Key Result Area (KRA) number 1 of the PNG National Health Plan 2021-2030 is Healthier Communities Through Effective Engagement.

There are 3 objectives to achieve KRA 1.

1 – Improve access for Communities to a range of people centered services.

2. Implement sustainable community-based options for delivering
health promotion, awareness, and preventive activities.

3. Strengthen Primary Care through Health Promotion, Prevention and Protection.

In this post I do not want to comment on how the 3 objectives can be achieved. But I want to ask some probing questions to examine the KRA.

To begin with I want to start with the first word – Healthier. How is health defined here? I am assuming Health is defined in its broadest sense as defined by the World Health Organisation, which is not merely the absence of disease. However, a closer look at the objectives indicate that the objectives are directed at clinical care. How about other aspects of health?

Secondly, I examine the word Effective. Here it is referring to effective Engagement. This means, any intervention implemented to achieve KRA 1 has to be assessed to be EFFECTIVE. Or that there must be mechanisms in place to ensure that strategies that are implemented are effective. How will being EFFECTIVE be measured and monitored? Will effectiveness be measured/monitored using quantitative indicators, qualitative tools or both?

Although KRA 1 indicates improving community health, the objectives appear to be individual level/clinical care level points of intervention. I would have thought that more broader community level engagement and empowering interventions would be the best approach.

The highest burden of health problems continue to be infectious diseases compounded by an ever rising prevalence of non-communicable diseases (NCDs). The health plan fails to identify the social determinant of health that are the key drivers of the burden of diseases treated at health facilities throughout PNG. KRA 1 focuses on improving community access to primary healthcare services but unfortunately does not have a strategy to target social determinants of health at the community level by having strategies aimed at empowering communities to take action at the community level to improve the health of the community. It appears to me that KRA 1 reflects a dependent mindset – makes the assumption that the government will make the community healthier. KRA 1 does not show or indicate that the PNG Health Plan intends to empower the community to take action. To empower the communities to take ownership of the health problems in their communities by identifying and improving the driving factors – the social determinants of health in their communities.