scholarly journals Mortality surveillance and verbal autopsy strategies: experiences, challenges and lessons learnt in Papua New Guinea

2020 ◽  
Vol 5 (12) ◽  
pp. e003747
Author(s):  
John D Hart ◽  
Viola Kwa ◽  
Paison Dakulala ◽  
Paulus Ripa ◽  
Dale Frank ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Papua New Guinea ◽  
Verbal Autopsy ◽  
Health Workers ◽  
New Guinea ◽  
Local Context ◽  
Lessons Learnt ◽  
Essential Components ◽  
Death Notification ◽  
Mortality Surveillance

Full notification of deaths and compilation of good quality cause of death data are core, sequential and essential components of a functional civil registration and vital statistics (CRVS) system. In collaboration with the Government of Papua New Guinea (PNG), trial mortality surveillance activities were established at sites in Alotau District in Milne Bay Province, Tambul-Nebilyer District in Western Highlands Province and Talasea District in West New Britain Province.Provincial Health Authorities trialled strategies to improve completeness of death notification and implement an automated verbal autopsy methodology, including use of different notification agents and paper or mobile phone methods. Completeness of death notification improved from virtually 0% to 20% in Talasea, 25% and 75% using mobile phone and paper notification strategies, respectively, in Alotau, and 69% in Tambul-Nebilyer. We discuss the challenges and lessons learnt with implementing these activities in PNG, including logistical considerations and incentives.Our experience indicates that strategies to maximise completeness of notification should be tailored to the local context, which in PNG includes significant geographical, cultural and political diversity. We report that health workers have great potential to improve the CRVS programme in PNG through managing the collection of notification and verbal autopsy data. In light of our findings, and in consultation with the main government CRVS stakeholders and the National CRVS Committee, we make recommendations regarding the requirements at each level of the health system to optimise mortality surveillance in order to generate the essential health intelligence required for policy and planning.

scholarly journals How advanced is the epidemiological transition in Papua New Guinea? New evidence from verbal autopsy

2021 ◽  
Author(s):  
John D Hart ◽  
Viola Kwa ◽  
Paison Dakulala ◽  
Paulus Ripa ◽  
Dale Frank ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Papua New Guinea ◽  
Verbal Autopsy ◽  
Diagnostic Algorithm ◽  
New Guinea ◽  
Automated Analysis ◽  
High Fraction ◽  
Research Consortium ◽  
Disease Study ◽  
Critical Policy

Abstract Background Reliable cause of death (COD) data are not available for the majority of deaths in Papua New Guinea (PNG), despite their critical policy value. Automated verbal autopsy (VA) methods, involving an interview and automated analysis to diagnose causes of community deaths, have recently been trialled in PNG. Here, we report VA results from three sites and highlight the utility of these methods to generate information about the leading CODs in the country. Methods VA methods were introduced in one district in each of three provinces: Alotau in Milne Bay; Tambul-Nebilyer in Western Highlands; and Talasea in West New Britain. VA interviews were conducted using the Population Health Metrics Research Consortium (PHMRC) shortened questionnaire and analysed using the SmartVA automated diagnostic algorithm. Results A total of 1655 VAs were collected between June 2018 and November 2019, 87.0% of which related to deaths at age 12 years and over. Our findings suggest a continuing high proportion of deaths due to infectious diseases (27.0%) and a lower proportion of deaths due to non-communicable diseases (NCDs) (50.8%) than estimated by the Global Burden of Disease Study (GBD) 2017: 16.5% infectious diseases and 70.5% NCDs. The proportion of injury deaths was also high compared with GBD: 22.5% versus 13.0%. Conclusions Health policy in PNG needs to address a ‘triple burden’ of high infectious mortality, rising NCDs and a high fraction of deaths due to injuries. This study demonstrates the potential of automated VA methods to generate timely, reliable and policy-relevant data on COD patterns in hard-to-reach populations in PNG.

Strategies to plan and assess alternative programs to train rural-based health workers in Papua New Guinea

1988 ◽  
Vol 22 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Sherilynn F. Spear ◽  
Ellen Vor Der Bruegge ◽  
Charles B. Hamilton ◽  
Stewart N. Blumenfeld
Keyword(s):  
Papua New Guinea ◽  
Health Workers ◽  
New Guinea ◽  
Alternative Programs

Case Management Quality Assessment in Rural Areas of Papua New Guinea

1995 ◽  
Vol 25 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Elvira Beracochea ◽  
Rumona Dickson ◽  
Paul Freeman ◽  
Jane Thomason
Keyword(s):  
Health Services ◽  
Case Management ◽  
Rural Health ◽  
Papua New Guinea ◽  
Health Workers ◽  
Health Centre ◽  
New Guinea ◽  
History Taking ◽  
Primary Health ◽  
Tract Infections

A study was carried out to assess the quality of case management of malaria, malnutrition, diarrhoea and acute respiratory tract infections in children in rural primary health services in Papua New Guinea. In particular, the study focused on the knowledge and skills of different categories of rural health workers (HW) in history taking, examination, diagnosis, treatment and patient education. Quality criteria were defined and health centre (HCW) and aidpost workers' (APWs) knowledge and practices were assessed. Primary health workers' (PHW) knowledge of case management was weak, but in all cases better than their actual practice. History taking and examination practices were rudimentary. HWs tended not to make or record diagnoses. Treatment knowledge was often incorrect, with inappropriate or insufficient drugs prescribed, being worst at aidpost level. These findings raise serious questions about the effectiveness of providing health services through small, isolated health units. Far greater attention must now be directed to focus on the institutionalization of problem-based training, continuous supportive supervision and maintenance of clinical skills and provision of essential drugs, supplies and equipment to ensure that rural health workers (RHW) can provide sound care.

scholarly journals Mobile phones and media use in Madang Province of Papua New Guinea

2013 ◽  
Vol 19 (2) ◽  
pp. 156 ◽  
Author(s):  
Amanda Watson
Keyword(s):  
Mobile Phone ◽  
Papua New Guinea ◽  
Mobile Phones ◽  
New Guinea ◽  
Mobile Telecommunication ◽  
Media Access ◽  
Telecommunication Sector ◽  
Rural Villages ◽  
Early Adoption ◽  
Culture Model

A mobile phone service was not available to the majority of the population in Papua New Guinea (PNG) until mid-2007. Since that time, commercial competition has been introduced into the mobile telecommunication sector and coverage has spread across many parts of the country. While the focus of this article is on mobile phones, the research has also explored media access and media usage more generally. Analysis in this article adopts the ‘circuit of culture’ model developed by du Gay et al. (1997). The article is based on data from a survey conducted in 2009 in eight rural villages in Madang Province. The research occurred during the primary stages of mobile phone adoption in these places, providing a rare opportunity to gauge early adoption behaviour and attitudes.

scholarly journals Adult mortality surveillance by routine health workers using a short verbal autopsy tool in rural north India

2011 ◽  
Vol 66 (6) ◽  
pp. 501-506 ◽  
Author(s):  
Anand Krishnan ◽  
Rakesh Kumar ◽  
Baridalyne Nongkynrih ◽  
Puneet Misra ◽  
Rahul Srivastava ◽  
...  
Keyword(s):  
Verbal Autopsy ◽  
Health Workers ◽  
Adult Mortality ◽  
North India ◽  
Mortality Surveillance

Health worker confidence in diagnosing and treating mental health problems in Papua New Guinea

2004 ◽  
Vol 15 ◽  
pp. 29-42 ◽  
Author(s):  
Betty E. Koka ◽  
Frank P. Deane ◽  
Gordon Lambert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Papua New Guinea ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Workers ◽  
New Guinea ◽  
Health Problems ◽  
Mental Health Training

Confidence in identifying different diagnostic categories of mental disorders by general health workers who provide the bulk of Papua New Guinea's (PNG) mental health care is vital for the country's provision of mental health care. Making a psychiatric diagnosis is complicated by PNG's diverse culture and estimated 800 distinct languages. These cultural-linguistic factors influence help-seeking behaviour and continued use of traditional treatment despite the introduction of western approaches to mental health care. The aim of this study was to determine the confidence of health workers in identifying and diagnosing different categories of mental health problems in this complex environment. A sample of 209 Papua New Guinea health workers from four geographic regions completed a questionnaire that assessed background levels of training and confidence in diagnosing a range of modern and culture specific diagnoses. Overall, respondents reported relatively little prior mental health training. Consistent with this were the relatively low levels of confidence for culture specific diagnoses (e.g. sorcery), but significantly higher levels of confidence with modern diagnoses (e.g. depression). The implications of the findings for training and provision of mental health care are discussed.

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