Lecture #7 Health Services
Page 1: Introduction
Health Services in Papua New Guinea presented by Mr. Yagahe, FMHS-Health Extension Department.
Date of presentation: 3/6/2025.
Page 2: Health Administration in PNG
Health administration is a joint responsibility between:
Department of Health: responsible for policy, decision-making, and resource provision.
Provincial Health Authorities (PHAs): responsible for implementation.
Recent changes due to decentralization policy empower PHAs to plan and manage their own health services.
Page 3: Primary Healthcare
Definition: Primary healthcare is essential for addressing most health needs throughout a person's life (as defined by WHO).
Features of Primary Healthcare:
Accessible close to home.
Addresses individual, family, and public health needs.
Encompasses health promotion, disease prevention, treatment, rehabilitation, and palliative care.
Page 4: PNG Healthcare Delivery Network
Structure includes:
Government & Church hospitals.
Health Centres.
Sub Health Centres.
Aid posts.
Community Health Posts.
New concept introduced by the Provincial Health Authorities (PHA).
Page 5: Department of Health Structure
Ministry of Health led by the Minister of Health.
Department of Health led by the Secretary of Health.
Key assistive roles include:
Two first assistant-secretaries.
Three assistant-secretaries overseeing divisions:
Health Improvement
Health Care
Health Planning and Research
Medical Training
Finance and Management
PHA led by the CEO and Directors for various sectors.
Page 6: Historical Perspective of Health Officer Responsibilities
Previous structure had Provincial Health Officer as Assistant Secretary for Health Division.
Under PHA, new roles established for managing various health aspects like Malaria, Family Planning, and more.
Page 7: Provincial Health Officer (PHO) Responsibilities
PHO accountable to the Administrative Secretary of the province.
Collaborates with other sectors for:
Construction of health facilities.
Infrastructure like water supply and sewerage.
Health planning activities.
Page 8: POM General Hospital
General Hospital overview unavailable; simply titled for future information.
Page 9: Health Centre Functionality
Typically staffed by:
Health Extension Officers.
Nurses.
Nurse aides.
Health inspectors.
Serves population between 5,000-20,000.
Subcentres operated often by church groups provide additional care.
Page 10: Health Sub Centre Characteristics
Represents primary healthcare delivery level.
Services about 2,000-10,000 population.
Managed by Nursing Officers supported by Community Health Workers (CHWs).
Responsible for supervising and supplying essential drugs.
Direct referrals to hospitals are not common.
Page 11: Urban Clinics Overview
Created to alleviate hospital influx for primary health issues.
Managed by Nursing Officers, with a rising trend in Health Extension Officer (HEO) recruitment.
Generally serving a population of around 10,000.
Capable of urgent referrals to base hospitals.
Page 12: Aid Posts
Most peripheral health units, overseen by an aid-post orderly.
Serves a population of 500 - 3,000.
Operational supervision may come from either health sub-centres or health centres.
Page 13: Comprehensive Health Services
Includes:
Medical Care
Immunization
Sanitation
Health education
Nutrition
Maternal and Child Health (MCH)
Family Planning and Disease Control.
Services at government facilities are generally free; church-run facilities may charge fees.
Page 14: Role of Health Manpower
Traditionally revolves around doctors as central healthcare figures.
Focus on effective management of health teams in urban settings under decentralization policy.
Page 15: Health Provider Cadre Development
In 1979, major health personnel included:
Doctors, health extension officers, aid post orderlies, nurses, nurse aides, health inspectors, and health educators.
Emerging roles include health managers, physiotherapists, and radiotherapists.
Page 16: Aid Post Orderlies (APO)
Basic health workers providing services in rural areas.
Training conducted by the government and churches, adapting from previous aid-post orderly schools to CHW schools.
Annual training aims to fill roles created by retirements and new positions.
Page 17: Nurse Aides & Community Health Workers
Nurse aides and aid-post orderlies are crucial primary health workers.
Work in various settings (aid posts, health centres, hospitals).
Government and church institutions responsible for training (just over half of aid posts currently unmanned).
Page 18: Evolution of Health Extension Officers (HEOs)
HEOs bridge primary and advanced health services, trained for comprehensive care.
Responsibilities include liaising with various health authorities and management of health at centers.
Page 19: HEO Qualifications
Requirements for HEO at DWU include:
Academic performance in key subjects: English, Maths, Biology, Chemistry.
Training duration of 4 years at College of Allied Health Sciences.
Page 20: Nurse Officers Introduction
Nurses provide comprehensive healthcare and work within community health programs.
Historical training and current evolution in training institutions.
Page 21: Basic Nurse Training
Transition from multiple types of courses into a streamlined three-year general nursing program with updated academic standards.
Availability of post-basic training and graduate courses in various nursing fields.
Page 22: Role of Health Inspectors (Environmental Officers)
Health inspectors focus on:
Pollution prevention.
Wholesome food and safe water.
Waste disposal, housing, and health facilities.
Page 23: Environmental Health Priorities
Health inspectors play key roles in water supply initiatives and overall health improvements.
Page 24: Training of Environmental Health Officers
Training has evolved to new methods and institutions to ensure effective public health management.
Page 25: Medical Officers (MOs)
MOs provide comprehensive health services and supervise rural workers.
Transition of medical training within PNG and localization efforts.
Page 26: Health Centre Management
Day-to-day operations of health centres rely heavily on Health Extension Officers.
Effective support and management critical for service delivery.
Page 27: Previous Primary Healthcare Network System
Illustrates hierarchical structure of primary healthcare services in the past.
Page 28: Levels of Public Health Care System
Overview of the various public health service levels, core services, and responsibilities at each tier in PNG.
Page 29: References
WHO, (1981) "Final Report of a Technical Assistance Study" related to health services in Papua New Guinea.