National Health Road Map.

This National Health Road Map is the first 20-year document of its kind in the Cook Islands, incorporating relevant targets of the Sustainable Development Goals, the Healthy Islands Initiative and the Cook Islands National Sustainable Development Plan. It is a sectoral plan that sets out the agenda for the Ministry of Health regarding the long-term strategic direction for health care and health services. There are three key focus areas of the road map and from where action domains and implementation strategies will be drawn, they are (i) strengthening health system; (ii) health care service excellence; and (iii) public and private partnership. The main outcomes to be reached through interventions in the focus areas are (i) reduced health risks; (ii) increased health protection; (iii) improved health care service; and (iv) improved population health status.
As for the strengthening health system, the Ministry, among others, shall (i) formulate and/or review health laws and regulations with the aim of enforcing the health workforce regulations, protecting patient rights, and well managing the health sector; (ii) strengthen national regulatory authority for medicines and health technologies; (iii) adopt service standards for health facilities and infrastructure; (iv) ensure sufficient resources for health; (v) empower communities to participate in decisions and actions that affect them; and (vi) improving the efficiency of the health care system through rationalizing health expenditures and particularly addressing inequity, inefficiency and low quality. As for the second focus, about the health care service excellence, the road map envisages (i) implementation of both communicable and non-communicable disease control and interventions; (ii) staff training; (iii) strengthened mental health well-being programs; (iv) expand diagnostic capabilities; (v) develop efficient health information system; (vi) improve health medical records system; (vii) improve environmental health monitoring; (viii) strengthen safe water and sanitation initiatives; (ix) support school health programs; and (x) strengthen nutrition programs; (xi) support food safety and food standards initiatives. The public and private partnership is intended for achieving (i) inter-sectoral collaboration across government and non-state partners; (ii) cater for services not provided by government; (iii) support initiatives for community based facilities for the care of the elderly; and (iv) scale up capacity for environmental health risk assessments and address risks to sustain and enhance ecological balance.
To make agriculture, forestry and fisheries more productive and sustainable, the road map suggests (i) to support initiatives against exposure to toxic and hazardous materials, especially asbestos and pesticides; and (ii) strengthen stakeholders in different settings – households, schools and health facilities – to implement programs for safe water and sanitation including community management of water, land, forest and coastal resources.
In order of increasing the resilience of livelihoods to disasters, main actions are directed to (i) ensure that health facilities are resilient to climate change impacts through retrofitting and relocation; (ii) support new hospital construction to improve accessibility and safety during disasters for uninterrupted quality services; (iii) support multi-sectoral actions to address national climate change health adaptation plans; (iv) develop, update and implement national action plans on disaster risk management for health that include prevention, preparedness, response and recovery; and (v) build comprehensive health surveillance and early warning systems for early response and recovery to reduce disaster-related health impacts.
As for the Governance, it is necessary to support capacity building for leadership, management and governance that extends to all levels of the health systems, and guarantee accountability and transparency to the public to ensure cooperation with key stakeholders.