Tanga’eo is the weekly communication piece of Te Marae Ora Cook Islands Ministry of Health (TMO) for our people. Tanga’eo is the endangered Mangaian Kingfisher bird that has a distinct call. The burden of disease with the NCDs/obesity epidemic alongside the impact of climate change, threatens the health of the Cook Islands population as well as planetary health. Tanga’eo is a call to action. Tanga’eo is for the people of the Cook Islands.
TMO’s vision is for all people living in the Cook Islands to live healthier lives and achieve their aspirations. This vision cannot be achieved by TMO alone. Instead, we need our whole community and whole of society to support our country achieve this.
The aim of this page is to provide our community some insight into the work of TMO and other organisations regarding our contribution to improving the health and well-being of our people. Space will be provided for some of our health system users to share their thoughts on areas for improvement. Tanga’eo will also include the writings of one of our patients as he navigates our health system.
In January 2019, TMO finalised the new organisation structure. See attached Figure 1.
The TMO restructure at executive level establishes strong Clinical Governance and Leadership that supports a more flat and inclusive decision-making process, and clear line of sight to core services. With complex health systems and a finite health budget, expanding the executive team as well as establishing a more comprehensive suite of advisory bodies (community, traditional medicine, and diaspora health professionals), provides TMO access to a larger workforce pool to help shape the design and delivery of health services in the Cook Islands.
Key positions in the TMO structure
- Clinical Governance and Leadership with the establishment of the Chief Medical Officer and Chief Nurse Officer advisory roles (situated above that of the TMO Executive) provides these positions high-level oversight of the entire health system.
- Community Health Services (CHS). CHS includes directorates for Public Health, Oral Health, and Primary Health Care (PHC). PHC services have traditionally operated within hospital settings and is a new initiative that will be phased over three years. In working towards achieving universal health coverage, TMO is reorienting services to move PHC services closer to the community. The focus is to keep people healthy and well, and invest in preventative services and the fence at the top of the cliff, rather than waiting for people to become unwell i.e. ambulance at the bottom of the cliff. Mental health services operate under the Public Health directorate, but is expanding and will operate as a standalone directorate within three years.
- Hospital Health Services (HHS). HHS services include general and specialist clinical services provided by TMO staff and visiting health specialists. Apart from Anaesthetics and Eye and ENT, each service has a complement of specialists and/or senior medical and nursing officers.
- Planning and Funding. TMO’s engine room which ensures the efficient management of our services comprise Funding and Support, Policy and Planning, and Human resources functions.
- Pa Enua. In order to ensure the Pa Enua is included in TMO services planning and delivery, a ‘whole-of system’ approach is placed on the structure with reporting lines direct to the relevant directorates.