Client: Cure Kids, New Zealand Ministry of Foreign Affairs and Trade, Fiji Ministry of Health


Rheumatic fever is caused by an abnormal immune response to infection with a bacteria called Streptococcus (GAS), usually in the throat. The symptoms of rheumatic fever resolve over a few weeks, however, damage to the heart valve is usually permanent and referred to as rheumatic heart disease (RHD). With repeated episodes of rheumatic Fever the damaged heart valves become thickened and do not work properly, leading to heart failure and early death.

Rheumatic Heart Disease is a significant health problem in Fiji. Each year, at least 60 people die of RHD in Fiji and the average age of death is 38 (Singh P., et al 2007). The reported prevalence in children aged 5-14 years in Fiji is 19.2 per 1000 (Colquhoun S., et al 2014) – that is almost one child in every classroom with RHD.

From 2014 to 2019, Cure Kids, the New Zealand Ministry of Foreign Affairs and Trade (MFAT) and Fiji Ministry of Health and Medical Services (MHMS) worked together to expand upon the Fiji Islands Rheumatic Heart Disease Control and Prevention Programme. Their goal was to reduce morbidity and mortality in Fiji, and to do this, they made use of the vast RHD research as well as health and contextual experts to create a sustainable and effective programme in Fiji.

Standard of Proof supported Cure Kids and their partners design and implement a mixed-methods evaluation of this work. We collated and triangulated evidence across various sources, demonstrating the weight of the evidence to help the health and contextual experts make informed decisions moving forward. The next steps for the activity are being planned, using evidence and expertise to achieve their goals.

We are proud to have supported Cure Kids, MFAT and MHMS obtain useful evidence to inform their success, and we wish the hard-working rheumatic heart disease team every success at further improving the health outcomes for Fiji peoples.

The report: Fiji-Islands-Rheumatic-Heart-Disease-Control-and-Prevention-Evaluation.pdf (

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