1. To what extent does the public have trust in the healthcare system, service and staff?
2. What issues are there regarding the healthcare human resources development meeting minimum human resource requirements for the atolls?
3. What are the healthcare legislative requirements and changes needed for efficient medical services in the atolls?
4. What benefits and challenges are there regarding the delivering and receiving of an affordable National Health Insurance service? 
5. What issues of equity (if any) of healthcare access exist in healthcare services in the 7 atolls?

The above themes, research questions and follow up questions were discussed online amongst stakeholders in groups. After analysis of the qualitative data, 37 recommendations for policy and practice were identified and nine priority recommendations were identified from the analysis of the data from the five themes.

Download the full report.

Improving Health in the Maldives: Stakeholder Perspectives on the Maldivian Health Sector – the North Region

Maldives Research would like to share with Maldivian healthcare stakeholders, collaborators, and the general public videos of the keynote speeches by Dr. Abdul Sattar Yousuf and Dr. Ali Niyaf from our event, ‘Improving Health in the Maldives: Stakeholder Perspectives on the Maldivian Health Sector – the North Region (2020)’ held online via Zoom on 14^th November 2020.

Dr. Ali Niyaf is the first Maldivian neurosurgeon and the President of the Maldives Medical Association. Dr. Abdul Sattar Yousuf serviced the Maldives Healthcare sector for nearly two decades (1974-1994) and for another two decades (1994-2013) for the World Health Organisation. Currently he is the Executive Director, the International Center for Environment, Development and Operational Research (ENDEVOR), an NGO registered in the Maldives.

Dr. Niyaf’s speech focussed on trust in the healthcare services in the Maldives; public’s perception and level of current development and areas that are experiencing challenges in further development. He used his experience in working in both private and state sector; also as a practitioner and as a patient/ service user. Past and current issues arising from the public not having complete trust has led to a number of problems including the public and practitioners’ frustrations; breakdown in relations between service providers and patients; having to look for alternative services abroad even when equivalent services are available locally, putting financial burden on the health system via health capital outflow, which overall has a negative impact on the nation’s overall economy. These effects have the tendency to demoralise local practitioners. Relevant issues that need addressing include undue political pressure and unethical practices within the health system.

Dr. Niyaf spoke in length of a pilot survey involving 100 respondents, where survey questions had been used to explore the level of public trust in healthcare service; questions had been adapted from those used in the UK and amended to fit the Maldivian context. The results show that most respondents have a medium level of confidence (5/10) in the service they receive; the vast majority feel that the services have improved in the country. Dr. Niyaf shared his experience as a surgeon since 2014, where there have been gradual increases in the level of confidence in the nation’s healthcare system overall; and there is even bigger level of confidence amongst the respondents about the future of our healthcare system. He noted the low level confidence in GPs (general doctors); counter staff and call centre staff; mental health care services; disability services; physiotherapy services; and that all of these services need to be particularly improved; but relatively high confidence in the service provided by ambulance and emergency services and hospitals in general. Dr. Niyaf highlighted the high level of customer confidence in some services and especially services provided by specialist doctors and dentists; and emphasised the need to learn lessons from these practices. Although the public have a high level of confidence in most service aspects, there are areas of high public concerns such as education and training for doctors; patients’ waiting times; the extent to which doctors’ practices are regulated and he highly recommended authorities to revisit the practice of transferring doctors with a poor service record to other locations.

Dr. Niyaf ended his speech by emphasising that the pilot study was a small study of 100 people. He revealed his plans to conduct more extensive research to understand the areas of concerns further and hoped the Maldives Research’s health forum would prove to be an opportunity to understand some of the highlighted issues. The speech followed a question and answer discussion between Dr. Niyaf and the audience.

In Dr. Abdul Sattar Yousuf’s keynote speech, he thanked Maldives Research for the opportunity and pleasure in seeing so many stakeholders from the Northern Atolls. His speech focussed on preventive public health policymaking and legislation development in the country from early 20^th century up to today throughout the noting the vast differences between now and his time of service in the Maldivian health sector covering the understanding of policy; health policy in the Maldives; global influences on the local health policy; the new challenges and contemporary changes needed at system level in this new era.

Dr. Yoosuf used an intriguing set of historical images of Maldivian societal scenery (from the northern atolls and the capital contained in Mr. Mohamed Ismail Fulhu’s legacy book, “Healthcare Services in the Maldives: Yesterday and the Day Before”) relevant to public life and health, covering scenes of island life, first rain water collection project (1919), the first polio immunization programme (1980s); mass cholera vaccination programme (1978); malaria control (1960s). However, the first Health Plan was formulated 40 years ago in 1980, which began to be implemented through a mobile health team strategy in 1985 due to the lack of the essential health infrastructure at the time.

Dr. Yoosuf shared his experiences in the 1980s in running WHO and UNICEF’s Primary Health Care to achieve the goal of Health for All by 2000 through various programmes such as Community Health Workers programme. He also noted the UN’s Rio Conference in 1992 as a key event where Maldives collaborated in the integrating global health in the sustainable development agenda whereby all came to the agreement that health needs to be incorporated into all developmental sectors rather than leaving it a matter of interest solely for the health ministry to be governed. The new reality, Dr. Yoosuf, described is an era where novel inter-sectoral leadership needs to emerge in producing new types of health policies in collaboration with the communities the polices serve. These policies may need to take account of the epidemiological transition we are going through by considering the resources needed, involve public and expand health governance at island level.

Throughout his speech Dr. Yoosuf gave insights into related concepts. He Yoosuf defined ‘health’ as a holistic umbrella term to cover physical, social, mental states and overall wellbeing as a balanced concept. He continued specifying policy as a sign of deliberation, intention and evidence that a decision has been taken; health governance encompasses both policymaking and policy implementation in the course of achieving outcomes that are critical to citizen’s lives. Many public health issues need legislation to support policy. Transformative changes need decisions backed by deliberative intentions, which releases powerful emotions. What follows next are the detailed plans of elements in the form of strategy, processes, procedures and policy implementation. He highlighted the important role of health legislation and law in protecting rights and citizens’ health; managing risks; developing public health and related institutions, stakeholder relations; reducing inequities; managing globalisation and its positive and negative effects. Dr. Yoosuf underlined the importance of an unbiased and open-minded stance when developing health-related legislation and policies.  Much of the content of Dr. Abdul Sattar’s speech is derived from his book, Himeyn Bathalun (English version: Unsung Heroes).

Maldives Research’s team believes the speeches are an invaluable resource in terms of the diverse and expert insights the speeches provide; hence our decision to publicise the speeches with keynote speakers’ consent.

In addition to the Keynote speeches, we would like to highlight the inspiring talk delivered by Dr. Ahmed Shahid, Dean of Research at Villa College focussing on the institute’s collaborative work with Maldives Research.

The forum’s purpose was to research current issues in healthcare services facing stakeholders and the public in the northern atolls in the Maldives. The forum aimed to explore views and concerns from different stakeholders on the relevant issues through interacting with experts, practitioners and recipients of health services in the Maldives.

The event was hosted through a collaborative partnership between Villa Foundation, Villa College, ADK Hopital and coordinated and run by Maldives Research. Digital Services Partners of the forum were Ooredoo and Dhiraagu. Maldives Research’s organisation team would like to mark the event as s success for despite the difficulties in digital connections, the forum was well-attended by the target stakeholder groups. Altogether the forum was attended by 45 participants via Zoom, which included 35 stakeholders mainly composed of healthcare professionals and the members from general public from the Northern atolls; policymakers and representatives from healthcare organisations based in the capital, Male’.

The Forum gathered and collected stakeholder perspectives on the topic of Improving Healthcare in the Maldives, with a particular focus on the North Region of the country. The key themes for the Forum were Trust in the healthcare system, service and staff; Human Resources; Legislation; Affordability and National Health Insurance schemes; and Equity of healthcare access; fairness and impartiality.

Evaluation of the results of the end-of-forum survey showed a significant level of satisfaction (4+ stars /5 stars; 28 responses across 2 surveys: English and Divehi) for the overall experience at the forum; forum organisation and communication; keynote speeches; theme presenters; forum’s topics; and how Zoom platform was used. The only aspect that did not receive a 4 star rating was the length of the forum in the survey in the Divehi survey. Participants particularly liked and made positive comments about the forum’s aims and potential outcome of improving the nation’s healthcare services. There were also suggestions made to increase the number of stakeholder participants. We, at Maldives Research are very grateful for the participants’ contributions and feedback and we aim to use the comments to improve the quality of our future events. The forum organisation committee is currently in the process of finalising a report for publication in collaboration with health experts and key interested figures in the Maldivian society. The report will be published in 2021 and shared with the general public, health policymakers, healthcare practitioners and key national and international developmental institutions in the country. The focus of the report will be healthcare policy and practice recommendations based on the perspectives of the stakeholder participants.

Maldives Research will be running a health forum in November 2020 to research current health issues facing Maldivians in the northern atolls in the Maldives. The forum aims to explore views and concerns from different stakeholders on the relevant issues through interacting with experts, practitioners and recipients of health services in the Maldives. Based on the outcome of this Forum, Maldives Research will provide some recommendations for policy development around health issues in the Maldives.

The event will be hosted through a collaborative partnership between Villa College, ADK Hopital and Maldives Research and it will be coordinated by Maldives Research. Digital Services Partners of the forum are Ooredoo and Dhiraagu.

The Forum will be financed mainly through sponsorships as well as Maldives Research’s own funds.

The Forum will be conducted to gather and collect opinion on the following general topic, which will be guided by some suggested questions: Improving Health in the Maldives: Stakeholder perspectives on the Maldivian Health Sector – the North Region”.

Stakeholders here mean anyone who has an interest in the healthcare system in the Maldives, in particular health experts, practitioners, politicians, academic researchers, insurers, healthcare service providers (public and private) and the public. The following themes have been developed around the above topic, which are to be discussed in the Forum.

The key themes for the Forum are:-

1. Trust in the healthcare system, service and staff 
2. Human Resources
3. Legislation 
4. Affordability and National Health Insurance schemes 
5. Equity of healthcare access; fairness and impartiality

The discussions of the themes will be guided by a set of questions formulated by the forum organisation committee under expert advice from the Maldivian health sector.

Forum Digital Services Partners –

The signing ceremony was attended by the representatives of the parties to these agreements; namely, Mr. Mohamed Hameed (Umarube), Executive Director at Villa Foundation; Dr. Ahmed Anwar (Rector, Villa College); Dr. Ahmed Shahid (Dean of Research, Villa College); Mr. Ahmed Afaal (Managing Director, ADK Hospital), and via Skype Dr. Abdulla Sodiq, (Director, Maldives Research). Following are the summary of the views expressed by each party during the signing event.

Mr. Hameed mentioned that Villa Foundation has always been keen to invest in academia but need to collaborate with other organisations with the required skills and to add partners to their brand components such as Villa College. Maldives Research and ADK Hospital are the perfect partners for this purpose.

Dr. Shahid said that Villa College was already engaged in research activities through its Institute for Research and Innovation and this three-year collaboration with credible partners is an immense energiser to reach higher levels.

Dr. Anwar particularly noted the capacity and potential of each of the partners in the 3-year collaboration, especially the expansion of the international research network that Maldives Research could bring in.

Mr. Afaal pointed out the importance of research-informed policy practice, especially in the health sector and that ADK has been a forerunner in this aspect. He also noted that the capacity of the forum of the three journals of the organisations involved, ie:- Maldives Research’s academic journal, International Journal of Small Economies, Villa College’s International Journal of Social Research and Innovation, ADK’s ADK Journal of Health and Medicine. Hence, this venture creates an invaluable space for researchers from the Maldives and abroad.

Dr. Sodiq thanked Villa Foundation’s officials for their ideas and investing time and for sponsoring this academic research collaboration, which aims to empower Maldivian citizens in the area of public policy. He further thanked Dr. Shahid, and Mr. Afaal, ADK Hospital for recognising the importance and the richness of this opportunity to identify new areas to do productive research. Dr. Sodiq also congratulated Mr. Abdul Matheen Ismail for securing the new position as an Administrative Manager, who will work with us to ensure that our targets for the 3 years are achieved both in the Maldives and abroad. Based on the past achievements of Maldives Research, he reiterated his commitment to making the plans a success. In conclusion, Dr. Sodiq expressed his optimism that in this 12^th year of Maldives Research’s life, the organisation will reach a significant milestone together with Villa Foundation, Villa College, ADK hospital.

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Education Forum Report

The forum titled ‘Improving Education in the Maldives: Stakeholder perspectives on the Maldivian Education Sector’ was attended by parents, teachers, students, school principals, education ministry officials and business sector representatives from across the country.

The forum discussions were guided by five selected themes focussing on education and industry; qualification and quality of control; national curriculum; language in education and governance and management in schools. The report details the findings of the forum and provides a number of recommendations for further research and capacity building.

The findings and recommendations provided in the report are presented in the hope that it draws attention to the key issues within the Maldivian education system, and informs and influences policy decisions.

The full report can be accessed from www.maldivesresearch.org.

Download the report “Improving Education in the Maldives: Stakeholder perspectives on the Maldivian Education Sector” – PDF version.

Celebrating 5th anniversary

During 2012 MaldivesResearch also registered its Maldives branch with the Ministry of Home Affairs, Maldives.

MaldivesResearch held its first public policy forum in the Maldives at Iskandhar School, Male’ on 30 June 2012. The forum provided a venue for stakeholders to discuss and share knowledge on improving education in the Maldives. The forum theme was ‘Improving Education in the Maldives: Stakeholder Perspectives on the Maldivian Education Sector’.

On the occasion of its fifth anniversary MaldivesResearch will be publishing the findings of the Education Forum along with recommendations on 25 March 2013.

1-      you may join us as a researcher, research assistant or help us in the organization of our events;

2-      you may make a financial contribution. To join us as a researcher or research assistant, please complete the MaldivesResearch Membership Form and email it, attaching your curriculum vitae, and indicating the nature of your interest to info@maldivesresearch.org.

Download MaldivesResearch Membership Form (MS Word file).

Maldives Education Forum 2012

Maldives Research held its first forum in the Maldives at Iskandhar School, Male’ on 30 June 2012. The conference theme was  ‘Improving Education in the Maldives: Stakeholder Perspectives on the Maldivian Education Sector’ and keynote speaker, Dr. Hassan Hameed (Vice Chancellor, Maldives National University) and Professor Hassan Ugail (Trustee, Maldives Research; Director of Centre for Visual Computing, University of Bradford, UK) addressed delegates.

Below are the slides from the presentation given by:

Dr. Hassan Hameed (Vice Chancellor, Maldives National University) (document in PDF)

Professor Hassan Ugail (Trustee, Maldives Research; Director of Centre for Visual Computing, University of Bradford, UK) (document in PDF).

Professor Hassan Ugail introducing IJSE special print edition

Maldives Research has published a special print edition of International Journal of Small Economies (IJSE) during the Maldives Education Forum held on 30 June 2012 at the Iskandhar School, Male’, Maldives.

The special print edition was introduced at the Education Forum by the editorial board member, Professor Hassan Ugail from the University of Bradford.

The IJSE special print edition consists of 5 papers submitted to the journal. The journal is a peer reviewed journal focusing on small state economies.

This special edition was printed in the Maldives by the well known printer and publisher, Novelty Printers and Publishers Pvt Ltd.

The journal copies were distributed to the Maldives Education Forum participants. It will also be send to University libraries.

If you wish to submit a research to the journal please send the manuscript to ijse@maldivesresearch.org. Manuscripts may be submitted as, inter alia, case studies, comparative analyses, theories, book reviews, etc. No topic is excluded from consideration provided it is of relevance to public policy of small economies.

The following is a list of non-exhaustive areas on which articles may be written: environment, socio-economic development, law, governance, technology, etc. Interdisciplinary articles are also welcome.

For more information on journal visit: http://ijse.maldivesresearch.org