At Wagbel village at the edge of Mt. Hagen City, 22-year-old nurse, Roselyn Pakil’s work day has started. As early as 8am, the first lot of patients have begun arriving bringing with them various medical complaints.
Rosleyn Pakil represents the first layer in the Western Highlands provincial Health system. At this makeshift clinic, she treats patients with minor complaints and refers only the serious cases to Mt. Hagen General Hospital.
“I’ve been working here for 8 months,” she says. “At first when I came, there weren’t many patients. But then more people came.”
Four years ago, the Western Highlands, became one of the first provinces to trial the Provincial Health Authority concept. It is a design that brings together previously fragmented services and functions under a single authority.
The man driving the transformation is Dr. James Kintwa, who was previously Chief executive of Mt. Hagen General Hospital. He later become Chief Executive of the Provincial Health Authority bringing with him experiences and lessons learnt from his term as hospital CEO.
“When we started we looked at developing a health service plan. A health service plan that concentrated on the national health model that had different levels of service.
The Health Authority has focused on building capacity at the district level with multiple layers of coordination all reporting ultimately to the Chief executive.
Previously, the provincial Hospital operated as an entity separate from the provincial and district health system. That resulted in poor coordination, less efficient use of resources and a highly fragmented health delivery system didn’t meet national health expectations. The compartmentalization of services meant that resources that could be used collectively remained underutilized es
In a country with some of the most rugged terrain in the world and some of the most isolated populations, a fragmented health system was practically ineffective even with enormous amounts of donor funding coming from various sources.
Under Dr. James Kintwa as CEO, the provincial Health Authority has been able to provide a clear vision and framework to both donor partners and health staff in the province.
While the Health Authority remains a government agency, it relies heavily on support and cooperation from churches and non-government agencies. Three district health centers in the Western Highlands are operated by the churches and NGOs. It is set of partnerships that are working well for the provincial health authority.
“In this period of the national health plan, the two key reforms were: the Provincial Health Authority reform and the Community Health Post Reform.”
The Wagbel community has gone a step further.
Samuel Ropkil, landowner and community leader recently gave up a third of his traditional land for the construction of a community health post.
He also gave up his house to be used as a temporary health clinic and that is where Nurse Roselyn Pakil has come to work everyday for the last eight months.
Ropkil given that the health was a big concern for his people, he decided to allow his land to be used for beneficial development.
Mr. Ropkil has since moved out of his house and is in the process of constructing a new house on another portion of his land.
At recent national health meetings, the western Highlands has moved up the health system rankings to number one placing in health service delivery.
Another one of the building blocks to their success has been strong political support from Western Highlands governor, Paias Wingti and other members of parliament from the Western Highlands.
BUT as a growing health system, there are increasing challenges: An aging workforce and an education system that is not producing enough nurses and doctors for their growing needs.