Promoting Good Health in Fiji

Case Study

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Have you noticed the many community service announcements and advertisements for products on Australian television which promote a healthy and disease-free lifestyle? Some advertisements are aimed at preventing the spread of infectious diseases, but more are aimed at preventing the spread of non-infectious diseases which result from poor diet, lack of exercise, smoking, overconsumption of alcohol or lack of understanding about health and safety. Health authorities have realised that many Australians need more education about responsible personal and community health care, and they are maximising use of the media.

The same situation holds true for health care in Fiji. Whilst the incidence of infectious diseases has tended to stabilise or decrease, the incidence of non-infectious diseases has increased. As western foods and less strenuous western lifestyle have become more common, growing numbers of Fijians are facing the major health problems of heart disease, stroke, diabetes and cancer, as well as illnesses resulting from inadequate understanding of how to properly handle western foods. In many cases, Fijians are now more seriously at risk than the residents of western countries where the foods and lifestyles have originated.

Comparisons of the rates of two non-infectious diseases in Fiji and Australia illustrate the situation. According to the World Health Organisation, 1998, Fijians are far more likely to suffer from diabetes and obesity than Australians:

Diabetes: (percentages) Fijian rural males 7.4; urban males 8.6; all Australian males 3.0; Fijian rural females 12.0; urban females 18.8; all Australian females 2.9

Obesity: (percentages) Fijian urban males 17.8; Australian urban males 11.1; Fijian urban females 40.8; Australian urban females 12.7

The cost of lifestyle diseases is high for any community. People who are unwell, unfit or unable to work to their potential are usually less able to look after themselves and their families and to contribute to their personal, family and community financial wellbeing. They and their communities must bear the costs of health care, and deal with physical and psychological trauma which could have been avoided. Diabetes and obesity, for example, combine alarmingly in Fiji. The two often result in limb amputations, usually of legs, being 10 per cent of all surgery performed in the country.

The Governments of Fiji, Australia and Japan have realised the seriousness of these problems and are working to help Fijians educate themselves to avoid lifestyle and other diseases caused by inadequate knowledge. The Fiji Trilateral Health Promotion Project is making maximum use of the media to successfully deliver positive messages in a range of ways.

Beginning in 1996, the government building which had previously housed health administration staff was upgraded and refurbished to become the National Centre for Health Promotion. Computers and high quality audiovisual equipment were installed, and staff underwent intensive training in using the equipment and deciding how best to reach the public at community and national levels.

Since then, the Centre has devised a number of highly successful campaigns in a very short time supported by a number of print, radio, audio, video and television materials, as well as cinema messages, in Fijian, Hindi and English - all at relatively small cost. Print materials have included posters, stickers, pamphlets and phone cards. There have also been health fairs and many visits to urban squatter communities and rural areas with portable education kits.

National Centre for Health Promotion anti-smoking poster

Smoking: The Centre has surveyed youth attitudes to smoking and has run cessation workshops. It has devised the 'Be smart, don't start' anti smoking campaign, using Fiji's winning relay and netball secondary school teams and a sports theme in television mini-drama anti smoking advertisements. The catchy phrase is now known by young children, teenagers and adults alike, and the phone cards and poster pictures have rated well. The Centre has also made recommendations to the Government of Fiji on its Tobacco Control Bill aimed at deterring Fijians, especially the young, from smoking. The Government has since proposed a fifty per cent increase in cigarettes tax, as a deterrent and to help fund the Centre.

Safe handling of food: The Centre has liased with the University of the South Pacific in recommending policies and education programs. The 'Cool, clean and covered' radio and television campaign has been very successful. Children sing the catchy jingle and many women, the main food preparers, can quote the phrase. There are plans to extend the training and promotion of safe food handling beyond the home to schools, restaurants and hospitals.

National Centre for Health Promotion Health Express publication

Alcohol consumption: The Centre has undertaken research into the effects of alcohol on Fijian society in terms of health, car accidents and violence. It has developed draft policies for more responsible alcohol use and aims to play an increasing role in the area.

Nutrition: Campaigns have aimed to increase awareness of good nutrition, including appropriate consumption of foods from all food groups, and sensible exercise. A series of ten 30 minute aerobics segments has been prepared for television.

A weekly health program on the radio addresses all health issues. Considering the importance of radio over television in Fijian society, the program has the potential to reach many people and must be of high quality and interest level to hold public attention.

The project has two particularly strong focuses - involving young people as much as possible in promoting and engaging in a healthy lifestyle, and ensuring that women receive benefits from the project equal to those of men.

The Government of Fiji has funded the Centre's building and staffing, and the Japanese Government has funded audiovisual equipment and technology training. The Australian Government, through AusAID, has been the largest funder, helping supervise management, policy research and development, market testing, project design, publications, training of 'trainers' and delivery of education programs.

The Fiji Trilateral Health Promotion Project is a high quality model for future developments in health education and promotion.