The successful implementation of the PNG National Health Plan 2021-2030 will be heavily influenced by how each of the Provincial Health Authorities (PHAs) execute this plan at the provincial and district level. The health plan is guided by other government policies and the key ones are the PNG government medium term development plan (MTDP) and the PNG development strategic plan (DSP). Both of these policy documents stem from the PNG National Development Plan – PNG Vision 2050.

However, the major challenge (and has always been) is how to operationalise the PNG Health Plan. Many transformative health plans have come and gone, but reviews of the implementation of past health plans has always shown that no single health plan has even been operationalise successfully. I agree with many commentators/researchers and health leaders that PNG is not an easy plan to deliver government services. Many of the well recognised challenges remain – geography, poor civil infrastructure (road, bridges, airstrips, wharfs, jetties etc), security problems (ethnic wars, crime), unmotivated health workforce, complex/fragmented pharmacy procurement/deliver system and corruption. These barriers are not easy to fix and certainly will not be fixed by the year 2030, by which time the current health plan will be up for revision and a new health plan will be written up.

The success of the PNG Health Plan 2021-2030 is dependent on how successful the MTDP and the DSP are implemented as well. Because the PNG Health Plan is linked by policy to these two policies – MTDP and DSP. If the MTDP and DSP are not successfully implemented, many of the Key Result Areas (KRAs) in the PNG Health Plan will not achieve their intended outcomes. The Health Minister and the Health Secretary (plus his team) will need to make sure that other government ministries support the health plan through the MTDP and DSP. This leadership will be required at the national and political level.

At the provincial/district level, PHAs are the implementing agency. I think some PHAs will implement the health plan more successfully than others. The reason is that some PHAs are already working successfully while some are struggling to function. I think those PHAs that are operating well now will run with the health plan. While those PHAs that are struggling to make the PHA structure operational will lag behind, worse they may fail to implement the health plan. If this happens, PNG may see a greater disparity in health outcomes around the country by region and by province.

The PHAs will need to work very hard to establish and nurture good working relationships with the national health department, District Development Authorities (DDAs), the local level governments (LLGs) and the church run health facilities. CEOs of PHA will need to realise that their responsibilities does not lie only in making sure the hospitals and health facilities are functioning but must realise that their role is more broader. Ensuring the key implementing partners in their provinces (Church run facilities, DDA and LLGs) are onboard to implement the health plan must be their number one priority. PHAs can not do it alone but PHAs must provide the leadership and direction in the provinces.