Measuring unmet need for contraception among women in rural areas of Papua New Guinea

Expanding access to reliable contraception is a global priority in the fight to lower maternal morbidity and mortality. Papua New Guinea (PNG) continues to face significant challenges in enhancing contraceptive services for women. PNG Demographic Health Survey (DHS) has been undertaken every 10 years since 1996 and describes the major trends in crude birth rates, fertility rates and preferences, contraceptive use, and the unmet needs for contraception. The latest survey in 2016 means that there are now 20 years of data available. Between 1996 and 2016, modern contraceptive prevalence increased from 14% to 29% with a preference for longer acting reversible contraception, though the unmet need for contraception persisted at 32% with minimal change since 1996. Rurally dwelling women as well as those with low literacy, who make up the majority of reproductive age women in PNG, were consistently the least likely to use contraception. Expanding access to reliable contraception should therefore be prioritized for these women.

Download Full-text

Individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea: insights from a nationwide demographic and health survey

International Health ◽

10.1093/inthealth/ihaa097 ◽

2020 ◽

Author(s):

Abdul-Aziz Seidu ◽

Ebenezer Agbaglo ◽

Louis Kobina Dadzie ◽

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

...

Keyword(s):

Papua New Guinea ◽

Health Survey ◽

Rural Areas ◽

Contextual Factors ◽

Statistical Significance ◽

New Guinea ◽

Wealth Quintile ◽

Demographic And Health Survey ◽

Outcome Variable ◽

Factors Associated

Abstract Background This study sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea. Methods The study was conducted among 14 653 women aged 15–49 y using data from the 2016–2018 Papua New Guinea Demographic and Health Survey. The outcome variable was barriers to accessing healthcare. Descriptive and multilevel logistic regression analyses were conducted. Statistical significance was declared at P < 0.05. Results Women aged 15–19 y were more likely to experience at least one barrier compared with those aged 40–49 y (adjusted OR [AOR]=1.48; 95% CI 1.18 to 1.86). Women with secondary/higher education (AOR=0.68; 95% CI 0.57 to 0.81), women in the richest wealth quintile (AOR=0.36; 95% CI 0.28 to 0.46) and those in the least disadvantaged socioeconomic status (AOR=0.46; 95% CI 0.33 to 0.64) had lower odds of having challenges with at least one barrier to healthcare. However, living in rural areas increased the odds of facing at least one barrier to healthcare (AOR=1.87; 95% CI 1.27 to 2.77). Conclusions This study has demonstrated that both individual and contextual factors are associated with barriers to healthcare accessibility among women in Papua New Guinea. To enhance the achievement of the Sustainable Development Goals 3.1, 3.7 and 3.8, it is critical to deem these factors necessary and reinforce prevailing policies to tackle barriers to accessing healthcare among women in Papua New Guinea.

Download Full-text

Exploring the sustaining factors that motivate nurses to work in the rural areas of Papua New Guinea

10.26686/wgtn.17136290 ◽

2021 ◽

Author(s):

◽

Priscilla Poga

Keyword(s):

Developing Countries ◽

Papua New Guinea ◽

Latin American ◽

Rural Areas ◽

Work Experience ◽

New Guinea ◽

Social Aspect ◽

Rural Nurses ◽

Rural Work ◽

Personal Challenges

Papua New Guinea is among other developing countries that are faced with a critical shortage in human resources in health, specifically nurses, and rural areas are the most affected. Initially, and perhaps unsurprisingly, there were only two relevant studies that directly related to Papua New Guinea in this area based on the literature search. The first of these two studies was focused on nurses and the social aspect of rural motivation compared to the other which was focused on rural health professionals in general. Nevertheless, other research studies were eventually found from other developing countries such as certain Pacific, African and Latin American countries that served to assist in focusing the research on the chosen topic. This descriptive-exploratory study set out to explore the sustaining factors that influenced existing nurses to remain (or otherwise) in their work in Papua New Guinea’s rural areas. As such, the study involves 10 rural nurses with over two years of rural work experience in two different organisations; government and church. The interviews were semi-structured and were designed to explore the motivating factors for rural nurses and how any challenges, or demotivating factors, were overcome. The interviews were conducted in the common spoken language Tok Pisin which was translated into English, transcribed and analysed thematically. Overall the study found that rural nurses are disadvantaged because they struggle with limited resources to deliver effective health care, and they also face several personal challenges which are often overlooked. The main findings are categorised under two major themes, 1) safety and 2) socioeconomic, and each are explored by further exploration of the themes and sub-themes that are evident in both. The implications of this study are examined, including recommendations, to develop policies that are designed to address the ongoing needs of rural nurses in Papua New Guinea.

Download Full-text

Prevalence of syphilis, gonorrhoea and chlamydia in women in Fiji, the Federated States of Micronesia, Papua New Guinea and Samoa, 1995–2017: Spectrum-STI model estimates

Western Pacific Surveillance and Response ◽

10.5365/wpsar.2019.10.2.003 ◽

2020 ◽

Vol 11 (1) ◽

pp. 27-40

Author(s):

Takeshi Nishijima ◽

Devina Nand ◽

Nefertti David ◽

Mathias Bauri ◽

Robert Carney ◽

...

Keyword(s):

Papua New Guinea ◽

Rural Areas ◽

Test Performance ◽

Control Strategies ◽

New Guinea ◽

Federated States Of Micronesia ◽

Sexually Transmitted ◽

Diagnostic Test Performance ◽

Urban And Rural Areas ◽

Active Syphilis

Objectives: To estimate prevalence levels of and time trends for active syphilis, gonorrhoea and chlamydia in women aged 15–49 years in four countries in the Pacific (Fiji, the Federated States of Micronesia [FSM], Papua New Guinea [PNG] and Samoa) to inform surveillance and control strategies for sexually transmitted infections (STIs). Methods: The Spectrum-STI model was fitted to data from prevalence surveys and screenings of adult female populations collected during 1995−2017 and adjusted for diagnostic test performance and to account for undersampled high-risk populations. For chlamydia and gonorrhoea, data were further adjusted for age and differences between urban and rural areas. Results: Prevalence levels were estimated as a percentage (95% confidence interval). In 2017, active syphilis prevalence was estimated in Fiji at 3.89% (2.82 to 5.06), in FSM at 1.48% (0.93 to 2.16), in PNG at 3.91% (1.67 to 7.24) and in Samoa at 0.16% (0.07 to 0.37). For gonorrhoea, the prevalence in Fiji was 1.63% (0.50 to 3.87); in FSM it was 1.59% (0.49 to 3.58); in PNG it was 11.0% (7.25 to 16.1); and in Samoa it was 1.61% (1.17 to 2.19). The prevalence of chlamydia in Fiji was 24.1% (16.5 to 32.7); in FSM it was 23.9% (18.5 to 30.6); in PNG it was 14.8% (7.39 to 24.7); and in Samoa it was 30.6% (26.8 to 35.0). For each specific disease within each country, the 95% confidence intervals overlapped for 2000 and 2017, although in PNG the 2017 estimates for all three STIs were below the 2000 estimates. These patterns were robust in the sen sitivity analyses. Discussion: This study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO’s Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.

Download Full-text

Case Management Quality Assessment in Rural Areas of Papua New Guinea

Tropical Doctor ◽

10.1177/004947559602600440 ◽

1996 ◽

Vol 26 (4) ◽

pp. 200-200

Author(s):

Miguel San Sebastian ◽

Isabel Goicolea

Keyword(s):

Case Management ◽

Quality Assessment ◽

Papua New Guinea ◽

Rural Areas ◽

New Guinea ◽

Management Quality

Download Full-text

Continuing professional development and challenges facing newly graduated midwives in Papua New Guinea

Pacific Journal of Reproductive Health ◽

10.18313/pjrh.2016.920 ◽

2016 ◽

Vol 1 (4) ◽

Author(s):

Alison Moores ◽

Paula Puawe ◽

Nancy Buasi ◽

Florence West ◽

Mary K Samor ◽

...

Keyword(s):

Professional Development ◽

Papua New Guinea ◽

Clinical Supervision ◽

Rural Areas ◽

Maternal Mortality Ratio ◽

Hospital Setting ◽

Continuing Professional Development ◽

New Guinea ◽

Child Health Services ◽

Rural And Remote

Background: The Maternal Mortality Ratio in Papua New Guinea (PNG) in 2008 was estimated at more than 700 deaths per 100,000 live births. In recognition of the high MMR, a Ministerial Taskforce was established in 2009 with recommendations to urgently address the workforce capacity in regard to maternal and child health services. In 2010, a new competency-based Bachelor of Midwifery curriculum was introduced into four universities in PNG and an increase in the numbers of midwifery students took place over a four year period.Aim: The aim of this study was to explore the experiences of Papua New Guinean midwifery graduates from the 2012 and 2013 Bachelor of Midwifery cohorts. These graduates were among the first to complete the revised national midwifery curriculum designed to improve the knowledge and skills of a registered midwife graduate.Method: A descriptive exploratory study was undertaken to explore the experiences of 174 graduates in the first two years post-graduation. All graduates that were able to be contacted were provided with information about the study, consented and were interviewed either face-to-face or by phone/email. Quantitative data were analysed using simple descriptive statistics in SPSS and qualitative data underwent content analysis and coding by the research team.Findings: Almost all (90%) graduates were working as midwives with 39% of graduates working in rural and remote locations across PNG. Midwifery education prepared graduates well for their work as midwives, but many commented that the course needed to be longer to improve feelings of competence. Professional support during their graduate year varied depending on location and motivation of supervisors. Many graduates, particularly those in rural areas, expressed the desire to work under clinical supervision in a hospital setting for a period of 6-12 months at the end of their training to become more skilled and confident prior to seeking employment.Conclusion: Most midwifery graduates from the new curriculum found employment as midwives. Only a minority of graduates have had opportunities for continued professional development or support from a mentor of senior colleague. Regular, ongoing professional development and supervision needs to be initiated for the provision of skilled and evidence based care. Support and incentives for staff to work in rural and remote areas should be considered.

Download Full-text

Impact of internal female migration on unmet need for modern contraception in Zambia

Reproductive Health ◽

10.1186/s12978-019-0803-9 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Melanie T. Almonte ◽

Caroline A. Lynch

Keyword(s):

Family Planning ◽

Rural Areas ◽

Unmet Need ◽

Modern Contraceptive ◽

Migrant Women ◽

Logistic Regression Models ◽

Female Migration ◽

Family Planning Programs ◽

Rural And Urban ◽

Unmet Need For Contraception

Abstract Background Unmet need for contraception, the proportion of women who want to limit or delay childbirth but use no form of contraception, is the core indicator to evaluate the effectiveness of family planning programs. Understanding how migration influences unmet need is important to identify to whom and how to target sexual and reproductive health programs. We assessed how migration status in rural and urban settings is associated with having an unmet need for family planning. Methods Data on sexually active, fecund, reproductive-aged (15–49 years) women from the 2013–14 Zambia Demographic and Health Survey were analysed through univariate and multivariate logistic regression models. Results Unmet need for modern contraceptive methods was significantly higher among rural to rural migrant women (OR 1.30, 95%CI 1.00–1.70 p < 0.05) and rural non-migrant women (OR 1.41, 95%CI 1.06–1.85 p < 0.01) compared to urban non-migrant women after controlling for age, marital status, parity, religion, education and wealth. Conclusion Women residing in, and migrating between, rural areas were significantly more likely to have an unmet need for contraception. Our findings highlight the importance of understanding migration and migrant streams to strengthen family planning programs. In Zambia, a focus on rural-rural migrants, rural non-migrants and the poorest could improve the health of the entire population.

Download Full-text

The governance of natural resources: Issues affecting better management of revenues and distribution of benefits within Papua New Guinea

International Journal of Rural Law and Policy ◽

10.5130/ijrlp.i1.2014.3850 ◽

2014 ◽

pp. 1-7

Author(s):

Hitelai Polume-Kiele

Keyword(s):

Natural Resources ◽

Papua New Guinea ◽

Social Services ◽

Rural Areas ◽

Oil And Gas ◽

Social Indicators ◽

New Guinea ◽

Social Infrastructure ◽

Regulatory Frameworks ◽

Essential Services

Papua New Guinea is rich in natural resources, including minerals, oil, gas, timber and fish, and cash crops such as coffee, palm oil, cocoa, copra, rubber, tea and spices which contribute significantly to Papua New Guinea’s overall development. Several mining, oil and gas companies are currently operating in Porgera, Ok Tedi, Lihir, Hidden Valley, Sinivit, Simberi, Tolukuma, Kutubu and Gobe. The operations of these companies have generated an estimated K13.42 billion to Papua New Guinea’s economy. Landowners affected by these developments also receive royalties from those operations. However this wealth has not been translated into tangible human development across the country, as shown in persistently poorly performing social indicators. Instead income from the exploitation of natural resources is being used in unplanned projects and not focused on the delivery of core social functions, such as the provision of a stable and non-distorting policy aimed at building and sustaining the development of a modern market, and legislative and regulatory frameworks, social services, social security and social infrastructure which would lead to the improvement in the delivery of essential services to all Papua New Guineans. There is widespread evidence of benefits not being distributed to all landowners. Landowners are yet to fulfil their aspirations regarding these developments and to see improvements in their living standards. This paper discusses two case studies: the Porgera and Lihir mines, outlining the landowners associations’ experiences, which illustrate issues of governance and management of the distribution of benefit flows from the exploitation of Papua New Guinea’s natural resource wealth.The focus of the article’s discussion is on governance and management issues that affect the distribution of benefits, delivery of essential services to rural areas of PNG, stability within government, and the expectations of landowners.

Download Full-text

TIME ALLOCATION TO SUBSISTENCE ACTIVITIES AMONG THE HULI IN RURAL AND URBAN PAPUA NEW GUINEA

Journal of Biosocial Science ◽

10.1017/s0021932002001335 ◽

2002 ◽

Vol 34 (1) ◽

pp. 133-137 ◽

Cited By ~ 3

Author(s):

MASAHIRO UMEZAKI ◽

TARO YAMAUCHI ◽

RYUTARO OHTSUKA

Keyword(s):

Papua New Guinea ◽

Time Allocation ◽

Rural Areas ◽

Urban Areas ◽

New Guinea ◽

Urban Environments ◽

Observation Data ◽

Rural And Urban ◽

Urban Migrants ◽

Subsistence Activities

Time spent on subsistence activities was compared between rural sedentes and urban migrants of the Huli population in Papua New Guinea. Person-day observation data were collected for rural sedentes (441) in the Tari basin and for urban migrants in Port Moresby (175). The time spent on subsistence activities by males was longer in the urban area than in rural areas, while that by females was similar in both areas. Conspicuous gender inequality with respect to labour hours in rural areas seems to diminish when people move to urban areas, reflecting the different subsistence regime between rural and urban environments.

Download Full-text

Commonwealth Local Government Forum Pacific Project

Commonwealth Journal of Local Governance ◽

10.5130/cjlg.v1i0.762 ◽

2008 ◽

pp. 137-145 ◽

Cited By ~ 1

Author(s):

Terry Parker ◽

Megan Praeger

Keyword(s):

Local Government ◽

Papua New Guinea ◽

Rural Areas ◽

Urban Areas ◽

Local Governments ◽

Good Governance ◽

Good Practice ◽

New Guinea ◽

City Council ◽

Social Infrastructure

The Commonwealth Local Government Forum (CLGF) Pacific Project works with local government and other stakeholders in nine Pacific Island countries – Cook Islands, Fiji Islands, Kiribati, Samoa, Papua New Guinea, Solomon Islands, Tonga, Tuvalu and Vanuatu. It seeks to strengthen local democracy and good governance, and to help local governments deal with the increasing challenges of service delivery and urban management in the unique Pacific environment.Human settlement patterns in the region are changing rapidly. The Pacific has traditionally been a rural agricultural/subsistence society, but this is no longer the case. The accelerated pace of urbanisation has impacted significantly on Pacific nations and in the very near future the majority of Pacific Islanders will be found in urban areas. Already over 50% of Fiji’s population are urban dwellers. Rapid urbanisation brings with it unique challenges and opportunities. Local governments are at the forefront of this phenomenon, with the responsibility to manage urban development and the transition from rural areas to cities and towns. Their success or failure to manage urbanisation and provide the required levels of physical and social infrastructure will affect many lives in a new urban Pacific.The project now has three components – the main Pacific Regional Project and two country-specific programmes: the Honiara City Council Institutional Capacity Building Project and the Commonwealth Local Government Good Practice Scheme in Papua New Guinea.

Download Full-text