This service is part of the preparatory study for the project to rebuild the Melsisi health centre and provide support for its reopening. For component 1 "Diagnosis of the healthcare system", the expected deliverables are described below:

1. Deliverable 1: Methodological proposal, detailing the working approach, tools, planned methodology and detailed work schedule.

      2. Deliverable 2: A diagnostic report on Vanuatu's healthcare system, including the following :

a) Overview of health system regulation:

• Governance and organisation of the health system;
• Nature of the operators and their methods of operation;
• Details of healthcare provision, patient flows and organisation on Pentecost Island and in Melsisi in particular;
• Analysis of the needs of the Pentecost island population and access to healthcare;
• Mapping of the main partners and interventions in Melsisi.

b) Overview of the financing of the health and care system (health structures, health professionals, share of private financing in the financing of care, share of public financing and its nature);

c) Health infrastructure development policy:

• Presentation of the strategy, structure and resources for managing the creation/maintenance of health infrastructures and equipment;
• Assessment of the operationality of the "Draft clinical services model and master plan for hospitals" and its applicability to the project;
• Identification and feedback from recent health infrastructure projects.

d) Assessment of human resources in health in Vanuatu:

• Details of training methods for professionals and their integration into the labour market; Analysis of training stakeholders and assessment of the quality of nursing and midwifery curricula; Specification of HHR regulation methods;
• Management of human resources in health: Details of the availability of HHR in Vanuatu and Melsisi, and in particular the existence of a rural doctor and nurses; Details of the management framework for health professionals by the Ministry of Health (access to continuing training, careers, distribution throughout the country);
• Mapping of those involved in strengthening HRH, and in particular support for the Vanuatu College of Nursing Education;

e) Evaluation of the e-health policy and opportunities for implementation on Pentecost Island;

f) Operation, resources and governance of the Melsisi health centre:

• Presentation of healthcare provision on the island of Pentecost and in Melsisi;
• Details of cooperation between the island's healthcare structures;
• Current management of the Melsisi health centre: the aim will be to assess the legal nature of its operation and the associated resources (human and financial); the aim will also be to collect statutory documents specifying its governance arrangements, the status of site occupation and the contractual relations with the Ministry of Health (MoU) validating the beneficiary's authorisation to operate a health facility. The functional and hierarchical link with the Penama DPS should also be clarified.
• The links between the Catholic Mission and the local customary authorities will have to be detailed, as will the structure and role of the Catholic Mission and its possible links beyond the island of Pentecost.
• The activities of the health centre will be detailed and compared with the missions entrusted to the establishment, and the financing of this activity will be detailed;
• The existing teams, resources and equipment will be put into perspective in relation to the real needs;