Revitalising Papua New Guinea’s health system: the need for creative approaches
The scale of public health challenges in Papua New Guinea heightens the need to improve management capacity and ensure value for money. Proposed changes to health facility financing and plans to replace drug supply system open up possibilities for wider use of delivery mechanisms previously difficult to operationalise.
- ‘Access to health services in rural areas has become increasingly challenging; over the last ten years hundreds of rural health facilities have either closed or are not fully functioning.’
- PNG’s National Department of Health is seeking ways of encouraging families to take greater responsibility for their health and to make greater use of safe motherhood services.
- Distribution of health vouchers will ensure safe transport of pregnant women and their guardians to a designated health facility for supervised delivery.
- Micro-health insurance could also act as an incentive to improve service quality.
Health services in Papua New Guinea need substantial strengthening. Deteriorating performance, persistently poor health outcomes and worsening trends on key indicators are well documented. Challenges facing the health system result not just from low expenditure; performance is also constrained by its structure and by cultural factors. In general, investment is determined by supply-side strategies – providing infrastructure and resources consistent with ‘minimum standards’. If expectations for improved health outcomes, heightened by the bounty of resource development, are to be achieved without substantial wasting of additional investment, policy-makers need to consider all potentially viable options. Lessons can be drawn from countries facing similar challenges where the policy mix was broadened to include both the supply-side strategies and ‘demand-responsive’ mechanisms (voucher schemes, micro-health insurance, social businesses and social franchises). Trialing these mechanisms has the potential to reshape key elements of PNG’s health system, redressing structural weaknesses and reducing inconsistencies with cultural realities.