducting public health research and implementing public health programs in low and middle income countries. His research interests include but not limited to development and evaluation of novel rapid, point-of-care diagnostics for infectious diseases; maternal, child and adolescent health; and global/public health emergencies. Dr. Pham received his MPH from the University of Alabama at Birmingham, the United States, and a PhD from Monash University, Australia.
Adapting the Safe Delivery App for Papua New Guinea
This study used a mixed-methods approach to evaluate usage and acceptability of the Safe Delivery App among health
care workers in PNG and worked with midwives, educators, obstetricians and
paediatricians to adapt the App specifically for the PNG context. Conducting individual interviews with users of the App and worked with clinicians
to review and redesign images and align clinical content to reflect national
guidelines. Delly will share the findings of this study.
Dr Delly Babona
Papua New Guinea Country Coordinator, Global Monitoring Platform for Maternal and Newborn Health - Asia Pacific
Dr Delly Babona is an Obstetrician Gynaecologist
and an early career researcher from Papua New Guinea. Currently in
Australia, completing a Master of Public Health at the University of Melbourne
under an Australian Award Scholarship. Delly also serves as a part-time Research
Officer at the Burnet Institute working on various projects on maternal and
newborn health in Papua New Guinea including the role as the PNG Country
Coordinator for the WHO/Burnet Institute’s multi-country project called the
Global Monitoring Platform for Maternal and Newborn Health – Asia Pacific (GMP
Asia-Pacific).
Delly holds a Master of Medicine in O&G, Diploma in O&G and MBBS, all from the University of Papua New Guinea. During clinical practice, Delly enjoyed running the Department of Health’s (NDoH) Reproductive Health Training Unit’s (RHTU’s) emergency obstetric and newborn care workshops and the Community Health Care Worker (CHW) Upskilling in advanced midwifery care course in the East New Britain Province of PNG. Dr Babona also been the recipient of the AOFOG Young Gynaecologist Award (2017), SOMANZ International Travel Award (2019) and is currently on Australian Award Scholarship (2021) for her master’s program.