Who we are
The Papua New Guinea (PNG) Reproductive Health Training Unit (RHTU) is a novel Public-Private Partnership intended to assist interested provinces, organisations and health services, to improve reproductive health service delivery and indicators. It is being established in phases at the request of the National Department of Health (NDoH) to develop and deliver PNG-contextualised reproductive health continuing professional development (CPD) to their health workers and educators (pre-service, post-graduate and in-service educators). The RHTU is established to assist provinces and partners who would like to establish achievable and functional reproductive health CPD programs for their workers. However, the RHTU only operates upon the explicit invitation from a province, and after a Memorandum of Agreement has been signed.
Urgent need for reproductive health services
The establishment of the RHTU comes in response to the urgent need to prioritise reproductive health services in PNG, and recognises the current challenges that limit the capacity of the PNG Government to manage this essential public health requirement in the short-term. Reproductive health indicators in PNG demonstrate the urgent need to improve services, but the challenges that compound reproductive health service delivery in PNG are manifold, including:
- The population of Papua New Guinea has increased by 36% between 2000 and 2011;
- Several health cadres are working at different levels of the health system, with over half of them operating in rural and remote areas;
- The need for reproductive health CPD is not being met by the existing capacity of the NDoH, educational institutions, and specialist organisations;
- The NDoH is withdrawing from CPD activities to concentrate on other core functions, consequently CPD has become the sole responsibility of the Provinces;
- The needs of the people of Papua New Guinea change over time; as do evidence, policy, procedures, standards and national guidelines. Many health workers, however, are still providing care according to what they were taught decades ago. Health workers are strongly requesting regular, up-to-date CPD to fill their knowledge and skills gaps. There are ~ 9,000 health workers in PNG, 1/3 of them being directly involved in reproductive health service delivery;
- The morale of health staff is often poor, due in part to gaps in contemporary knowledge and skills.
Accordingly, as a functional and increasingly resourced training unit, the RHTU sets out to offer a range of essential training packages to partnering Provinces. However, this long-term endeavour necessitates a careful and phased approach.
The first phase (Phase I) spans from September 2012 to June 2015, in which the Partnership that forms the RHTU consisting of:
- The National Department of Health (NDoH) as recipient of capacity building;
- The Australian Agency for International Development (AusAID) functioning as funder; and
- The Oil Search Foundation (OSF) assuming the role as initial operations manager for the RHTU.
In the second phase (Phase II) the management of the RHTU will transition to the most appropriate PNG health education institution, and the final phase (Phase III) will see the RHTU stand alone as a completely locally owned and managed National training body that provides links between the NDoH and the Provinces, as well as between pre-service and post-basic training facilities for all health provider cadres.
Sep 2012 – Jun 2015
The first phase will be overseen and managed by the public-private partnership between the NDoH, AusAID and the OSHF from September 2012 until June 2015. During this period the engagement and participation from Provinces will be sought and EmOC, EOC and FP programs will be delivered to selected staff. Some Provincial staff will be offered training to become accredited as RHTU Trainers in selected training packages.
Jun 2015 – Jun 2017
The second phase will commence post June 2015 and last for a few years. This time frame should see the RHTU transition from the Partnership (NDoH, AusAID, OSHF) oversight to a home at the most appropriate PNG health education institution. The number of provinces being reached should be increasing at this stage, as well as the menu of reproductive health CPD packages.
Jun 2017 – onwards
The final phase will see the RHTU transition entirely to an independent, PNG-owned and managed institution. The RHTU will need to attract its own funding and should include expansion/value-adding by integrating with other courses offered at educational institutions. This may offer the opportunity to develop some combined yet flexible Public Health, Management, Reproductive Health, and related post-graduate courses for service providers and educators.
Strategic objectives for Phase I
SO 1 :Formal communication and coordination system established and implemented for all RH training stakeholders in PNG
SO2: Operational research for RH IST in rural/remote health facilities in pilot program (Milne Bay Province) applied, evaluated and informing national approaches
SO3: Development of comprehensive and context-specific IST packages in EOC, EmOC and FP
SO4: Demonstrated governance, planning and budgeting capacity at national and provincial levels and in training institutions for RH IST
SO5: Significantly increased health workforce capacity to provide quality EOC, EmOC and FP IST to health workers in 10 provinces and training institutions
The principal purpose of the RHTU is to improve the knowledge, skills and attitude of front line health workers, initially in Family Planning (FP), Essential Obstetric Care (EOC), and Emergency Obstetric Care (EmOC) service provision in Papua New Guinea. We endeavour to enhance the expertise and capacity of health educators by providing them with continuing professional development.
To achieve this goal, the predominant focus of the RHTU is on capacity building in the Provinces, particularly in the areas of planning, funding, implementation, evaluation, acquittal, reporting and reproductive health training. This means that the RHTU will assist Provinces and institutions to identify and prioritise their local reproductive health training needs and develop a structured program to refresh and reinforce the reproductive service provision according to National Department of Health (NDoH) policies and guidelines at health facility level.
This approach is framed around three core strategies identified by the 2009 PNG Ministerial Taskforce on Maternal Health and confirm with recommendations from the 2011 World Bank Report “PNG Health Workforce Crisis: A Call to Action”. To improve maternal health outcomes in PNG, the RHTU is committed to the following strategies:
- Providing comprehensive, integrated reproductive health services, mainstreaming quality Family Planning (FP) services;
- Improving Essential Obstetric Care (EOC) by trained health workers for all pregnant women throughout pregnancy and especially during and soon after childbirth (i.e. supervised delivery and post-natal care);
- Improving Emergency Obstetric Care (EmOC) for women with life-threatening complications (~ 1.5% of all pregnancies) and their newborns supported by timely, safer referral.
As recommended by the RHTU Steering Committee, the target audience for the RHTU continuing professional development (CPD) packages includes the following reproductive health Service Providers/Clinicians:
- All cadres: CHW, nurses, HEOs, Midwives and Doctors
- All levels of the health system: provincial hospital to rural health centre
- Reproductive health educators in Pre-service, Post-basic training schools and potential CPD trainers in the provinces
- Post-basic trainees and graduates involved in reproductive health services provision:
- DGO, MMeds (O&G, R&RM, A&E, Anaesthesia)