Rural health service crisis in Papua New Guinea: causes, implications and possible solutions
Edwards, K.N.
Papua and New Guinea Medical Journal 37(3): 145-151
1994
ISSN/ISBN: 0031-1480 PMID: 7668051 Document Number: 426175
Anecdotal evidence and some routinely collected data suggest that the rural health services in Papua New Guinea (PNG) have been declining and, more recently, have collapsed. In recognition of this situation, the national government recently launched the Child Survival Crash Programme specifically to address the 'silent disaster' of maternal and child deaths. In contrast to deaths from the more visible, short-term disasters of earthquakes, floods and droughts within Papua New Guinea, maternal and child mortality appear to be the highest in the South Pacific and higher than many other developing countries. Some province and district authorities claim that funding is the major issue, whilst others claim that the lack of supervision and inservice training of health workers, the stock-outs of medical supplies and lack of maintenance of buildings and equipment relate as much to defects in management as they do to inadequate funds. The paper attempts to diagnose key issues underlying the current malfunctioning of the rural health system and suggests priority management remedies to improve the efficiency of the service in the face of real or apparent funding shortfalls. It concludes with some possible solutions which include: simplify funding mechanisms; establish priorities for funding; improve communications; make inservice and supervision routine; improve community education; place a moratorium on new projects; and increase church responsibility.