Problems facing Tonga's health care system intensified in the 1990s leading eventually to a decision by the government to address the «core problem», the Ministry of Health's planning, management, and coordination capacity. This case explores how attempts to enhance Ministry's organizational capacity, and improve its organizational culture, were aided by: consistent and strategic leadership and political support, participatory approaches, a clear sense of the capacity challenges, and the facilitative role played by the Australian Agency for International Development (AusAID). The paper describes it as a process of «developing Tongan solutions to Tongan problems».
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Kaveinga Tu’itahi. A New Vision for the Health Sector in Tonga
PACIFIC CHOICE. A New Vision for the Health Sector in Tonga
CONTENTS
FOREWORD
Kingdom of Tonga Facts
BACKGROUND. Declining Health Services and Demands for Change
Keeping the Ship of Health Afloat
The Storms Intensify: Changing, More Urgent Challenges
All Hands on Deck: Rallying Behind the Reform Process
Engaging the Enemy: A Call to Arms
THE REFORMS: RETHINKING TONGA’S HEALTH. The Tonga Health Sector Management and Planning Project. Goals and Objectives
Project Implementation Arrangements and Activities
Conceptualizing Capacity Development in the Project Plan
Implementing the Reforms
ANALYSIS: KEY ISSUES AND EMERGING LESSONS
Timing and Readiness
Beginning with the End in Mind: A Clear Vision and Direction
Local Champions and Leadership
Participatory Approaches and Local Ownership
Intensive Diagnosis of CD Issues
Facilitative Donor Role
An Integrated Approach: Factoring in the Broader Capacity System
Effective Communication
Real Benefits?
LOOKING FORWARD
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CAPACITY DEVELOPMENT SERIES
Change and Capacity Development Strategies
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The case studies in this series and the overall study report are the result of collaboration among a number of consultants working with ADB under the direction of Steve Pollard, Principal Economist, PARD. The team leader for the overall study was Joe Bolger, and the authors of the studies were Helio Augusto, Kevin Balm, Brian Bell, Ron Duncan, Ben Graham, Ueantabo Mackenzie, James McMaster, Samson Rihuoha, Cedric Saldanha, Tom Seta, Paulina Siop, Esekia Solofa, Kaveinga Tu’itahi, Henry Vira, and Vaine Wickman. The study also benefited from the input of a number of resource persons, including Tony Hughes (Solomon Islands), Lynn Pieper (Timor-Leste), Tim O’Meara (Samoa), and Patricia Lyon, Senior Capacity Development Specialist, AusAID. The case studies represent the situation at the time of writing in 2007.
In conclusion, this report seeks to enhance understanding and dialogue on capacity development and its potential for contributing to poverty reduction and improvements in the quality of life of all Pacific islanders. I trust that you will find it both thought-provoking and practically helpful in advancing our collective commitment to development in the Pacific.
