The first section of Part A of this document describes the health needs of adolescents in Fiji,
poorly described to date. It identified that Fijian adolescents experience an excess burden of
poor health, which has not improved substantially over time. Communicable disease, under
and over nutrition and poor sexual and reproductive health are common health needs for
Fijian adolescents. Violence and unintentional injuries are important causes of preventable
morbidity and mortality, particularly for males. There is also a very large burden of noncommunicable
disease, including chronic physical illness and mental disorder. Health risk
behaviors including substance use, physical inactivity and sexual health risk were found to
be common. These outcomes and risks relate to the disadvantage that many Fijian
adolescents experience across the social determinants of health. Given many outcomes and
risks share common determinants, comorbidity is likely to be common.
The second section of Part A of this document maps current programmes and approaches
for adolescent health in Fiji. While many programmes relating to adolescent health were
identified, there are a number of reasons why these programmes may not be resulting in
improved health outcomes for adolescents. Firstly, it appeared that many programmes are
not aligned with health needs of Fijian adolescents. Programmes for some health needs
were absent (for example, mental health). Additionally, existing programmes did not always
meet the needs of particular risk groups (for example, programmes relating to sexual and
reproductive health largely catered for older and married adolescents). Secondly,
programmes tended to focus on discrete issues and were poorly integrated and coordinated
with other programmes, likely to introduce barriers for access. Thirdly, many programmes
were funded for only short time periods, this sporadic funding likely to translate to sporadic
programme delivery. Fourthly, programmes and approaches to adolescent health in Fiji
remain poorly evaluated, their reach and effectiveness largely unknown (introducing
barriers to taking these programmes to scale). Finally, current approaches to adolescent
health in Fiji largely exist in a legislative context that is restrictive to addressing many key
needs of adolescents.