Independent State of Papua New Guinea health system review

Overview

The Independent State of Papua New Guinea is a geographically challenging country with a population of 7 million, 80% of which are rurally based. Although in the early stages of a demographic and epidemiological transition, the country remains beset with morbidity and mortality challenges linked to maternal and child health and communicable disease conditions, particularly for the rural and remotely located populations.

Examination of health coverage data demonstrates that there are significant inequities in access to primary health care and the WHO-defined essential package of services with the coverage for these services being low and stagnated. Under the decentralization, it is the local-level governments that have the primary responsibility for the majority of the funding and delivery of provincial- and lower-level healthcare services. However, they are inadequately resourced to do so. Churches, through government subsidies, play an active role in the delivery of health care, particularly in rural locations, but are also under-resourced. None the less, government continues to be the main financier for the health sector.

The government’s main policy priorities are tackling human resources for health and infrastructural needs of the country, particularly at the primary care level in rural and remote locations. Several reform measures are proposed by the government including “Getting back to basics” (rural and primary health care), finalizing the roll-out of the decentralized model of governance through the Provincial Health Authority Framework, and reintroduction of a policy of free primary health care.

Health policy and planning challenges in Papua New Guinea support the case for the “back-to-basics approach” adopted by the Government. This will entail investment in human resources for health and infrastructure across the country for improved access to primary health care, particularly in rural and remote areas, as well as improved management capacity at provincial level. The convergence of these reforms will, if achieved, support the transition towards universal coverage of an acceptable quality of and cost-effective primary care services.