New research identifies future priorities for sexual and reproductive health in Kiribati

Tarawa, Kiribati

The island nation of Kiribati faces unique challenges when it comes to SRH and family planning. Its scattered geography, cultural diversity, and limited healthcare resources have made it important to tailor health, education and outreach programmes to local contexts. Over the last decade, various initiatives have been implemented to improve family planning accessibility and outcomes in Kiribati. The Kiribati HFP is one such initiative, working to improve the SRH of I-Kiribati in South Tarawa and 6 outer islands (Abaiang, Abemama, Aranuka, Butaritari, Marakei and North Tarawa), and is jointly led by Kiribati Family Health Association (KFHA) and Sexual Wellbeing Aotearoa, with funding from the New Zealand Ministry of Foreign Affairs and Trade (MFAT) Aid Programme. This research was undertaken as part of the HFP, and highlights some of the success stories from SRH service delivery efforts in Kiribati.  

The report indicates that SRH services have been evolving over time to respond to the different and growing needs in the community. KFHA delivers several SRH and family planning services in the community that closely align with the Government of Kiribati’s health sector priorities, allowing Kiribati’s Ministry of Health and Medical Services to focus on primary care and secondary care.

KFHA’s approach to working within i-Kiribati culture and with different faiths is seen as critical to its success. KFHA adapts its services and training to the different cultures on the different outer islands and uses a variety of approaches to deliver sensitive information. KFHA also works closely with several churches, Island Councils and Unimane (traditional leaders) to reach out to villages and communities across the outer islands. 

Research participants from some of the outer islands highlighted the lack of a local KFHA branch or hub on their island as a significant barrier to service access and uptake. This gap in service delivery is largely due to the limited frequency of outreach visits by KFHA teams and government public health nurses to the outer islands. Cervical cancer screening continues to have low uptake as well, despite the introduction of faster diagnostic methods. Insights from community surveys suggest that misinformation, a lack of awareness, and stigma, fear and embarrassment, are key factors contributing to this. 

To meet growing demand and improve service delivery, future programming will require increased funding, staffing and capacity. Engaging trained volunteers and peer educators offers a practical solution to help overcome resource gaps and extend regular SRH services to outer island communities that are currently underserved. Strengthening skills and capabilities remains a high priority, while securing new or alternative funding will be critical to meet increased demand, expand reach, strengthen resilience, and ensure the long-term sustainability of SRH services across Kiribati.

Sexual Wellbeing Aotearoa chief executive Jackie Edmond visited Kiribati last week for the first time in ten years to see for herself the changes the HFP project has made.

“The KFHA team has achieved so much with this project, highlighting the power of local people delivering local services.  This research highlights the impact of these SRH initiatives and provides an evidence-informed plan for the future.” – Jackie Edmond

KFHA and Sexual Wellbeing Aotearoa remain committed to working in partnership with government of Kiribati and community stakeholders to ensure equitable, reliable access to SRH services for all I-Kiribati, regardless of where they live.