Strengthening epidemiology capacity through leadership skills workshops
In Naoero, the Pacific island nation formerly known as Nauru, health leadership training is beginning to come full circle.
When 12 Ministry of Health staff gathered for a leadership workshop this May, they were not being trained only by outside experts flown in from elsewhere in the Pacific. They were being trained by colleagues who had once sat where they were sitting.
For three days, Dr David Bill, medical officer from the Naoero Medical Centre, and Ms Chandalene Garabwan, Acting Director of Public Health (Health Promotion) from the Naoero Ministry of Health, facilitated much of the workshop in the Nauruan language (Dorerin Naoero).
Both Dr Bill and Ms Garabwan were participants in previous leadership workshops supported by the Pacific Evidence for Informed Policies and Programs Plus (Pac-EVIPP+) initiative. It is an ANU-led project working to strengthen epidemiology capacity across the Pacific, as well as in Cambodia and Lao PDR.
This one in Naoero was the first time a workshop was fully facilitated by local Ministry of Health staff, following feedback from the three workshops run from 2022 to 2024 in Fiji and Canberra that targeted public health leaders from Pacific Island Countries.
“The feedback from the workshops was a request for in-country delivery and to contextualise the workshops to the Pacific context,” says Dr Rosalina Sa’aga-Banuve, the Pac-EVIPP+ lead at ANU National Centre for Epidemiology and Population Health (NCEPH).
“This was also the first leadership workshop fully facilitated by local Ministry of Health staff,” says Pac-EVIPP+ researcher Dr Anaseini Ratu.
With a population of around 11,000, Naoero faces many of the health challenges common across the Pacific Island countries, including a limited health workforce and the growing impacts of climate change.
For its health workers, strong leadership isn't simply about managing a team but about how well the health system responds when emergencies arise.
Facilitated by Dr Bill and Ms Garabwan, the three-day workshop trained public health and clinical health leaders through interactive learning and role play with locally adapted public health scenarios.
“It’s developed to enhance learning through skills development and the practical application of evidence-based decision-making in the real-world contexts,” Dr Sa’aga-Banuve.
On day one, for example, participants were dropped into a Doomsday island survival scenario.
“They had to work through the process of decision-making and choose only five people to leave the island on one canoe,” explains Dr Ratu. “This scenario was used to discuss power, roles, and how gender and culture influence decision making.”
The workshop also included sessions where participants analysed outbreak response in a rotavirus scenario, where they worked through approaches to vaccine hesitancy, and discussed the role of adaptive leadership in public health emergencies.
Participants shared stories of their journeys through difficult times and the role of mentors in shaping experiences. They also reflected on cross-sectoral collaborations in health emergencies and the adaptive leadership skills needed in public health crises.
While the participants range in work experience from early career professionals to senior directors, all of them found the workshop content highly relevant and would recommend the workshop. Many reported that they now see the importance of having communities of practice for sharing knowledge and collaborating.
“Delivering the training in the Nauruan language had more impact,” reflects Dr Bill.
“The training has made me realise just how important leadership is,” says one of the participants. “It opened up my eyes and my mind on the way of being a leader.”
For the trainee-turned-trainers, the workshop was also an opportunity to build confidence in their role.
“I think with that set of skills I have gained, it will become easier for me to share at whatever workspace I am in, whether it’s within my current unit or throughout the broader public health space,” says Ms Garabwan.
She also has noticed the same growth in her trainees. “They are more confident in speaking to the group and in public and more organised in preparing themselves.”
One day, these trainees may again become trainers themselves, helping to build the leadership capacity of their own colleagues and communities—just as Ms Garabwan has done.
“A key outcome of Pac-EVIPP+ is to ensure sustainability of project activities by enabling in-country capacity to deliver leadership training,” says Dr Ratu.
“The Naoero case serves as the template of what we hope to be able to achieve across the region.”
The model will now be tested elsewhere. Pac-EVIPP+ plans to support locally led versions of the workshop next in the Solomon Islands and Samoa.
With funding from the Australian Department of Foreign Affairs and Trade (DFAT), the Pac-EVIPP+ initiative is also supporting health workers to strengthen their epidemiology skills through formal epidemiology training and qualifications delivered by ANU and the Fiji National University (FNU).
“Pac-EVIPP+ reflects the Australian Government’s ongoing commitment to strengthening health security across the Pacific,” says Dr Sa’aga-Banuve.
This commitment has been demonstrated through a range of initiatives, including the Strengthening Health Interventions in the Pacific – Data for Decision Making (SHIP-DDM) program through the Pacific Community, the ASEAN-Australia Health Security Fellowships, and the Pac-EVIPP program.
Dr Bill and Ms Garabwan are beneficiaries of these investments. Mentored by ANU, they both have completed the Postgraduate Certificate in Field Epidemiology at FNU. Ms Garabwan is also currently undertaking a Postgraduate Diploma in Applied Epidemiology.
By fostering the growth of healthcare professionals, Pac-EVIPP+ hopes to build on the inherent resilience of Pacific people and strengthen their ability to lead towards improving health services for their communities.