Fiji
Population, (2017): 905,502
Income per Capita, (2018): 5589.39 US
Percentage of GDP on healthcare, (2015): 3.55%
training
Year Family Medicine was Established: 1998 – postgraduate training, but not for family medicine (Haskel, Daniel, and John Calvin Smith, 1845)
Length of Medical School: 6 years (The University of Fiji)
Length of Training Program: No training for family medicine (Informant #1, MD, 2018)
Type of Training:
Number of Institutions That Offer Family Medicine Training:
Number of Trainees:
practice
Number of Family Physicians: 596 primary care practitioners in total (WONCA Asia, 2012)
Number of Physicians: 0.835 physicians per 1000, (Trading Economics, 2015)
QALY: Not Available
DALY: Not Available
Life Expectancy 2007: Males: 65.3 Females: 69.6
Mortality Rate is 17.9 deaths per 1,000 live births
Cost per DALY focuses 59% of the budget on primary prevention indicating the importance of primary prevention in this country.
Healthcare System
The healthcare system in Fiji is a mixed system. They treat everyone, and it is a two-tier system; private and public. The wealthy do fly out of the country for additional care. In total there are 884 general practitioners in total in both the private and public system (WONCA Asia, 2012). Family medicine in Fiji is not recognized at all. It is not publicly funded and there is no actual training program for it. Nonetheless, there is a college or body that looks after all the general practitioners in Fiji called the Fiji College of General Practitioners which was established in 1993 (FCGP.
Everyone has good access to medical care as there is a government system in place. Some barriers are long waiting lines, remote locations, and crowded urban facilities. There are school-based programs for immunizations and it is a standard in the system - everyone gets them. Everyone also has access to the normal medications. In terms of medical equipment, clinics are not the best suited and do not have the most up-to-date technologies (Informant #1, MD, 2018).
training
There is no training for family medicine in Fiji. Medical school is comprised of 6 years.
practice
The other primary care deliverers include OBs and other surgeons (Informant #1, MD, 2018). The role of the general practitioner in Fiji includes setting up their own team-based practice and handing out basic medications. For the most part, gatekeeping is not done by the general practitioners. If people needed a referral, they would go to a private general practitioner. The general practitioners that work for the public sector in the district hospitals more closely resemble gatekeepers. The general practitioners in Fiji are quite incompetent for their job since they are posted to government facilities without an internship and they are learning as they go (Informant #1, MD, 2018). Medical school in Fiji is more didactic which renders them unready to practice medicine (Informant #1, MD, 2018). They use a community-oriented primary care model (Informant #1, MD, 2018).
References
Haskel, Daniel, and John Calvin Smith. 1845. A Complete Descriptive and Statistical Gazetteer of the United States of America, Containing a Particular Description of the States, Territories, Counties, Districts, Parishes, Cities, Towns, and Villages--Mountains, Rivers, Lakes, Canals, and Railroads; with an Abstract of the Census and Statistics for 1840, Exhibiting a Complete View of the Agricultural, Commercial, Manufacturing; and Literary Condition and Resources of the Country. Sherman & Smith. https://researchonline.jcu.edu.au/7974/.
“Bachelor of Medicine and Bachelor of Surgery (MBBS) – The University of Fiji.” n.d. Accessed December 2, 2018. https://www.unifiji.ac.fj/bachelor-of-medicine-and-bachelor-of-surgery-mbbs/.
“FIJI COLLEGE OF GENERAL PRACTITIONERS Report to WONCA Asia Pacific Council Meeting.” 2012. https://www.wonca.net/site/DefaultSite/filesystem/documents/regionDocs/APR reports/Fiji.pdf.
“Fiji Physicians Per 1 000 People.” n.d. Accessed December 2, 2018. https://tradingeconomics.com/fiji/physicians-per-1-000-people-wb-data.html.
Informant #1, MD, interviewed by Althaf Azward, November 19, 2018
“About – FCGP.” n.d. Accessed December 2, 2018. http://www.fijigp.org/about/.