Small checks, careful follow-up: how frontline nurses are making NCD care safer in Honiara

A woman visited Mataniko Area Health Center asking to be checked for malaria. She had no idea she was also living with diabetes and hypertension. Because the clinic had strengthened its approach to quality improvement, her visit became more than a test for fever—it became a chance to detect serious conditions early and start the right care before complications developed. 

This incident shows why the 2026 World Patient Safety Day theme, safe care for noncommunicable diseases, matters far beyond one patient, one health worker or one clinic. For nurse Barbara Quiroquiro, patient safety begins in the moments most people may not notice: vital signs taken from a patient who came in about something else, a question asked, a concern heard before it becomes a complication. She checks, listens, and acts with every patient she sees.

Barbara has seen how routine encounters can become moments that protect a patient from harm. For her, a blood pressure reading, a blood glucose check, or a concern heard with care isn't just a routine; it's a chance to act early, reassure a patient, and ultimately, protect a life.


Barbara says careful assessment, accurate documentation, good communication, and following safety procedures can help identify problems early and prevent complications. Photo: WHO / Ruel Serrano

Nurses Mevilyn Manetei and Jay Rangitamaforau of Mbokonavera Rural Health Center and Mbokona Rural Health Center, respectively, have seen similar changes. Through quality improvement and coaching, they have strengthened how patients are assessed, documented, followed up, and supported to understand their own conditions and take greater responsibility for their health. Jay says even small improvements are changing clinic workflow, patient flow, documentation, and follow-up—showing how tiny changes across different facilities can strengthen safer care for people living with noncommunicable diseases.

"Safe care means providing the right care, at the right time, while preventing harm," Barbara says. "It also means respecting each patient, listening to their concerns and working with them to manage their condition safely."

Under the leadership of Honiara City Council (HCC) Health Director Dr Lawrence Diau, health workers at HCC are turning everyday consultations into opportunities to protect lives. “Patient safety is not optional; it is the foundation of quality health care,” said Dr Diau. “Every missed sign, every unclear instruction, and every gap in follow-up can have real consequences for patients and families. That is why I am proud of our HCC health workers, who are turning every consultation into an opportunity to prevent harm, protect dignity, and save lives”

When Mataniko clinic changed how it worked in April 2025, thanks to quality improvement initiated by the Ministry of Health and Medical Services, supported by the New Zealand Ministry of Foreign Affairs and Trade, the Institute of Philanthropy, and WHO, it helped health workers look beyond a patient’s immediate complaint and use each consultation to identify risks early. 


For Mevilyn, quality improvement has helped more patients fully understand their own conditions and take greater responsibility for their health. Photo: WHO / Ruel Serrano

The quality improvement model has now been introduced across all eight HCC clinics, with implementation underway in six clinics in Guadalcanal and seven facilities across Malaita’s four regions.

Instead of focusing only on the patient's immediate complaint, Barbara checked the patient's vital signs and blood glucose and reviewed her medication history and symptoms. The screening revealed newly diagnosed diabetes and hypertension, allowing her to be correctly classified and started on appropriate medication at an early stage.

"I followed the appropriate clinical procedures, informed the medical officer, and arranged timely management and follow-up," she recalls. For Barbara, the experience demonstrated why systematic screening and careful assessment matter: they can uncover serious conditions early, guide the right treatment, and prevent complications before they become life-threatening.

"Careful assessment, accurate documentation, good communication, and following safety procedures can help identify problems early and prevent complications," she says. Preventing serious harm, in other words, often begins with looking beyond the obvious.

The same principles guide Barbara during an ordinary day at the clinic. She begins by welcoming patients, confirming their identity and creating an environment where they feel comfortable. She takes a proper history, assesses vital signs and current conditions, identifies health needs, and reviews medicines and potential risk factors. Then she explains diagnoses, treatment, medicines, and lifestyle changes in simple language, so patients understand what they need to do after leaving the clinic.

Following up matters just as much. Barbara checks for warning signs and complications, refers patients when they need care the clinic cannot give, and makes sure they understand when to return or seek urgent care. "For me, safe quality care means putting the patient first, preventing errors, communicating clearly and providing care based on evidence and clinical standards," she says.

For Mevilyn, quality improvement has helped more patients fully understand their own conditions and take greater responsibility for their health. She has seen patients attend reviews, request medicine refills before supplies run out, and build stronger relationships with health workers. Monthly records also show more outpatient cases coming back for routine check-ups.

Jay says he has seen the effects visible on clinic operations as well. Quality improvement, he says, has helped the clinic organize patient flow more efficiently, allowing queues to move faster than before. It has also strengthened documentation and made follow-up monitoring more effective, especially for patients who need regular review and medication replenishment.

“My goal always is to provide quality care and services that will meet patients’ expectations,” Mevilyn says, reflecting on what safe care means in her daily work. For Jay, the message runs through the whole system: patient safety is the cornerstone of effective care and a shared responsibility among patients, families, and health workers.

The numbers show the results. Between August and October, NCD screening increased sharply across all three facilities compared with the same period in 2024. Mataniko screened 215 people in 2025, up from 19 in 2024, translating into an 11.3-fold increase. Mbokonavera screened 359 people, up from 14 resulting in a 25.6-fold increase. Mbokona screened 191 people, up from 47, which was a 4.06-fold increase. The numbers point to a growing shift from waiting for complications to appear toward actively finding risks earlier and keeping patients connected to routine care. 

Providing safe care is not always easy. Health workers can face staff shortages, heavy workloads, limited resources, and communication gaps, while patients themselves may struggle to understand or follow treatment plans.

Barbara responds through health education, counseling, and regular monitoring, working with patients to develop practical ways to manage their conditions. Teamwork carries the rest. "I remain calm, work as part of the team, and always put patient safety first," she says.

Mevilyn remembers a diabetic patient who came in with a small blister on her toe. Concerned about the risk of complications, she explained in simple terms what could happen if the blister was left unattended and convinced the patient to accept an early referral to the next level of care. Months later, the patient returned to the facility to continue daily care, with severe complications prevented. “Both of us were very happy with the outcome,” Mevilyn recalls.

This year, Jay shared lessons on diabetes and hypertension care in Solomon Islands with participants to the Global Health Learning Center. Coaching and quality improvement drove facility changes, resulting in 8x more patients with controlled diabetes. Photo: WHO / Ruel Serrano

Jay recalls another patient with diabetes who missed a scheduled follow-up after three months. He called to remind her to return for a check-up and to replenish her medication. The patient replied: “Hey nurse, thank you so much for being there for me and by helping me and reminding me.” The patient added that it was the first time a health worker had followed up with her in that way and promised to come the next morning. She did. For Jay, that moment showed how a simple phone call can help keep patients connected to care.

Across the clinics, the message is consistent: safe care is everyone’s responsibility. Barbara encourages patients and families to ask questions, follow their treatment plans, attend regular check-ups, and speak up when something does not feel right. Mevilyn’s experience shows how understanding one’s condition can help patients take more responsibility for their health. Jay’s follow-up call shows how health workers can help keep patients connected to care when life gets in the way.

Listening, checking, communicating, documenting, and following up may seem simple actions. But together, they form a powerful defense against avoidable harm and put patients at the center of safe, quality health care.