I have now worked in rural PNG doing primary health care activities for nearly 3 years now. I have worked in a district hospitals, health centres and even doing clinics in villages and Aid Posts. The question that I ask and maybe everybody is asking is why aren’t health workers stationed in rural health centres or Aid Posts nowadays?
I have come across abandoned Aid Posts because there have been no health worker stationed there for several years. And it’s usually the Community health Worker (CHW) who are based in these rural centres delivery primary health care. Currently I am involved with an exploration project in the remote parts of East and West Sepik Province. And part of our corporate social responsibilities is to assist in health services. I have seen the same pattern here. No CHW in the abandoned Aid Posts!
There is one fact in PNG now is that there are not many CHW training schools opened. Maybe less than 10.
So what is preventing health workers to be based in rural health centres, let along rural hospitals?
I was once of the opinion that it is because they are not paid enough. But now I have come to the conclusion that it is not just pay, it’s more than that. How can you expect a CHW based in a remote health centre with no road or airstrip come to the district centre or nearest town to collect their pay? or communicate with relatives or friends where there is no phone coverage? or attend in-service courses regularly for their professional development? or send their children to a properly resourced school? We can not really expect health workers to be based in rural health centres and Aid Posts when all these things which make life a little easier and bearable are absent!
It will take a broader and long-term approach to really deliver primary health care to remote and rural PNG. It’s a development issue to bring health workers to rural and remote PNG. Delivering primary health care is not just about constructing a building, AKA Aid Post, put in a VHF radio, construct a bush material house for the CHW, put in solar operated vaccine fridge and basic drugs and consumables and put a human being called a “CHW” and expect primary health care to be delivered. These approaches will only work 40% of the time. What about the remaining 60%?
I heard Dr Puka Temu, former Health Secretary and former Health Minister say once that “health interventions solve our health problems only 40% of the time. It is the non-health interventions (essential infrastructure, education, communication etc) that will account for the 60%”.
Conclusion: Delivering rural health service is a development issue. Not just a health issue.
Hi Rodney,
Fantastic site! As a way on introduction my name is Jonathan Claydon, I’m a third year resident/Junior Intensive Care, Emergency Registrar in Melbourne Australia. I have a great interest in Health Care and Health Care outcomes in PNG having visited a number of times over the last four years.
Myself and a number of my colleagues here in Australia, and some within PNG have recently formed a new organisation PNG Health Partnerships, we aim to improve healthcare outcomes through Partnership, Education, Exchange and Equipment.
We have a new website:
http://www.pnghealthpartnerships.org
Please have a look and tell me what you think. It remains somewhat a work in progress but it’s getting there. I encourage any constructive criticism!
cheers,
Jonathan Claydon
President and Co-Founder PNG Health Partnerships
Partnership, Education, Exchange, Equipment
Thanks Jonathan. I will visit your site too. Maybe we can explore ways of working together. I will email you.
Hi Rodney,
This is what I see as the syndrome of health system failure in PNG.
No district health, no provincial health, NGOs, Church run facility or the national health can address this issue.
Even if they do, they will not sustain those isolated facilities (aid post) or the health worker rendering the services.Except those few rare ones.
We are holding symposiums and seminnars in PNG on HIV, lifestyle diseases,TB, new research break through and new treatment protocol, but not on those providing the service.We are on the fringes of this countrys health delivery system.Serving the bulk of our people and a buffers to our burdened health centres and hospitals.
Being a health officer by profession, I suggest there must be a conference (annual) were the OICs, DHOs, health avisory/secretariat,national health department,policy makers and government representatives convene and start making headway on this problem.
I am seriously thinking of organising one.
Do you think you can help or anyone ?
My email is matthewmangre@gmail.com
As you well put it is more a development issue than a health issue.But I see both.
Very true and I think it would be a good idea. We need more applied and systems research – data we can use to improve our current systems. But then again, we seem to have good systems and policies but implimentation is the a real concern.
I’ll right away grab your rss feed as I can not find your e-mail subscription hyperlink or newsletter service. Do you’ve any? Kindly let me know so that I may just subscribe. Thanks.
click the “subscribe’ icon to subscribe. Its on the Home page. Thanks. Best
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