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community health worker completing a stock take

Keeping health facilities open and ensuring frontline workers have the capacity to provide health care to the people in remote communities of Papua New Guinea is essential.

In Hela, Southern Highlands (SHP) and Gulf Provinces, district health facilities are now able to plan, budget and manage health services better, because they now have access to funds which most can use to address their highest priorities.

Provincial Health Authorities (PHA) in these three provinces have recognised that improved public financial management which enables funds to flow to frontline health workers, is needed for effective service delivery.

To strengthen governance and ensure adequate financing flows, the Oil Search Foundation (OSF) working in partnership with the PHAs introduced an innovative approach called Facility Based Budgeting, which has for the first time seen health facilities receive a direct budget allocation that they can spend against an Annual Implementation Plan.

CEO SHP PHA, Dr Joseph Birisi said, “Funding received from the National Government through the Health Functional Grant, is linked to each service deliverable according to the Minimum Priority Activities (MPA) and allocated accordingly, enabling health facilities to have their own budgets.”

He adds, “previously facilities couldn’t purchase by themselves the basic supplies they needed, such as fuel for their vehicles or generators, carry out repairs and maintenance or even purchase bleach or chemicals to sterilize equipment. Often, because of slow procurement systems, money for such requests was either given late or not at all which hindered service delivery. However, this waiting process will no longer be a concern to our facilities.”

CEO Hela PHA, Dr James Kintwa said, “since the implementation of facility-based budgeting, we have seen funding reach our front-line services in Government and Church run facilities. Many are happy that they can effectively deliver health care to the people. As a result, we are seeing the health indicators for the province improve.

He adds, “This system helped us identify and bridge a gap that existed. For instance, in Benaria, the Community Health Worker (CHW) was so excited because from their own budget, a generator that had been sitting idle for 15 years was fixed and is now fully functioning, supplying electricity to the whole community.”

“Previously, our requests to have this generator serviced and fixed was not given the priority it needed, but things changed when we were allocated our own budget. A positive impact of having electricity is that our health centre is now able to serve sick patients in the evening as well, which has improved our health services from what it used to be, to what it’s supposed to be’, said Martin Kogowe, CHW at Benaria.

CEO Gulf PHA, Dr Paul Wari said, “Although the PHA is still in its infancy stage given its recent establishment in 2019, we were able to get an approval from the Gulf PHA board to implement the 2020 budget using this facility- based budgeting approach.

He adds, “Although the PHA inherited some challenges from the past health system which has had Gulf Province sit at the bottom of the performance scoreboard with health indicators the lowest, it is slowly changing. With the OSF support, we are seeing some system change allowing us to improve planning and coordination to deliver effective financial management and good governance which will address some of these very poor health indicators.

“The recent success in preventing a potential measles outbreak in Kikori District demonstrates how much the systems are already improving outcomes."
- Dr Paul Wari CEO Gulf PHA