HEALTH SITUATION - Papua New Guinea

HEALTH SITUATION

According to the 2011 population census, the

population

of PNG increased by 40% at an average

annual growth rate of 3.1% since the last populatio

n census in 2000. During the same period the

life expectancy at birth increased from 58.80 years

to 60 years. Between 1990 and 2012 the infant

and under-5 mortality rates decreased steadily from

65 and 89 per 1000 live births to 48 and 63

per 1000 live births respectively. This decline is

however not sufficient for PNG to meet its MDG 4

targets. Very few mothers deliver at health facilit

ies. In 2012 on average only 44% of births

occurred at health facilities. The maternal mortali

ty ratio for PNG is estimated to be 230 per

100,000 live births. Whilst PNG has maintained its

polio free status since 2000, there have been

breakthrough measles outbreaks in 2005 and recently

in 2013-2014.

Communicable diseases continue to be the major caus

e of morbidity and mortality, with malaria,

tuberculosis, diarrheal diseases and acute respirat

ory infections at the top of the list. Studies

conducted by the Institute of Medical Research PNG

indicate an incidence of malaria is on the

decline. Tuberculosis (TB) remains a problem of pub

lic health significance with drug resistant

strains becoming increasingly common and extremely

drug resistant (XDR) TB being reported in

some areas. The HIV prevalence amongst pregnant wom

en has stabilized at 0.56% (2013).

The 2007 STEPS report indicates that noncommunicabl

e diseases (NCDs) and related modifiable

risk factors are prevalent in PNG with adults at in

creased risk of developing chronic diseases.

77.7% of the population surveyed was at moderate ri

sk and 21.1% at high risk for NCDs. According

to the Household Income and Expenditure Survey (201

0), 48.2% of children less than 5 years were

significantly shorter than the reference population

and 27.2% weighed significantly less.

Challenges include a rapid population growth; limit

ed access to services, high maternal mortality

ratio, dual burden of communicable and NCDs, shorta

ges of HRH and essential medicines,

insufficient funding for service delivery and weak

management capacity.

HEALTH POLICIES AND SYSTEMS

The

PNG

health delivery system is heavily decentralized. Un

der the National Health Administration

Act (1997) and the Organic Law on Provincial and Lo

cal level Governments (1977) health service

delivery is fragmented between NDoH and provincial

governments. The Provincial Authority Act

(2007) establishes a system of Provincial Health Au

thorities (PHA) which integrates the

management of hospitals with that of rural health s

ervices. Under this Act, the PHA Chief Executive

Officer has direct management control over health f

unction grants and health workers, with the

potential for improved staff supervision accountabi

lity.

The National Health Services Standards (NHSS) of 20

11 define seven levels of the PNG health

service delivery model, minimum standards for healt

h facility infrastructure, minimum staffing

levels, standard equipment lists for each level of

service delivery and an accreditation system for

hospitals and health centers. In 2012 the 10