2013 under-five mortality stood at 61 deaths per 1,000 live births – twice the target figure – and measles immunisation at 70 per cent, making it unlikely that Papua New Guinea will meet the targets for this goal. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. For Papua New Guinea, the maternal mortality rate should fall to 98 cases per 100,000 live births. In 2013 Papua New Guinea had an adjusted maternal mortality ratio of 220 deaths per 100,000 live births (this figure was estimated at 230 deaths per 100,000 by UN agencies/World Bank in 2010). Although the rate is decreasing, it is still more than double the target figure and so is very unlikely to hit the target. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2011 this figure stood at 43 per cent, so attainment of this target is also looking unrealistic. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other communicable diseases. There has been no notable reduction in HIV/AIDS prevalence in Papua New Guinea since 2000. Work is needed to ensure that HIV/AIDS does not become a generalised epidemic – the UN considers an epidemic as ‘generalised’ when more than one per cent of the population is HIV-positive. There was a significant overall increase in reported cases of malaria in 2011–12, however, this corresponded with a reduction in deaths from the disease, which is encouraging. There has been an overall increase in the estimated incidence of, and only a slight reduction in estimated mortality (when mortality data excludes cases comorbid with HIV) from, TB since 1990. Accordingly, progress in these areas is required and the country is unlikely to achieve MDG 6 by 2015. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Less than a fifth of health care in Papua New Guinea (17 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.2 per cent of GDP in 2012, of which 83 per cent (US$94 per capita) was covered by the government. Lack of local or easily accessible facilities is the main barrier stopping people in the most rural areas from accessing health care. In a report on the Papua New Guinea post-2015 development agenda entitled The Future We Want – Voices from the People of Papua New Guinea, the introduction of health centres throughout P a p u a N ew Gu i n e a rural areas was recommended. The lack of clinics in rural areas is, among other things, responsible for women dying during childbirth before they can reach the nearest health centre. For serious conditions, travel to Port Moresby General Hospital would usually be necessary. Although treatment there is free, the expense of travelling to the capital is prohibitive for some. Papua New Guinea was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 2008 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Around 213,000 people in Papua New Guinea are over the age of 65 – three per cent of the total population (2013). At the age of 60 a person living in Papua New Guinea can be expected to live for an additional 24 years, on average (2013). Papua New Guinea’s Old Age and Disabled Pension Scheme dates back to 2009 and is in place in New Ireland only. Today, monthly pension credits in New Ireland are paid by the state at a rate of US$14 per person (2007–12) on a universal basis. Overall, public pension spending is equivalent to 0.2 per cent of the country’s total economic output (2005). Population over 65 3% In tribal areas, elderly people are usually cared for by members of their extended family, but traditions vary between ethnic groups. Prime Minister Peter O’Neill has been championing the idea of a nationwide pension for people over 65, most likely means tested, as a safety net for those who do not have family living locally to care for them. Further information Department of Health: www.health.gov.pg Commonwealth Health Online: www.commonwealthhealth.org/pacific/papua_new_guinea Commonwealth Health Partnerships 2015 239
Commonwealth Health Partnerships 2015
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