A New Vision for the Health Sector in Tonga

Kaveinga Tu’itahi

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 MoH’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 AusAID. The paper describes it as a process of “developing Tongan solutions to Tongan problems”.

The Tonga Health Sector Management and Planning Project has received predominantly favourable reviews. As such, the moral of its story may well be that “Prospects for developing or effectively utilizing domestic capacity are enhanced when a) capacity issues (individual, organizational, and institutional) are addressed systematically, and b) the approach to capacity development is rooted in host country vision and leadership.”

The story that this case study has attempted to tell is, to a large extent, only a preliminary narration based on promising success signals. The project has sought to address a comprehensive range of issues across the ministry, focusing on the short, medium, and long term. Monitoring of progress is ongoing and the full impact, and associated benefi ts, may take a little time yet to show.

On balance though, the project’s progress to date is acknowledged. And indeed it should be an inspiration leading to greater vigilance in support of ongoing improvements, particularly those focusing clearly on long-term, sustainable improvements in capacity which can yield real and enduring benefi ts for the citizens of Tonga.

For now, however, and given the positive and encouraging indicators already being experienced, the Ministry of Health would be well advised not to rest on its laurels. The key question should always be “If it works – how can we make it work

Year of publication: 
ADB Capacity Development in the Pacific
Themes and sectors: 
Health sector
Case story length: 
32 pages

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