I think global actors have a big influence in policy development and health system restructuring in Papua New Guinea. So you may be wondering – are we really shaping our health policies and health systems? Or are there other players that shape and influence how we are writing our health policies and reforming our health systems?
Global health actors help the government write policies and provide technical advise at the national level. Sometimes at provincial level but most times it is at the national level. Global health actors also provide human resource capacity training – either by funding the training or directly providing the training.
Sometimes, global health actors influence how money is spent and where it is spent. This is not surprising because almost always, health sector spending by global actors tend to be strictly controlled due to stringent reporting, monitoring and evaluation requirements.
Faith based organizations have been and continue to provide critical health service in rural PNG. But they are more influential at the local and community level. Sometimes, depending on the size of the organization, faith based organizations/NGOs are influential at the national level.
Private companies are another group of important health actors/drivers in PNG. They work under the private-public-partnership agreements and influence how and where money is spent. Most times, their area of influence is specific and narrow focused – either to specified programs/activities or limited to specific geographical areas within which the companies operate. Private companies can also influence health department and national government to buy their products.
This table show the main donors to Papua New Guinea. Clearly Australia is the biggest donor to PNG.
Most global health actors operate in technical advisory roles, consultancies, bilateral agreements, multilateral agreements and other forms of agreements with the national government. They have little presence in the communities.
Faith based organisations/NGOs on the other hand are very engaged at the community level. They also have very strong link with local, district and provincial governments. They are mostly independent of the national department of health.
Churches provide up to 50% of health services in PNG. “Churches are also active in training health care workers: administering 2 of 3 universities providing health worker education, 5 of 8 general nurse training institutions and all 12 community health worker training schools in the country” (Mapira & Morgan 2011).
This table clearly shows all rural health facilities are operated by churches in PNG.
Some NGOs (non faith-based organizations) are active in reaching the poorest, marginalized, minority groups and stigmatized. Some have been active at the village level providing care to HIV/AIDS/victims of violence, victims of domestic violence, victims of sorcery related violence and the like. Started by individuals from the community. Unfortunately these organizations are limited by funding constraints and sometimes their vital services are not sustained.
Overseas based NGOs have a lot of funding and have many operations in PNG and are very important. But these actors are short term and their activities are project based. Therefore not sustainable.
•National Department of Health, & World Health Organization. (2016). Papua New Guinea–WHO country cooperation strategy 2016–2020. http://iris.wpro.int/bitstream/hanlde/10665.1/13444/WPRO-2016-DPM-005-eng.pdf?ua=1, accessed 23.10.2019
•Mapira, P., & Morgan, C. (2011). The contribution of church health services to maternal health care provision in Papua New Guinea. Papua and New Guinea Medical Journal, 54(3–4), 139–146.