Browsing by Author "McLennan S"

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Critically understaffed and with Omicron looming, why isn’t NZ employing more of its foreign-trained doctors?
(The Conversation Media Group Ltd, 2022-02-04) Thomas-Maude J; McLennan S
Health system resilience in the Pacific: A scoping review of Fiji’s COVID-19 response
(Elsevier Ltd, 2025-12-01) Thomas-Maude J; McLennan S
In mid-2021, Fiji recorded one of the highest rates of COVID-19-related deaths in the world, amidst a rapidly disintegrating health care system. This scoping review examines Fijian health system responses to the COVID-19 pandemic, exploring both the vulnerabilities and adaptive strategies that emerged during the crisis. Using a systematic search strategy to identify studies relating to how the Fijian health system responded to the COVID-19 pandemic, and what insights could be drawn about adaptive practices and resilience in this context, 71 papers were included. The findings demonstrate that while Fiji experienced significant workforce shortages, infrastructure constraints, and disruptions to routine healthcare, the pandemic response was also characterised by rapid policy adaptations, innovative use of some digital technologies, and strong community-led initiatives. However, challenges with public trust and culturally inclusive governance remain key areas for consideration. By applying a health system resilience framework that explores the tangible and intangible dimensions of health systems, this review offers insights relevant both for Fiji and the region. Strengthening local capacity, investing in sustainable infrastructure, and embedding Indigenous and other local knowledge in public health strategies are crucial steps toward building resilient Pacific health systems and preparing for future crises.
“We are the ones who will have to make the change”: Cuban health cooperation and the integration of Cuban medical graduates into practice in the Pacific (preprint)
(Biomed Central Ltd, 2023-05-03) McLennan S; Werle C
Background: This paper responds to Asante et al (2014), providing an updated picture of the impacts of Cuban medical training in the Pacific region based on research carried out in 2019-2021, which focused on the experiences of Pacific Island doctors trained in Cuba and their integration into practice in their home countries. Methods: The research focussed on two case studies – the Solomon Islands and Kiribati. Study methods for this research included multi-sited ethnographic methods and semi-structured interviews as well as qualitative analysis of policy documents, reports, and media sources. Results: The Cuban programme has had a significant impact on the medical workforce in the region increasing the number of doctors employed by Pacific Ministries of Health between 2012 and 2019. Qualitatively, there have been some notable improvements in health delivery over this period. However, the integration of the Cuban-trained doctors into practise has been challenging, with criticisms of their clinical, procedural and communication skills, and the need for the rapid development of bridging and internship training programmes (ITPs)which were inadequately planned for at the outset of the programme. Conclusions: The Cuban programme in the Pacific is an important model of development assistance for health in the region. While Cuba’s offer of scholarships was the trigger for a range of positive outcomes, the success of the programme has relied on input from a range of actors including support from other governments and institutions, and much hard work by the graduates themselves, often in the face of conservable criticism. Key impacts of the programme to date include the raw increase in the number of doctors and the development of the ITPs and career pathways for the graduates, although this has also led to the reorientation of Cuban graduates from preventative to curative health. There is considerable potential for these graduates to contribute to improved health outcomes across the region, particularly if their primary and preventative health care skills are utilised.