IRIN NEWS & ANALYSIS
ALTHOUGH IT IS RICH in natural resources, Papua New Guinea’s health staffing levels are comparable to the world’s poorest countries due to a rapidly retiring workforce and lack of qualified replacements.
“If we do not do anything about our ageing workforce quickly, the health system may collapse,” former health minister Jamie Maxton Graham told parliament in 2012.
Despite repeated warnings of the shortage since 2002, the country faces what the government calls a “drastic” health worker shortage. A World Bank report has predicted a large decline in nurses and midwives, the backbone of rural service delivery, by up to half.
Rural health care is especially threatened, noted 2011 field research led by Care Australia and the Australian National University.
Health experts say the shortage of qualified nurses is due to falling government support for nursing schools since 1999, which has forced the closure of all but three of the eight public nursing schools.
The team leader of the World Bank report, Aparnaa Somanathan, told international media in 2011: “I think training capacity in PNG has weakened considerably over the last 10-15 years. There is less and less resources being put into training, so PNG’s ability to train more and more doctors and nurses has declined.”
Fourteen community health worker schools produce graduates who work mainly in facilities in rural areas - where 90% of the population lives - mostly in aid posts.
Churches or faith-based groups operate aid posts, which are staffed with a nurse or community health workers. In areas largely bereft of government services, they provide frontline primary care and become the de facto village doctors.
The World Health Organisation recommends at least 23 health workers per 10,000 residents; PNG has five nurses and doctors per 10,000.
“Many of our qualified nurses have taken up employment in the resource sector for better pay and conditions,” said Manga Bengi, a public relations officer with Mount Hagen Provincial Hospital, the country’s third largest.
Meanwhile, with poorly-funded health training opportunities, almost no midwives have registered with the state since 2000. However, since the Australian government gave $120 million last year for midwifery training, a new group of midwives is due to graduate this month.
Even so, these graduates will be far outnumbered by the number of health workers expected to retire soon. Out of 570 doctors, 3,429 nurses and 4,400 community health workers, 20% have passed the legal retirement age of 55, while nearly 40% are aged 45-55.
Nurses will retire the soonest, with more than one-third of specialist nurses (including midwives) expected to retire in the short term, according to a 2011 health profile by the Australia-based University of New South Wales and health think tank Burnet Institute.
Prime minister Peter O’Neill told local media in December that foreign workers are needed as a stop-gap measure.
About 10 years ago, former prime minister Sir Michael Somare moved to bring in nearly 100 nurses and doctors from Cuba on temporary work contracts, but the cost and heated opposition from the local medical community of being “replaced” by foreign workers stymied the effort.
The present government’s latest bid to import health workers has met similar resistance, but plans proceed.