Interview with Nancy Pego, Ministry of Health and Medical Services, RMNCAH Programme Manager, Solomon Islands

Nancy Pego Vienna: Thank you for taking the time to speak with me today. Can you please tell me about yourself and your role?

Nancy: Yes, my name is Nancy Pego. By profession, I’m a registered nurse midwife, before I started overseeing these public health programs, under the Reproductive and Child Health Department. Now I’m the program manager for RMNACAH, the Reproductive, Maternal, Newborn/Nutrition, Child, Adolescent Health Department, and my role is to oversee the six national programs that are under my care at the reproductive health national level. We also have subunits, like maternal health and nutrition for children, so my main role now is to support them all at the program level.

Vienna: What are some ongoing sexual and reproductive health programs in the Solomon Islands?

Nancy: There are some ongoing programs despite the challenges that we have with COVID. One of the big ones is the family planning program for the general population, which also targets adolescents and young people. This focus has grown over the years as we have tried to address the issue of unmet need in the younger population. Many young people lack the right information to make their choices. There is a preconceived notion in the country that family planning is for married people or for people who already have kids.

Also, the STIs and the HIV department work closely with us, so we have sexual and reproductive health aligning with the STI and HIV work. We have a gender-based violence program which is under our care here, and we also now have a cervical cancer program which is under maternal health as well. Under maternal health we have the ANC program, postnatal program for mothers, and even the emergency obstetric care where some of our clinical midwives support us within the clinical settings, and the maternal death surveillance response.

We have the sexual reproductive health emergency plan, which is still in draft, but soon to be implemented under the ministry as well. That is supported by IPPF, and SIPPA (Solomon Islands Planned Parenthood Association) has been helping us so now, we have a plan in place with the ministry. This plan is under the SPRINT initiative, which provides access to sexual and reproductive health services through capacity building for humanitarian workers for the delivery of the Minimum Initial Service Package (MISP).

Vienna: Can you elaborate on what are the gaps and challenges that you face with the sexual and reproductive health programs in the Solomon Islands?

Nancy: Yes, despite the work that we do here, we still have challenges and gaps, for which we need continued support.

We really need to improve on the funding process. I think RMNCAH is one of the very complex programs because we have a lot of donors who support reproductive and child health, like UNICEF, UNFPA, WHO. The processes are not standardized, some have shorter cycles, and some have longer cycles.

I also think one of the challenges is COVID transmission. This disabled us to travel, especially to the provinces, where a lot of work should be done. Travel restrictions across the globe also affect us because I think we really need some of you, people from the global family planning community, to come and see us and see what we are doing here in our country. Because we are focusing on COVID implementations, some of our activities have been on hold. Some of our staff are deployed since most of us here are midwives, nurses and public health officers, so we have challenges with human resources to implement and support our programs.

We also really need support with commodities, equipment, and space for adolescents. We need space because most of the family planning services down at the provincial level are also integrated with other sexual and reproductive health services. Therefore, we need to use the same space for family planning, gender-based violence counseling, and STI treatment, for example. I think in terms of space as well, we need to look at infrastructure so that quality services can be done across our country.

Lastly, in terms of coverage, there are times that we miss some of the provinces because our support goes to certain provinces first. Solomon Islands is very challenging in terms of its demographic. We have a lot of islands, and we have ten provinces. So, if our support goes to maybe the first three priority provinces, then some of the provinces can be left out. In terms of coverage, when it comes to surveys or assessments, which should be done across the whole country, there might be some of the provinces we will miss.

Vienna: Great, thank you, Nancy. What actions or support are needed to address these ongoing challenges?

Nancy: I think we need more political will and support from our leaders and the provinces so that we can capture some of the priority activities that we really need to align within the annual operation plan of the National RMNCAH program. Some of the things that we need support for is capacity building. At a national level, we have eight people looking after adolescent health, maternal health, child health, GBV, and other things. However, at the provincial level, there will be only one officer looking after all these activities. These programs are not very small, and they have a lot of things to do, so we really need somebody at the provincial level to drive the activities.

Vienna: Thank you so much, Nancy. Is there anything else that you’d like to add?

Nancy: Yes, I remember three or four years ago when Family Planning 2020 brought us to Nepal [for the 2018 Regional Focal Point Workshop]. We were developing a plan to support the Solomon Islands along with UNFPA. That is one of the things that we want to continue to strengthen. Since then, we have had UNFPA leading and supporting us in our family planning work at the country level. We want all stakeholders and local organizations, like our SIPPA NGO, to come together, support each other, so we can strengthen partnerships and support the country.

Vienna: Great, thank you so much for taking the time to speak with me today.