In his recent maiden speech in the parliament house, Prime Minister James Marape promised to improve the public health system of PNG. But what does he really mean? What does he mean by IMPROVEMENT!
The PNG government already has a National Health Plan, launched in 2022, with the theme Back to Basics. The said national plan simplifies the actions that are required to reach pre-defined key performance indicators. The plan focuses on improving Primary Health Care and intends to improve Universal Health Coverage.
I am hoping that when PM Marape said he plans to improve the health system, he meant funding the national health plan so that the national health plan is implemented fully. At least 80% implemented.
Despite the growing media coverage on the increasing burden of diseases caused by Non-communicable Diseases (NCDs) – diseases such as cancer, high blood pressure, diabetes etc, primary healthcare is not available to majority of the people. Services such as immunisation, antenatal care, treatment for common health issues such as diarrhoea, cough, fever and many more. Many people in PNG still struggle to access and utilise services to treat these many simple health conditions. That is the nuts and bolts of primary healthcare.
I think PM Marape’s government should focus on improving the AVAILABILIITY and ACCESSIBILYTY of primary healthcare services.
Availability means making sure there are adequate trained healthcare workers employed at Aid Posts, Health Centers, District Hospitals and the recently launched Community Health Posts. This will mean not only increased recruitment but also ensuring those already working in these health facilities are retained. Have a ATTRACT AND RETAIN POLICY FOR HUMAN RESOURCES.
Availability means making sure 80% of all ESSENTIAL medicines are available at Aid Posts, Health Centers, Community Health Posts and District Hospitals.
Availability means making sure basic diagnostic and monitoring medical equipment are available and functioning at Aid Posts, Health Centers, Community Health Posts and District Hospitals.
Availability means making sure Aid Posts, Health Centers, Community Health Posts and District Hospitals are refurbished, renovated and functional, at least at 80% capacity.
The next thing PM Marape’s government should focus on is accessibility.
Accessibility means improving physical access. This means making sure all rural roads are improved and maintained.
Accessibility means improving law and order problems so that people feel safe going to health centers for services, and that they will not be robbed or killed.
Accessibility means improving financial barriers. This means making sure services are FREE or subsidized by government so people do not pay large out-of-pocket costs for primary healthcare. Removing financial barriers also means improving microeconomic environment where large proportion of PNG live (ie rural, settlements) so that people have income generating activities to pay for the costs of accessing and using primary healthcare services.
Accessibility means removing cultural and other social barriers preventing people accessing and using primary healthcare services. This means dealing with ethnic and tribal conflicts, dealing with gender issues at the community level and the like.
Accessibility means streamling and prioritizing services to cater for vulnerable segments of the population (e.g. women, girls, children, disabled , internally displaced people etc) so that these segments of the population have equitable and equal access to primary healthcare.
So Mr, Prime Minister, I ask you, What do you mean when you say you will improve the public health system of PNG?