The Bougainville Plan for Health 2012 to 2030
Priorities These are the four priorities for the next three years. Maternal health
Download 365.74 Kb.
|
- Navigate this page:
- Rebuilding the health system infrastructure
- Developing and growing the health workforce
- Forming the Bougainville Health Authority
- Demography
- Health trends
- Strategies Good health Long life Women at centre Health sector human and financial resources
PrioritiesThese are the four priorities for the next three years. Maternal healthConsistent with our commitment to putting women at the centre, the first priority we have is to improve maternal health for the women of Bougainville. We are already close to achieving the expectations of the Millennium Development Goal to reduce maternal mortality. With a committed effort from the sector we will achieve this goal. Success in this area will help build the momentum for health so that we can tackle other goals in this plan. Rebuilding the health system infrastructureThe Autonomous Region of Bougainville (ARB) health care infrastructure was partially destroyed during the crisis, and it is our intention to bring it back to strength. Beginning with the rural infrastructure, we will progressively rebuild our health facilities, so that all our population has access to quality health services. This rebuild will first focus on rural health facilities, followed by a CHW training schools, then hospital facilities in Central and South region. Developing and growing the health workforceThe workforce is the fundamental building block for improved health delivery. This plan makes a priority of increased training and development support for the current workforce, as well as developing the workforce for the future. These three priorities cannot wait for the ideal structures to be put in place. Taskforces will be formed to progress these issues, led by senior people from the sector. These taskforces will be made up from the different parts of the sector – not just government. The focus will be on achieving the required results within a specified budget and timeline. Forming the Bougainville Health AuthorityThis will combine the Buka Hospital and the rural health services into a single organisation. It will make all the health service directly accountable to the ABG. It will also enable better use of scarce existing capacity (eg in HR, medical officers, training) across the Autonomous Bougainville Government (ABG) health system rather than being confined to a particular institution. DemographyDemographyThe population in Bougainville has grown by 2.6% per cent a year for the last decade. This means that between 2000 and 2010 the population increased by 60,000. Even if this trend is partially arrested, we can expect the population to reach 350,000 by 2030. Population growth depends on fertility, mortality and migration. Improved family planning reduces fertility and population growth. Infant survival decreases mortality while an ageing population and NCDs increase mortality. Migration is likely to increasingly play a role in ARB’s population, and depends on economic and security conditions in ARB and surrounding areas that are accessible to the Bougainville people. In the table below, we have assumed the rate of growth will slow to 2.3% (the current average for the Islands region) until 2020, then to 2.0% for the period 2020 to 2030. Health trendsThis plan for health will focus on three long term outcomes:
The National Department of Health indicators show ARB as the sixth-best performing province in PNG, although ARB’s performance dropped in 2010. The performance for 2011, however, shows there are distinct improvements in ARB’s indicators over the last year. The North Region has a higher level of performance on most indicators than the South and Central. This is a major focus of this plan – making a priority of improving service provision in the Central and South Region, while maintaining improvements in the North. This plan needs to lift the performance of ARB, by more closely focusing on performance at all levels and facilities. In many instances the knowledge on how to improve performance already exists within ARB. The information from high-performers can be used by other health facilities, districts and regions to lift their performance. Take, for instance, births in health facilities: The health plan intends to train health workers undertaking deliveries and to develop the Arawa and Buin hospitals. This should result in an increase in births in facilities in Central and South, reduced travelling times for obstetric emergencies and fewer maternal deaths. The result these developments will aim for is that 80% of women in all three regions will give birth in health facilities under a health worker with training in obstetric care. Another part of reducing maternal mortality is family planning. Over the last three years, the North Region has made a dramatic improvement in its family planning services. From 2008 till the present they have provided one fifth of women of reproductive age with contraception. This has resulted in fewer maternal deaths, fewer deliveries and improved child health. The challenge is for this success to be sustained, and for the Central and South Region to achieve the same level of performance. If that happens, the predictions of population growth in this plan would need to be revised downwards and many of the goals will be achieved earlier. The strategies outlined in this plan need to be continuously linked to improved performance against the health indicators. For example, if a facility is improved, or a training course is conducted, these developments should demonstrate improved performance. The appendixes discuss the current performance of health facilities across a range of indicators. StrategiesGood health Long life Women at centre Health sector human and financial resourcesHuman resourcesHealth services primarily rely on skilled health workers. Health system performance depends to a large extent on the skills, training and commitment of the health workforce and their accessibility by the population. The current ARB health workforce has approximately 520 people, divided between the ABG rural health sector (190) the churches (170) and Buka Hospital (117). The geographic distribution of skilled health workers is uneven, largely concentrated on the North Region because that is where Buka Hospital is.
The rural health workforce however is well distributed. The regional distribution of rural health workforce by cadres, 20111 HW/Population Ratio (2008) North 828 Central 861 South 680 Source: ABG. Building on the Bougainville Strategic Implementation Plan 2011 To meet the requirements of this plan, the health workforce needs to: increase to keep up with population growth replace itself as workers retire increase the skill level of both the current and future health workers. Increase in the central and south regions Retraining the large group of workers who had restricted opportunity due to the crisis is an early priority. In addition, the plan intends to make the most skilled workers, (doctors, midwives, nurses) more accessible to the rural population, particularly in the Central and South Region. As a consequence of the crisis, the health worker training institutions have been lost. The priority is to re-establish the community health worker (CHW) training school, at the same time work with existing PNG training institutions to ensure future workforce requirements are met. A taskforce made up of Buka Hospital, the Rural Health Division and the churches will lead the development of this area to meet the plan’s requirements. The work of the taskforce includes:
Download 365.74 Kb. Share with your friends:
|