The Papua New Guinea National Health Conference is on this week in Port Moresby and the Government has launched the National Health Plan 2011-2020.
It is planned that the government will spend K1.2 billion (US$ 400 million) starting next year, up from K900 million (US$ 300 million) in 2009. An increase of K100 million (US$ 300 000). When launching the plan Deputy Prime Minister Don Polye said ‘the implementation must take place at the local level government to ensure improvement of health indicators in the districts”. I could not agree more on this statement. This is because I am working at a district hospital and I see exactly what needs to be done! The media reports on the launching were very brief but I would be interested in the details. According to the health minister, trained health workers will now be able to make outreach patrols into remote areas. How exactly do you plan to do that minister? Do not get me wrong. I am a supporter of Minister Zibe because he is focusing on rural health, which has been a lip service from previous governments. But working here in a district, the problem is with the implementation of the plans. It has been and I am afraid to say it may be for the new health plan 2011-20.
For the Wapenamanda district, there are only two doctors, for a population of over 80,000 (from last census – 10 years ago!). Papua New Guinea’s population is growing at 2% per annum. This figure has definitely gone up! I want to make rural health centre visits but I do not have a car – a four-wheel drive landcruiser – that is. The road is really bad into the remote areas. Is the health plan in line with rural infrastructure development? Is there something in this new plan for drs in districts to have supervisory vehicles? Will there be extra funding to cover the running costs of this vehicle in this new plan? (on assumption of course). Or will poor district hospitals will have to dig deep into their operational accounts to cover extra costs? Will there be extra funding for districts to extend MCH clinics or give annual in-service for health workers in health centres on essential obstetric care?
I did only one supervisory visit last year. The car was hired. The fuel was provided by the provincial health office. Since than no more visits! The single most common thing aired by the health workers was lack of on-going in-service. I hope this new health plan takes professional development for rural health workers into account as well. By the way, there was no extra allowances when I did my visit, which should be the case, because patrols and supervisory visits should be part and partial of routine district health services. Not “extra” work where health workers claim allowances. I just hope that this increase in health expenditure will not be spent on “administrative costs” with little to show to actually make a difference in our vital statistics.
I also hope that the bulk of this increase in health expenditure will go to church health services. Not provincial or district health offices. It is a fact that the rural health service in PNG is done by the churches medical agencies. Will there be an increase in funds to these church run medical agencies? The only district hospital in the Wapenamanda district is run by the Gutnius Lutheran Church. Will we get an increase in funds to cater for health centre visits or to extend MCH clinics? Or leave the rural outreach programs to the district health managers? We work in partnership but sometimes there are invisible walls that seem too hard to break. The government rural health services has deteriorated and it is the churches who are providing that service and I strongly believe that the churches medical agencies should get a larger piece of the cake.
I can’t wait to get my hands on the 2011-20 national health plan document to see the ‘road map’ government has produced to guide us to deliver health services to rural PNG. I know I am and will be doing my share of the workload.