scholarly journals The Tyranny of Size: challenges of health administration in Pacific Island States

2016 ◽  
Vol 11 (3) ◽  
pp. 65-74 ◽  
Author(s):  
Richard Taylor
Keyword(s):  
Health Services ◽  
Communicable Disease ◽  
Cost Effective ◽  
Pacific Rim ◽  
Health Staff ◽  
Pacific Island ◽  
Health Administration ◽  
Island States ◽  
Health Domains ◽  
Pacific Island States

There is great diversity among Pacific Island states (n=22) in geography, history, population size, political status, endemic disease, resources, economic and social development and positions in the demographic and health transitions and their variants. Excluding Papua New Guinea, all Pacific states are less than one million, and half of them (11) are less than 100,000. Smallness also means fewer resources available for health, even if percentage allocations are similar to larger countries, and a disproportionate amount may derive from international aid. Specialisation is not cost-effective or even possible in clinical, administrative or public health domains in small populations, even if resources or personnel were available, since such staff would lose their skills. In instances where only one to two staff are required, retirement or migration means decimation of the workforce. Training doctors within the Pacific Island region provides appropriately trained personnel who are more likely to remain, including those trained in the major specialities. Nursing training should be in-country, although in very small entities, training in neighbouring states is necessary. Outmigration is a significant issue, however, opportunities in Pacific Rim countries for medical doctors are contracting, and there is now a more fluid workforce among Pacific health personnel, including those resident in Pacific Rim countries. International and regional agencies have a disproportionate influence in small states which can mean that global policies intended for larger polities are often promulgated inappropriately in small Pacific states.Smallness also leads to strong personal relationships between health staff, and contributes to teamwork, but can also create issues in supervision. Small health services are not just scaled-down versions of large health services; they are qualitatively different. Smallness is usually intractable, and its effects require creative and particularistic solutions involving other more endowed Pacific states and Pacific Rim countries. Abbreviations: NCD – Non-Communicable Disease; NGOs – Non Government Organisations; ODA – Overseas Development Assistance; TFR – Total Fertility Rate.

scholarly journals Multilateral Resource Negotiations Between Weak and Powerful States: The Case of the 1987 United States-Pacific Island Fisheries Treaty

2021 ◽  
Author(s):  
◽  
Sōsefo Fietangata Havea
Keyword(s):  
United States ◽  
Soviet Union ◽  
United States Of America ◽  
Pacific Islands ◽  
The United States ◽  
Pacific Island ◽  
Island States ◽  
The Soviet Union ◽  
The Pacific ◽  
Pacific Island States

<p>On April 2, 1987, the Treaty on Fisheries Between Governments of Certain Pacific Island States and the Government of the United States of America was signed. The signatories to the Fisheries were the 16 members of the South Pacific Forum and the United States of America. After six difficult years of negotiations, the Treaty permitted American fishing vessels to fish in Pacific Islands’ waters in exchange for a substantial access fee. This thesis identifies key aspects of that treaty and examines what it meant from both a theoretical and practical standpoint. How did a collection of small, comparatively weak Pacific states strike a satisfactory deal with the most powerful state on the planet? What did the agreement mean in terms of its political, legal and environmental consequences? As well as looking at the events and negotiations that led to the treaty, this thesis also attempts to discern the key political lessons that flow from this case that might be relevant for the future development of the Pacific island States in the key area of fisheries regulation. The thesis argues that disputes between Pacific nations and the United States over tuna resources and the presence of the Soviet Union in the Pacific region were the two critical factors that led to the adoption of the Treaty. From the United States’ perspective, the Treaty was seen (at the time) as the only viable option if it were to reconsolidate its long and prosperous position in the Pacific region. The US did not want the Soviet Union to capitalize on American fishing disputes with the Pacific islands, and it could not afford for the Soviet Union to establish a strong association with the Pacific islands. The Treaty therefore served three purposes for Washington: (i) it maintained its long friendship with the Pacific islands, (ii) it maintained its fisheries interests in the region, (iii) and it kept the Pacific communist-free. This fusion of US economic and strategic interests gave Pacific Island States a stronger hand in the negotiations than their size and power would have otherwise offered.</p>

scholarly journals Local Government in the South Pacific Islands

2008 ◽  
pp. 7-29 ◽  
Author(s):  
Graham Hassall ◽  
Feue Tipu
Keyword(s):  
Local Government ◽  
Pacific Islands ◽  
Government Reform ◽  
Pacific Island ◽  
Capita Expenditure ◽  
Island States ◽  
The Pacific ◽  
Per Capita ◽  
Pacific Island States ◽  
South Pacific Islands

In this paper we seek to answer some basic questions about the condition of local government in the Pacific. Firstly, we examine what is meant by ‘local government’ in the various islands and for that matter how Pacific Island states have perceived and accepted local government institutions in practice; second, we ask basic questions about existing legal and constitutional recognition and powers; and third, we provide initial findings on current per capita expenditure and local government financial viability in a number of Pacific cities and towns. We also make some observations on current moves towards local government reform.

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