An project cofinanced by ADB is starting to make progress on expanding health coverage to underserved rural areas.
As our Land Cruiser pulls up the rugged road, winding through the Tambul Valley in the Western Highlands Province of Papua New Guinea (PNG), I am reminded of the remoteness of the areas where nearly 90% of PNG’s population of 7.3 million lives.
Without access to transport, how would a pregnant woman negotiate the long journey to the nearest health facility? When she managed to get there, would it provide a welcoming and safe environment for her to deliver? The reality in PNG is that this is often not the case and over half of births still take place outside of a health facility, often with severe consequences in the form of both infant and maternal health and mortality.
In a country that saw nearly 10% economic growth in 2015, it is almost inconceivable that 1,500 women die during childbirth every year due to lack of rural health services.
Upon entering the village of Alkena at the end of our 3-hour road journey, I start to hear the beat of drums and singing by various tribes who have gathered dressed in full traditional costume to greet us. Their immense excitement is because our arrival marks the official handover of the newly constructed community health post financed by the Rural Primary Health Services Delivery Project (RPHSDP) that will provide health services to over 11,000 people.
The residents were proud that their village had been selected as one of the locations picked by the project, and felt ownership of the health facility given that a number of locals had participated in its construction. Alkena is the second health facility to open under the RPHSDP, a multi-partner project with major funding from ADB and the governments of Australia and PNG. It will deliver 32 community health posts to 16 districts, together with provincial investments in health worker training, digital information systems, and middle management training. These additional investments will ensure local capacity building and ownership once the Alkena health facility becomes a fully functional rural health service delivery point.
Prior to the establishment of the new health facility, primary health services in Alkena were provided out of an old poorly lit trade store where some 75 patients a day turned up due to lack of a better alternative. With no beds or equipment, the facility was unable to perform supervised deliveries, and struggled to provide quality health services. Indeed, it showcased the neglect that the health sector has experienced in rural areas of PNG over the past decade despite the abundance of oil and natural gas reserves that have helped the country prosper economically.
Among the consequences of the lack of investment in primary health in PNG are that over a third of infants are not fully immunized, infectious diseases like tuberculosis are spreading and becoming more dangerous as they develop resistance to standard drug regimens, and—most importantly—PNG people are dying prematurely, with about one in three dying during productive life, compared to about 1 in 20 in Australia.
The initial results from the first community health post opened under the RPHSDP in Milne Bay are encouraging. A monthly average of 8-10 deliveries are performed and 15 inpatients are treated. By constructing health facilities that meet national standards, equipping them with the right supplies, training staff to perform their tasks and providing them accommodation to remain on site, the RPHSDP is supporting PNG’s goal of reducing urban-rural health disparities. In addition, the project is piloting a digital health information system that providing (for the first time in the country’s history) real-time, accurate health facility reporting. This enables health management officials to analyze and better understand health-seeking patterns in rural communities and use the data to identify disease outbreaks.
The next stage of the RPHSDP will be to strengthen local health governance to ensure that the health facilities are maintained and stocked with essential drugs, and expand investments to improve referral hospitals. The project is a-long term partnership with various levels of government, and will continue to support them to invest and realize the full economic potential of PNG’s most valuable asset – its population.