Draft report
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This document is intended to provide advice to the market about key elements of the design of the Nauru Health System Support Project (NHSSP). A more comprehensive design will be provided to those organisations successful at the Request for Expressions of Interest (REOI) stage and invited to participate in the subsequent Request for Tender (RFT).

Over 80 per cent of the population of Nauru is overweight or obese and over 95 per cent of the population eat a diet deficient in fruit and vegetables and high in salt, sugar and trans fats. With around half of the adult population using tobacco, Nauru has one of the highest rates of tobacco use in the Pacific Islands. How Nauru tackles the avoidable risk factors of poor nutrition, physical activity, tobacco and alcohol in the short-term, and how well its primary health care facilities manage NCDs to prevent or delay complications, will impact on the demand for health services and health costs in the long-term.

The extensive pressures placed on the health system in recent years, including the fire in 2013 that destroyed stores, pharmacy and medical records in the Republic of Nauru (RON) Hospital, have meant that capacity/capability remains low and health system development is a major challenge. This covers the whole range of systems, including planning, budgeting, performance management, computerised systems for procurement (supply chain management) and patient administration, and operational systems. Improvements are needed in the quality of both clinical and management information. Low systems capacity is increasing workload, increasing costs and, most importantly, affecting service delivery.

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