The Rural Primary Health Services Delivery Project (RPHSDP) is an eight (8) year, joint initiative of the Government of PNG, the Asian Development Bank (ADB), Australian Agency for International Development (AusAID), OPEC Fund for International Development (OFID), World Health Organisation (WHO), United Nations Children’s Fund (UNICEF) and the Japanese International Cooperation Agency (JICA). There is a total of US$81.2 million available as funds or contributions in kind to implement the Project between 2011 and 2019.
The Project will be governed by a Project Steering Committee representative of the National Department of Health, Treasury and the National Department of Planning and Monitoring, participating Provincial Health Offices or, where established, Provincial Health Authorities.
The goal of the RPHSDP is to strengthen the rural health system in selected areas of PNG by expanding the coverage and quality of primary health care in partnership with both State and non state health service providers, and in so doing, to assist the National Department of Health to implement the National Health Plan, 2011-2020 as it relates to primary health service delivery in rural areas.
The selected areas of operation for the Project are;
- Enga Province’s Laiagam & Kompian-Ambum Districts
- Western Highlands Province’s Mul-Baiyer & Tambul Nebilyer Districts
- Eastern Highlands Province’s Okapa & Kainantu Districts
- East Sepik Province’s Wewak & Maprik Districts
- Morobe Province's Bulolo & Menyamya Districts
- Milne Bay Province's Kiriwini-Goodenough & Alotau Districts
- West New Britain Province's Talasea & Kandrian-Gloucester Districts, and
- Autonomous Region of Bougainville's Central & South Bougainville Regions
The Project will provide national and international consultants and financial resources to support National, Provincial and District personnel to achieve the objective of improving access to quality primary health care for those living in the remote rural areas. The Provinces and Districts will priorities, within agreed guidelines, those locations where primary health services are to be enhanced. Health facilities available to the general public and operated by Churches, Non Government Organisations and Civil Society Organisations will also be eligible for upgrading through the Project.
The RPHSDP has six major deliverables, referred to as ‘Outputs’, in the Project documentation. They are:
The Project will assist the National Department of Health to develop and implement policies, standards and strategies for development of the Community Health Post initiative and the human resource capacity required to successfully operate and maintain them. The National Health Plan envisages that Community Health Posts will eventually replace the present Aid Posts and Sub Health Centre facilities for delivery of primary health care in remote areas with scattered catchment populations of up to 10,000 persons.
The Project will support improvements to health information systems and implementation of the National Health Plan’s Performance Assessment Framework by incorporating the use of information and communication technology (ICT) and geographic information systems (GIS) into data collection and reporting of clinical activity in the target Districts. The applicability of mobile telephone technology to support clinical practice will also be further explored in those Districts.
As the timeliness and reliability of activity reporting improves data will be used to support the roll out of direct facility funding where appropriate.
2. Sustainable PartnershipsThe Project will assist Provincial and District Governments to develop and formalise new partnerships with non-state providers of health services in their areas. Partnership Boards will be established to formalise existing arrangements and to assist in negotiating and implementing future agreements for coordinated health service delivery within Districts and Provinces.
3. Human resource development in the health sectorThe Project will increase the skills of health service personnel working in rural communities by focusing on retraining of existing staff whilst GoPNG, in conjunction with development partners, focuses on undergraduate training of health professionals. The Project will focus on upgrading the clinical skills required for safe obstetric care, management of common paediatric illnesses, appropriate referrals and clinical supervision and the skills required to manage the local workforce and other resources including facility maintenance. Incentives such as provision of adequate staff numbers and improved housing will be provided to aid recruitment and retention in the remote areas.
4. Community health facility upgradingThe Project will provide, subject to the existence of health partnership agreements and assurances with respect to staffing levels and recurrent funding, two new Community Health Posts and refurbishment of up to eight Aid Posts or Health Sub Centres in each of the sixteen (16) target Districts and new or refurbished health staff housing in those communities. Funding will be available for medical equipment and furniture, small vehicles, for sanitation and waste destruction infrastructure and for renewable energy supply systems.
5. Health Promotion in local communitiesThe Project will support health promotion programs, increase women’s involvement in all aspects of health service delivery at the community level, support village health volunteers and engage local communities in planning for their health care needs. Health promotion activities will follow the ‘Healthy Islands’ model and other existing health promotion strategies. The focus will be on sanitation, primary health, maternal and child health and HIV/AIDS awareness, gender equity and prevention of gender based violence.
6. Project monitoring, evaluation and management.The Project will establish a Project Support Unit (PSU) to support project planning, reporting, coordination with development partners and monitoring and evaluation activities. The Unit will be the foundational element of the National Department of Health’s ‘Rural Health Transformation Project’ through which the Department intends to concentrate Government and Development Partner health system strengthening activities. The Unit will be part of the Department and will be fully integrated into the Department over the life of the Project.
Generally, the Executing Agency for the Project will be the National Department of Health and the Implementing Agencies will be the respective Provinces and Districts. In those Provinces where Provincial Health Authorities have been established that body will be the Implementing Agency. For Outputs 1 and 6 the National Department of Health will be both the Executing and Implementing Agency.The Project Support Unit will be located within the National Department of Health and use Government of PNG systems to support its work. There will be a strong emphasis on developing the capacity of Departmental Officers during the life of the Project such that its activities can be sustained beyond 2019 when the Project is scheduled to end.