Health challenges

Letters

PAPUA New Guinea has major health challenges.
Among the top five causes of morbidity and mortality are those associated with PNG’s climate and environment, such as malaria and diarrheal and waterborne diseases.
But the top five list also includes vaccine-preventable diseases such as tuberculosis.
Immunisation coverage has fluctuated in recent years but is below World Health Organization (WHO) standards.
Approximately 30,000 people live with HIV in PNG.
The maternal mortality rate is very high at 230 per 100,000 live births, more than double the United Nations Millennium Development Goal target set for PNG in 2015.
The number of people affected by non-communicable diseases, including cardiovascular and respiratory disease, cancer, and diabetes, is also increasing.
Non-communicable diseases were responsible for an estimated 44 per cent of all mortality in 2008, up from 37.9 per cent in 2004.
Cardiovascular diseases accounted for 21 per cent of this mortality rate, with cancer accounting for 8 per cent, respiratory diseases 5 per cent, and diabetes 2 per cent.
Although these challenges are worrying, WHO statistics show that some of PNG’s health outcomes have improved.
The overall incidence of malaria declined between 2008 and 2013, with the prevalence of the parasite in the population falling from 18.2 per cent to 6.7 per cent.
And there has been a slow decline in under-five child mortality and infant mortality.
Still, despite increased levels of health spending by the PNG Government, improved health outcomes have been incremental at best and non-existent at worst.
For example, the UN Development Programme’s 2014 report on PNG notes that maternal health is poor and possibly worsening.
The report points to the Health department data from 2013 which showed that the level of antenatal care had declined in the previous three years in all regions except the Highlands and that there was an extreme shortage of skills in the maternal health field.
Treating the impact of violence against women and children is a major challenge for the health sector.
PNG has very low numbers of medical professionals per capita.
According to WHO, there are 5.3 nurses and midwives and less than 1 doctor per 10 000 people.
While some 85 per cent of the population live in rural areas, only 51 of an estimated 400 doctors work outside the capital, Port Moresby.
One benefit of a sustained period of economic growth over the past decade has been an increase in the proportion of government expenditure on health as a percentage of total expenditure, rising from 8.7 per cent in 2005 to 12.6 per cent in 2015.
Total expenditure on health as a percentage of gross domestic product rose from four per cent in 2005 to 4.5 per cent in 2015.
This is positive but more needs to be done to improve health outcomes for PNG’s citizens.
Churches have long played an important role in delivering health services in PNG.
They have carved out a niche in caring for the poorest, the most remote, and the most marginalised people and become an integral part of the nation’s health system.
Resources companies have taken responsibility for delivering health services to the districts where they operate.
Some health initiatives driven by the private sector have delivered impressive results in treating and preventing malaria and HIV.
On current trends, improvements in the delivery of health services are possible but based on the investment in doctors and infrastructure required, and the health challenges that the population faces, any improvement will be incremental at best.

ISAAC JAMES TIKINDI
DWU