Revitalising Papua New Guinea's health system: the need for creative approaches

Health services in Papua New Guinea need substantial strengthening. Deteriorating performance, persistently poor health outcomes and worsening trends on key indicators are well documented. Challenges facing the health system result not just from low expenditure; performance is also constrained by its structure and by cultural factors. In general, investment is determined by supply-side strategies - providing infrastructure and resources consistent with 'minimum standards'. If expectations for improved health outcomes, heightened by the bounty of resource development, are to be achieved without substantial wasting of additional investment, policy-makers need to consider all potentially viable options. Lessons can be drawn from countries facing similar challenges where the policy mix was broadened to include both the supply-side strategies and 'demand-responsive' mechanisms (voucher schemes, micro-health insurance, social businesses and social franchises). Trialing these mechanisms has the potential to reshape key elements of PNG's health system, redressing structural weaknesses and reducing inconsistencies with cultural realities.