The Bougainville Plan for Health 2012 to 2030
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Financial resourcesCurrently most of the money coming into the ARB health sector comes from the government of PNG (GoPNG), with smaller contributions by donors and the ABG government (see table below). The level of spending is about the bare minimum required to effectively run a health service, and well below what neighbouring countries are spending on health. This plan assumes that by 2030 ARB health spending will reach the current average expenditure on health for Melanesia, which is double the current ARB expenditure, or an annual real increase of 6%. Melanesian comparisons – per capita government health expenditure US$2 If expenditure only just keeps up with inflation (6.1%) and population growth (2.3%) then it will be impossible to staff and run the additional services and facilities outlined in this plan. Resources would have to be taken from an existing part of the health sector. The big challenge in financing this plan will come between 2015 and 2020 as a consequence of changes made as a result of the referendum. If the referendum decision leads to financial independence from PNG, then there is likely to be a lag period before ABG is able to generate enough of its own revenue to replace the current GoPNG contribution to health.
The financing of this plan requires a commitment by all partners: the government of PNG, ABG, donor partners and development banks to a funding pathway as indicated above. In addition, the different funding mechanisms need to be brought together so that the Bougainville health system can make optimal and efficient use of the funds. There is not the management capacity to deal with multiple funders and multiple accountability and reporting lines.
Buildings, timing and financingThe changing shape of the ARB health sector 2012 2030 The crisis has left the ARB health sector with a depleted healthcare infrastructure, as a consequence of the destruction of key facilities such as Arawa Hospital. A key focus of the plan is to rebuild this infrastructure over the next 10 years. This rebuilding will take a different shape to the current health infrastructure. Changes in communication and transport systems, including roads and bridges, make a big difference to the way people use health services. The redevelopment of the roading system will mean people travel to health facilities more easily. This means there will be a need for fewer facilities, but they will have far greater capacity. In addition, what is being expected of a health facility has changed. In order to meet the aspirations of this plan, health facilities need to be offering a higher level of skill and a wider range of services than is seen currently. The future will see fewer aid posts, and the development of community health posts with a minimum of three staff. There will be fewer in-patient facilities in health centres and community health posts – most people requiring more than a short stay as an inpatient will travel to the hospitals. Effective transport arrangements between the facilities will be an important part of the health system. The plan has indicated a number of buildings that are required for the ABG health sector. The timing of the building developments depends on the availability of financial and staff resources to sustain a facility once it is built. As the table below indicates, some of these are already planned and funded – others will require further development of a business case to resolve issues of location, size, cost and staffing. ARB health infrastructure plan
A full list of sector developments is in Appendix 10. Download 365.74 Kb. Share with your friends:
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