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Analysis of Current Public Health response to comprehensive/Selective primary health care and maternal Mortality in Papua New Guinea 4 Essay Example

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Topic: Analysis of public health response to not only comprehensive and selective primary health care but also Maternal Mortality in Papua New Guinea


Papua New Guinea is a country in Asia-Pacific region bordering Papua Indonesia and Australia. It has a population of 7.321 million (WHO, 2010). It the world’s most diverse country as far as native language is concerned; more than seven hundred. Basically, eighty percent of its population live in rural areas where modern facilities are scarce and those present have poor quality. It is naturally rich in resources like forestry, minerals, copper, Gold and petroleum. However, being one of the most rugged terrains in the world, the exploitation of these resources is limited. It is believed to be one of the countries with high biodiversity and harbors most endangered animal species.

Analyzing current Public Health response from both comprehensive and selective primary health care to maternal mortality rate in Papua New Guinea is a crucial in development. The purpose is to identify the responses, current rates of maternal mortality strategies put across to address poor health status in Papua New Guinea. The maternal Mortality Rate is 1 is to 20 compared to Australia which is 1 to 10 000.

The aim of this essay is to identify, explore, analyze and summarize both comprehensive and Selective Primary Health Care status in Papua New Guinea. It will also scrutinize Maternal Health, rates of Maternal Mortality rate and the strategies put across to help curb the menace. In addition, efforts towards achieving Millennium Development Goals will be addressed.

Millennium Development Goals and efforts made in PNG

The Millennium Development Goals are envisioned as roadmap to development especially in the third world countries (Brown & Gilbert, 2014).They were conceptualized in United Nations Millennium Declaration at the Millennium Summit in the year 2000 month of September. They are all intertwined and one can hardly be achieved without the other. All the problems they try to solve could be otherwise termed as complex. Annihilation of life-threatening poverty and food shortage is the basic Millennium Development Goalmouth, however, empowerment to all citizens and environmental sustainability have be achieved as well. The main focus of this essay is primary health care both comprehensive and selective not leaving out the crucial maternal Mortality.

Basically, Papua has not been successful in achieving most of the set goals towards the Millennium Development Goals by 2015. Gender disparities continue to deepen in the country. The more women are less empowered the more vulnerable they stand as far as Maternal Health is concerned. Communicable Diseases such as HIV/AID, Malaria, Tuberculosis and acute respiratory diseases continue to be causes of death in the country. Poor water quality fuels water borne diseases (Wilkison et al. 2015). Poor communication systems and low literacy levels have cultivated poor global partnership. The country has dependency syndrome since all HIV programs are suffer hence increased mortality cases.

Challenges Facing Realization on Millennium Development Goals in PNG

High population growth rate which has remained at two percent each year. The high fertility rate in the country has resulted to broad age sex structure. Meanwhile, the economic growth has been critically low compared to the population growth (Brown & Gilbert, 2014). This is great challenge because economic growth is directly proportional to poverty alleviation or stagnation.

Poor governance in PNG has resulted to political instability. Ideally, to successfully realize the MDGs, good transparent governance is a crucial prerequisite. Tribal alignment of political parties in the country is an indicator of failure in this civilized era. In addition, there are many governmental departments most of which are duplicated at the provincial level (Brown & Gilbert, 2014). In my own opinion, the high cultural diversity of the country could have been effectively managed by a simple government to avoid unintended wrangles. Due to the high number of departments, there is high corruption, misallocation of funds and embezzlement of funds purposed for public use.

Spatial disparities, environmental degradation and low literacy levels have stalled efforts to achieve some of the goals. The population is sparse and some places are highly inaccessible due to poor infrastructure and rugged terrain. The low literacy levels have led to most people practicing subsistence farming rather than venturing in commercial farming and seeking white collar jobs. They continue to lurk in poverty due to failure to exploit their rich resourceful country (Brown & Gilbert, 2014).Gender culture and gender disparities have led to marginalization of women in the country Gender Based Violence in rampant in the country which places women at a vulnerable position in times of war, disease outbreaks and societal leadership opinions. Is such a Gender culture rooted country, then empowerment of women is difficult and much has to be done through inclusive participation of both women and men.

Exploration of Dr. Barry Kirby’s work

According to Dr. Kirby, PNG consists one of the uppermost Maternal Death rate worldwide. He has highlighted the Three-Phases-Model which explains the factors associated with the menace. The first phase entails the period in which a birth attendant realized that there is a problem until seeking assistance decision was made. In my opinion this phase has to take the shortest time possible lest further complications arise. The second phase is the period between agreement to seek help and arrival at a health facility. Lastly, the time spend in the health facility which is the most crucial phase. All these phases are brought about by several factors, For example the distance between the place of decision making and the health facility. The infrastructural status and availability of reliable means of transport. At the health facility, the availability of competent birth attendants is crucial. In addition availability of adequate space to accommodate the patient is a key factor determining the success of the delivery.

Dr. Kirby outlines a case study of Lyneth a thirty two year old woman who experienced heavy bleeding after delivering at home. She resides in Lomitawa village. From the case, there was no means of effective transport since her husband was advised to make a stretcher to take her to hospital. On his way back he met a messenger who informed him of his wife’s demise. This is an implication that there is lack of modern means of communication in the area.

In his study, he discovered that women do not like delivering in hospitals due to a number of reasons. Some argued that they were shy since they lacked baby clothes. They considered it an embarrassment (Kirby & Gawin, 2015). Others claimed that their lame literacy would hinder communication between then and health practitioners. Some said that poor transport gets them trapped in the villages due to early labor onset.

Public Health and its role

It entails improving and protecting the health of individuals through promotion of healthy lifestyles, research, detection and prevention of diseases and injuries. The key providers are government public health facilities and agencies (Wilkison et al. 2012). They build partnership with other local non-Governmental agencies in order to coordinate or provide services to the communities they serve. Public Health agencies foster community initiatives to improve health conditions and promote health through various ways. They collect data, create awareness to the public either through door to door or community forums. This helps in data dissemination and empowerment of the public. It also their role to regulate any possible risk causes such as unsafe water and hazardous air pollution.

Selective Primary Health care was adopted from the broad primary health care in the Alma Ata declaration. It entails focusing on diseases on the basis their causes, prevalence rate. Mortality risks, morbidity or severity and feasibility of control (Cueto, 2004). Comprehensive Primary Health Care is a global framework formed to not only reduce inequities between and within nations but also influence community participation.

Maternal Mortality Rate status

Basically, women play triple roles in the society: reproduction, production and managerial. The death of a mother thus affects the society tremendously. In case infants are left behind, their growth and development is affected both physically and psychologically. The rate of Maternal Mortality rate is still high in PNG which stands at one in every twenty (WHO, 2016).In PNG, only forty four percent of the deliveries are done in hospitals. The life expectancy for women is sixty five compared to that of men which is sixty years.

The causes of Maternal Mortality in PGN are mainly pregnancy complications like heavy bleeding, infections after child birth, unsafe abortion and high blood pressure (Watson et al. 2015). Communicable diseases such as Malaria and Tuberculosis account for the rest. These can be controlled if efforts are made to improve the health facilities infrastructure.

Public Health Response to Selective and comprehensive Primary Health Care perspectives

Basically, public health agencies have put efforts to create awareness about various communicable disease such as Tuberculosis, Malaria, diarrheal diseases and acute respiratory diseases. They have collaborated with non-governmental organizations and the Burnet Medical Research to find information on how to deal with these diseases. As far as Selective primary Health Care is concerned, research has been done on HIV/AIDs which have seen it as one of the causes of mortality in the country. This is rooted on the strong cultural beliefs in the country. Use of mobile phones in the health facilities by health attendants has eased communication in health facilities (Yaho, 2013). Increased adoption of the practice even in the rural areas could realize improve response to cases.

Public Health agencies have used the comprehensive approach in community enlightenment. However, the limited number of Human Resources in health inhibits the success of this approach (Kotze, 2010). The spatial disparities in most PNG villages and poor infrastructure hinders the success of some awareness creation projects.

In my humble opinion, successful response of public health to these two perspectives requires Intersectoral collaboration (Kotze, 2010). Housing, health, finance, infrastructure, environment and education. Public health agencies will not succeed in research and community awareness creation in a country where the roads are impassable and the areas which need more concern are inaccessible. The low literacy levels among these people also hinders good communication since they have diverse native languages. Inadequate human personnel strains the available ones and renders some facilities to lack.

Public Health Response to Maternal Mortality

Maternal Mortality is a key issues of concern in PNG. Awareness creation through door to door and community forums is a positive response from the public health. Collaborating organizations such Burnet Medical Institute have done good job to research on the need to integrate men in family planning lessons (Wilkison et al. 2011). This is because the uncontrolled population growth puts the mothers at risk. According to research done by WHO 2016, most women were on their six pregnancy. Ideally, these are many children per woman in a country where poverty levels are very high.

I support the efforts made by the public of health in PNG, however, there is much to be done. Lobbying needs to be done for concerned ministries to empower their citizens with education, life skills and opportunities to access quality health care (Thackery et al. 2012). Access to credit facilities especially to women is very important to empower them economically. Adoption of current technology and decentralization of resources will help them realize the Millennium Development Goal five. This is because empowered women have a voice for themselves and can advocate for change as far as maternal health is concerned.

Media and access to information in Papua New Guinea

Access to information is key to power and empowerment. However, it is surprising that in PNG most people, get information through local radio channels. Televisions are only available in the capital city and provincial centers. In addition, due to poor funding, most local channels were pulled off air. The remaining ones are BBC 106.7 and Radio Australia. Media is source of information especially on family planning and maternal health. This is one of the channels public health uses to create awareness and enlighten the public. Therefore, much needs to be done in PNG to ensure at least three quarters of its population have access to media.


In summary, Papua New Guinea is a country which needs empowerment from all dimensions. They need economic empowerment, technology to exploit the rich natural resources and education so as to liberate their citizens from poverty. Public Health is a crucial department in health and thus requires adequate skilled personnel and finances so as to critically enact the Selective and Comprehensive Primary Health Care in Maternal Health and other health issues in the country. Collaboration and systems thinking will liberate this country


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