scholarly journals A Partnership Model for Improving Service Delivery in Remote Papua New Guinea: A Mixed Methods Evaluation

2018 ◽  
Vol 7 (10) ◽  
pp. 923-933
Author(s):  
Emma Field ◽  
Dominica Abo ◽  
Louis Samiak ◽  
Mafu Vila ◽  
Georgina Dove ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniela C. Rodríguez ◽  
Diwakar Mohan ◽  
Caroline Mackenzie ◽  
Jess Wilhelm ◽  
Ezinne Eze-Ajoku ◽  
...  

Abstract Background In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly achieving the UNAIDS 90–90-90 targets. In Kenya, PEPFAR designated over 400 health facilities in Northeastern Kenya to be transitioned to government support (known as central support (CS)). Methods We conducted a mixed methods evaluation exploring the effect of GP on health systems, and HIV and non-HIV service delivery in CS facilities. Quantitative data from a facility survey and health service delivery data were gathered and combined with data from two rounds of interviews and focus group discussions (FGDs) conducted at national and sub-national level to document the design and implementation of GP. The survey included 230 health facilities across 10 counties, and 59 interviews and 22 FGDs were conducted with government officials, health facility providers, patients, and civil society. Results We found that PEPFAR moved quickly from announcing the GP to implementation. Despite extensive conversations between the US government and the Government of Kenya, there was little consultation with sub-national actors even though the country had recently undergone a major devolution process. Survey and qualitative data identified a number of effects from GP, including discontinuation of certain services, declines in quality and access to HIV care, loss of training and financial incentives for health workers, and disruption of laboratory testing. Despite these reports, service coverage had not been greatly affected; however, clinician strikes in the post-transition period were potential confounders. Conclusions This study found similar effects to earlier research on transition and provides additional insights about internal country transitions, particularly in decentralized contexts. Aside from a need for longer planning periods and better communication and coordination, we raise concerns about transitions driven by epidemiological criteria without adaptation to the local context and their implication for priority-setting and HIV investments at the local level.


2018 ◽  
Vol 5 (3) ◽  
pp. 495-507
Author(s):  
Ron Duncan ◽  
Chris Banga

Subject The 2017 general election in Papua New Guinea. Significance A two-week long general election in Papua New Guinea (PNG) ends on July 8. The election campaign has not gone as well as hoped for the incumbent government headed by Prime Minister Peter O’Neill, due to concerns about economic management, corruption and service delivery. Impacts There is some risk, though small, that an O’Neill win would prompt local unrest or calls for regional independence. Cancelling plans to host the APEC summit could become a symbol for moving spending priorities to education, health and infrastructure. The need for budgetary support from the IMF or World Bank might encourage more market-oriented policies.


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