Homegrown Health Networks
Fiji recorded 2,003 new HIV cases in 2025 — a 17x increase in six years. When researchers went looking for solutions, they found them already running in village churches, women's fellowships, and youth WhatsApp groups.
Photo: IPPF / Rob Rickman / Xaume Olleros
Fiji's HIV diagnosis rate surged from 13 to 226 per 100,000 between 2019 and 2025 — 2,003 new cases in a single year, including 59 newborns. Sex remains unspoken at home. Family Life Education classes are "basic and moralistic." Health workers breach client confidentiality. The formal system is failing.
Includovate and IPPF interviewed 103 stakeholders across six Fijian communities — urban, rural, maritime — including youth, faith leaders, sex workers, and people with disabilities. What they found: grassroots solutions already exist. Faith leaders reframe reproductive health through compassion instead of shame. Women's church fellowships run safe discussion spaces. Youth peer educators deliver sessions via social media. Inclusive clinics serve LGBTQ+ individuals and people with disabilities.
The pattern is replicating. In the Solomon Islands, community-led SRHR outreach reached 1,500 people and prompted two communities to rewrite gender-based violence by-laws. In Tuvalu, 25 trained peer educators now run school programs. Three Pacific nations, same lesson: the infrastructure is already there — it just needs funding, not replacement.
Our take
This is a localization play disguised as a health crisis. The bottleneck in Pacific SRHR isn't program design — it's that donors keep importing frameworks when communities already have functioning networks. Faith leaders reframing reproductive health through compassion, peer educators on social media, inclusive clinics — these exist now. Funders should commission participatory mapping before designing a single new program.
What to do with this
Commission participatory network mapping before designing any new Pacific SRHR program. Includovate's 103-stakeholder methodology is the template — fund replication across island nations before writing another RFP.
Formalize referral pathways between informal community networks and the national health system. Fiji's faith leaders and women's groups already reach populations clinics miss — give them supplies, training budgets, and reporting lines.
Redirect program design budgets toward strengthening existing community structures. The evidence says stop building parallel systems — embed staff in the churches and women's fellowships already doing the work.
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