Professor blames rural health deterioration on decentralisation

UNIVERSITY of Papua New Guinea’s Professor of public health Paul Crouch Chivers says rural health services collapsed after the health system was decentralised in the 1990s.
“Poor maternal and infant mortality rates, which are indicators of the quality of rural health care delivery, are testimony to the collapse,” he said.
Prof Chivers said the Health Department had lost touch with supervision and support it used to offer to provinces and districts.
“No one in the provinces and districts is driving the rural health and the initiative is left
to the people on the ground,” he said.
Prof Chivers and gynecologist Dr Glen Mola  said: “When decentralisation started in 1996, the management of the health service was taken away from the department and placed in the hands of district administrators who knew nothing about health.
“In a Government health centre, when nurses don’t turn up to work, does the district administrator check to see if they are there? No,” said Dr Mola.
“If they (nurses) have a problem and they front up at his (district administrator) office and ask if he could fix it, he’d say ‘it’s an issue for you nurses and doctors’,” he said.
Dr Mola said, from experience, less than 50% of health workers at health centres in the country go to work but still got paid.
They said these were some of the reasons contributing to the deteriorating maternal and infant mortality rates in the country.
Prof Chivers, who has spent more than 30 years in the country, said villagers built traditional houses near schools for students who came from villages that were far from the school.
“Such houses could be built near health centres for pregnant women to live in until they go into labour and deliver at the health centre,” he said.