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Naumu Josy Stephen1, Jane Allnutt2, Trish Boss2, Sue Webster2
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1Lenakel
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2
Hospital, Tanna Island, Vanuatu
Australian Catholic University, Sydney
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Vanuatu has 83 islands of which
about 63 are permanently
inhabited
These islands are grouped into 6
provinces.
2009 census recorded a total
population of 245,000 people
Capital is Port Vila (Pop. 30,000)
Official languages English,
French and Bislama; with 113
indigenous languages
Adult literacy rate = 57% M 48% F
33% of the population is aged
under 15 years of age
Model of care
 5 Hospitals
 20 Health Centre
clinics
 >25 dispensaries
 >20 Aid-Post
HW demography
 46 doctors
 279 Nurses
Nursing & Medical
Training
 Nurses- VCNE
 Doctors (90%)– FSM,
Fiji National
University (Medical
training)
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Cultural influences
Shortage of human resource
Lack of skills or specialized nurses
Lack of resources (finance)
Geographical distribution
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There is increase in mental disorders
Social practices contributing to mental health
problems (high consumptions of kava,
marijuana, alcohol)
Unemployment
Population increase
Mission:
To improve mental health of all
people in Vanuatu through raising awareness,
developing services through training of
professionals in mental health and involving
the community in the process of prevention,
promotion and care.
Areas for Action: National Mental Health
Committee, Financing, Legislation and Human
Rights, Service organisation, Human resources,
Essential medicines, Information systems,
Quality, Advocacy, Evaluation.
MENTAL HEALTH IN VANUATU.
MENTAL HEALTH POLICY
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With support from PIMHnet developed
Vanuatu Mental Health Policy and Strategic
Plan 2009- 2015.
Launched on 9th October 2009.
Vanuatu Mental Health Policy and Strategic Plan 2009-2015
The vision for Vanuatu is for
awareness at all levels of
community and Government of
the importance of investing in
the mental component of health
as defined by the World Health
Organization, to realise to a
mentally healthy nation, and
commitment to equity and
accessibility for humane
community care for the
mentally ill.
Currently
There are about 46 doctors but there is no psychiatrist to
look after mentally ill patients and so, the physician
normally looks after the patient with two nurses
implementing mental health services in the referral
hospital.
9 nurses implementing mental health services in 2 Referral
Hospitals and 4 provincial hospitals.
Only three trained 3 months training overseas 6 underwent
1 months training locally.
1 Ni- Van Doctor has an interest in mental health and is
looking forward to commencing training in Psychiatry next
year.
One Ni- Van completed studies in mental health law.
1 RN currently studying mental health nursing in Fiji.
At the moment no psychiatric nurse, no Psychiatrist in
Vanuatu despite 9 years pleading.
There is a 2 bed unit within the medical ward at Vila
Central Hospital, and one bed in Santo not
operational full time.
By 2014, Vanuatu aims to have:
 2 psychiatrists
 4 specialist psych nurses
 45 SRNs with 3 months local training plus
ongoing mentoring and support
 21 doctors with 1-3 months local training
plus ongoing mentoring and support
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Total number of beds=
48
Total number of staff
=36
LENAKEL HOSPITAL TAFEA PROVIENCE VANUATU
STAFFING
 One(1) Doctor
 Six(6) Nurse
Practitioners
 Three(3) Midwifes
 Sixteen(16) Nurses
 Six (6) Nurse Aids
 Total – 36
(for a population of approx 33,300)
PROVINCE
ISLAND
MALES
FEMALES
TOTAL
TAFEA
ANEITYUM
557
490
1,047
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ANIWA
222
223
445
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ERROMANGO
1,047
1013
2,060
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FUTUNA
296
293
589
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TANNA
14,700
14,460
29,160
16,822
16,479
33,301
TOTAL
TAFEA
POSTNATAL DEPRESSION
RAISING AWARENESS AND
DEVELOPING A MODEL OF CARE
IN LENAKEL HOSPITAL
TANNA VANUATU
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July to October 2011 had
an Aus-aid funded
scholarship at ACU North
Sydney
Theoretical units done at
ACU
Clinical attachments in
various settings, including
public and private
hospitals, a rural inpatient
setting, Aboriginal Health,
perinatal mental health
service, and Ambulance.
BY: EZEKIEL DANMELIP (RN), NORTHERN PROVINCAL HOSPITAL SANTO (2011)
KATEM DAON NAOIA BIFO HEMI HOLEM NEK MO
SAREM WIN BLONG YU
Hemi tumas sipos yu trink bitem 6 sel evri nite
KAVA I KOSEM PYSICAL
PROBLEM
ol masel I slack
skin IDRINK
draeEVERY
moNIGHT.
rough
problem blong ae
problem blong liva mo kidni
KAVA I KOSEM MENTAL
PROBLEM
Tingting I sik
Tingting i no wok gud
KAVA I KOSEM SOCIAL
PROBLEM
Famli problem
Financal problem
komitem crime
drugs & substains abuse
SIPOS TRINK TUMAS KAVA,HEMI PROBLEM BLONG YU?
TOKTOK WETEM HELT WOKA LONG ERIA BLONG YU NAOIA.
REFERENCES:
CHRIS.K.(1996) KAVA:Medicine Hunting In Paradise.park street press.
Pictures from Googles images
This poster was completed to meet the course requirements of NRSGXXX for Australian Catholic University , Mackillop
Campus, completed through an Ausaid ALA Grant. The support of Ausaid, The Australian Catholic University and the
Vanuatu Ministry of Health is gratefully acknowledged.
Previously in Vanuatu there has been very little
awareness, focus on the issue on mental health
in pregnancy due to lack of qualified mental
health work force. Since 2009 Vanuatu has
increase a lot of awareness on mental health
disorders, I was interested in depression in
prenatal and post natal depression.
Depression one of the widespread illness needs
to be address so that women should be aware of
the early signs and symptoms ,treatment and
understand it is treatable.(WHO 2012)
The number of mental health disorders are on
the increase in Vanuatu in particular depression
and anxiety.
Facts about few mothers killing their babies in
early 2000 in capital port Vila
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Full training in mental
health nursing.
Educate mothers on
post natal and
antenatal depression.
My aim
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To be able to educate other nurses midwives
about mental health issues in pregnancy.
Promote and Educate mothers on other
support groups, where there is no
professional attention.
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Mental health clinic
sited next to GOPD
where it is affordable
for every patient.
Operates Wednesday
and Thursdays, clinic
days
Patients referred from
GOPD, Wards and
from dispensaries and
health centres.
OUTCOMES
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Received a lot of positive feedback from
antenatal and postnatal mothers after
awareness. They learned something new have
never heard this message before .
So far four ante-natal mothers and three
post-natal mothers have come into the
mental health clinic seeking assistance.
Increase number of patients 1-2 to 3-4.
Main conditions depression and anxiety.
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Vanuatu Government, through the Ministry of
Health, should improve training and start full
time clinical services in the Provincial
Hospitals.
Work together with RNs and midwives
bringing more attention, focus on mental
health issues of pregnancy.
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Ongoing local training for midwives and nurses
to be able to diagnose correctly and provide right
treatment accordingly.
Ministry of Health to push hard to have a
Psychiatrist appointed in Vanuatu
More training overseas opportunities training for
nurses to gain more experience until Vanuatu
Mental Health services fully developed.
Any comments or contributions from colleague
nurses from the south Pacific to assist my
colleagues and I in Vanuatu to improve mental
health services in prenatal and post natal
depression will be appreciated.
Insufficient resources
 Inadequate funds to run programs
 Limited staff to implement mental health
services.
 Attitudes/Behaviors
 Cultural beliefs
 Smoking/Kava consumption
 Non compliance
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Poor Reporting/Referral System
 Geography of place
 Political instability
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RAISING AWARENESS
ACTIVITIES
CME – 2days presentation on postnatal depression with
Nurses and Midwives
Awareness and distribution of cards to Ante-natal mothers
on first visits
Awareness and distribution of cards to post-natal mothers
ARRIVAL OF
INVITED GUESTS
SPORTS COMPETITION
HANGING OF SALUSALU
PRESENTATION OF PRIZES
FUTURE PLANS
 Continuous local training for health professional
especially midwifes in identification of cases
 Creation of additional posters/brochures…etc for
awareness
 Improvement in reporting/referral systems
 Development of an appropriately trained and
resourced work force
 Improved availability of resources
 Good budgeting and planning to run programs