The first section of Part A of this document describes the health needs of adolescents in Fiji, poorly described to date. It identified that Fijian adolescents experience an excess burden of poor health, which has not improved substantially over time. Communicable disease, under and over nutrition and poor sexual and reproductive health are common health needs for Fijian adolescents. Violence and unintentional injuries are important causes of preventable morbidity and mortality, particularly for males. There is also a very large burden of noncommunicable disease, including chronic physical illness and mental disorder. Health risk behaviors including substance use, physical inactivity and sexual health risk were found to be common. These outcomes and risks relate to the disadvantage that many Fijian adolescents experience across the social determinants of health. Given many outcomes and risks share common determinants, comorbidity is likely to be common.

The second section of Part A of this document maps current programmes and approaches for adolescent health in Fiji. While many programmes relating to adolescent health were identified, there are a number of reasons why these programmes may not be resulting in improved health outcomes for adolescents. Firstly, it appeared that many programmes are not aligned with health needs of Fijian adolescents. Programmes for some health needs were absent (for example, mental health). Additionally, existing programmes did not always meet the needs of particular risk groups (for example, programmes relating to sexual and reproductive health largely catered for older and married adolescents). Secondly, programmes tended to focus on discrete issues and were poorly integrated and coordinated with other programmes, likely to introduce barriers for access. Thirdly, many programmes were funded for only short time periods, this sporadic funding likely to translate to sporadic programme delivery. Fourthly, programmes and approaches to adolescent health in Fiji remain poorly evaluated, their reach and effectiveness largely unknown (introducing barriers to taking these programmes to scale). Finally, current approaches to adolescent health in Fiji largely exist in a legislative context that is restrictive to addressing many key needs of adolescents.

Part B considers the needs of adolescents and the strengths (and limitations) of existing programmatic approaches to recommend an adolescent health strategy for Fiji. The strategy includes recommended actions, with some guidance around implementation provided, further detail for indicators and actions will be determined during the Ministry of Health stakeholder meeting on 7th November 2016.