Health in Papua New Guinea: a Decline in Development

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Abstract
Papua New Guinea has experienced the start of an epidemiological transition in health status from infectious towards non‐communicable diseases, though the latter were absent until the post‐war years. This transition is particularly marked in urban and coastal areas, where life expectancies are higher and mortality rates lower. Tropical diseases remain significant, malaria has worsened and new mobility has increased the severity of epidemics of influenza and measles. Indigenous medical systems have increasingly given way to modern medical systems, though disease aetiology is usually perceived through traditional cognitive models. Modern medical systems were mainly developed in the 1960s and 1970s, on either side of independence, but despite an official focus on primary health care, have had much reduced effectiveness since the 1980s. Rural health centres have been poorly maintained and serviced, and health workers have limited skills and access to resources. The health budget has been increasingly concentrated in urban areas, though the bulk of the population and of the health problems are in rural areas, resulting in a worsening ‘inverse care law’, that is particularly significant for women. Overall health status has declined in the past decade despite overseas advocacy of new policies and the prospects for improvement are poor.

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