This report is part of a policy series that identifies challenges and opportunities in China’s South-South cooperation with Pacific island countries (PICs) in the context of the Sustainable Development Goals (SDGs), with a specific focus on SDG 3 related to health and health service delivery. It looks at health systems and health issues of three PICs, namely, Fiji, Samoa and Papua New Guinea, and identifies some of the major issues and challenges in their health service delivery. This report also maps out major development partners currently supporting the health sector of PICs and provides specific recommendations for China to enhance its health engagement in the Pacific with a view to supporting PICs in achieving its health targets under the SDGs.