In , WHO technical cooperation with the Government is expected to focus on the same WHO strategic objectives.

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1 PAPUA NEW GUINEA Papua New Guinea, one of the most diverse countries in the world and the largest developing country in the Pacific, is classified as a low-income country. PNG s current population is estimated to be 6.6 million and is predicted to reach 9 million by Close to 87% of the population lives in rural areas and access to widely scattered rural communities is often difficult, slow and expensive. Health services in Papua New Guinea are provided by the Government and church medical services and are financed primarily by public funds, but with considerable contribution from development partners. In recent years rural health services have deteriorated significantly mainly as a result of declining health infrastructure, frequent drug shortages, scarce and inefficiently deployed human resources for health and weak systems for support and supervision of staff. The shortage and skewed distribution of human resources is a critical issue in Papua New Guinea. PNG is unlikely to meet the Millennium Development Goals by 2015 and it is estimated that about 37 percent of the population is living below national poverty line. The doubling of maternal mortality over the last 10 years is an indication of shortcomings in the health service delivery system. Child morbidity and mortality are also high. Communicable diseases, including malaria and tuberculosis, remain the major cause of morbidity and mortality in all age groups. Papua New Guinea has a generalized epidemic of HIV/AIDS. The strategic directions for WHO s work in Papua New Guinea is outlined in the Country Cooperation Strategy (CCS) , which is aligned with both PNG s National Health Plan and the Medium-Term Development Plan In , WHO technical cooperation with the Government is expected to focus on the same WHO strategic objectives. 01 To reduce the health, social and economic burden of communicable diseases WP01 Member States supported to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential interventions with immunization and to control or eliminate targeted vaccine preventable diseases (VPDs). Office-specific expected result (OSER) OSER Indicator Baseline Target WP01.PNG05 Equitable access with vaccines of assured quality including new immunization technologies and to integrate other child and maternal health interventions with immunization strengthened WP01.PNG05.01 Number of districts with 90% DTP-Hib-HepB 3 dose coverage WP01.PNG05.02 Number of districts with 90% MCV 1 dose coverage WP01 Effective coordination and provision of support to Member States to retain certification of poliomyelitis elimination; including destruction and/or appropriate containment of polioviruses and other post eradication activities as required WP01.PNG01 Effective coordination towards retaining poliomyelitis free status and appropriate containment of poliovirus, leading to cessation of oral polio vaccination WP01.PNG01.01 Number of quarterly reviews of AFP surveillance performance that WHO supports or conducts.

2 WP01 Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases WP01.PNG02 Technical and financial support for the prevention, control and elimination of filariasis, dengue and other neglected tropical diseases WP01.PNG03 Policy and strategy developed and quality services and surveillance strengthened for leprosy elimination WP01.PNG02.01 Number of guidelines/plans for NTD diagnosis, treatment and prevention developed with support from WHO WP01.PNG Number of provinces implementing DEC (diethylcarbamazine) Salt supported by WHO WP01.PNG03.01 Number of programme evaluation conducted WP01.PNG03.02 Number of workshops conducted for leprosy elimination WP01 Technical coordination in developing research proposal protocols for the prevention and control of communicable diseases with scientists from developing countries and areas increasingly taking the lead WP01.PNG07 Strengthened capacity on operational research on dengue and parasitic diseases WP01.PNG07.01 Number of operational research projects supported by WHO WP01 Support Member States to achieve minimum capacities for preparedness, detection, assessment of and response to emerging diseases and other public health emergencies, as required under International Health Regulations (IHR) (2005), through implementing the updated Asia Pacific Strategy for Emerging Diseases (APSED) (2010) WP01.PNG04 Enhanced implementation of surveillance, assessment and response to communicable diseases of public health importance in line with APSED WP01.PNG04.01 Number of weekly bulletins sent to provinces WP01.PNG04.02 Percentage of rumors verified by NDoH within 48 hrs WP01.PNG04.03 Percentage of the syndromic surveillance sites reporting weekly. 10 Less than 100% 100% Less than 40% 50%

3 02 To combat HIV/AIDS, tuberculosis and malaria WP01 Regional guidelines, policies, strategies and other tools developed for prevention, treatment and care for STI and HIV/AIDS, malaria and tuberculosis (including innovative approaches for increasing coverage of the poor, hard-to-reach and vulnerable populations) WP01.PNG01 Policy and strategies developed, programme management improved and quality, surveillance and services for malaria control strengthened WP01.PNG08 Development/review of strategies, policies and guidelines and strengthened services for HIV prevention, treatment, care and support WP01.PNG09 Policy, strategy documents, protocols and guidelines for tuberculosis developed/revised WP01.PNG01.01 Number of guidelines/plans for malaria diagnosis, treatment and prevention developed with support from WHO WP01.PNG08.01 Number of HIV/AIDS guidelines reviewed, printed and disseminated WP01.PNG09.01 Number of TB control strategy and protocol reviewed/developed, printed and disseminated WP01 Countries and areas implemented prevention, treatment and care interventions for STI, HIV/AIDS, malaria and TB and scaling-up to reach the most in need (including integrated training and service delivery; wider provider networks; strengthened lab capacities, etc) WP01.PNG06 Capacity built for TB programme management, advocacy, communication and social mobilization and operational research WP01.PNG10 Strengthened health sector HIV linked services WP01.PNG06.01 TB treatment success rate among new smear positive cases WP01.PNG10.01 Number of provinces conducting, implementing and reporting congenital syphilis elimination strategies. 73% 80% WP01 Regional and national surveillance, evaluation and monitoring strengthened and expanded to monitor progress towards targets and resource allocations for STI and HIV/AIDS, malaria and TB control, including drug and insecticide resistance and impact of control efforts WP01.PNG11 STI/HIV/AIDS strategic information strengthened WP01.PNG11.01 Number of sites conducting HIV sentinel surveillance WP01.PNG12 Improved TB surveillance, and its monitoring and evaluation system WP01.PNG12.01 Number of NTP annual reports published and distributed.

4 WP01 Operational research for the prevention and control of STI and HIV/AIDS, malaria and tuberculosis supported and research capacity strengthened in target countries and areas WP01.PNG13 Strengthened capacity on operational research on HIV/AIDS and STI including innovative approaches WP01.PNG14 Strengthened capacity on operation research on malaria through training and other technical inputs WP01.PNG13.01 Number of ART sites conducting Early Warning Indicators WP01.PNG13.02 Number of ART sites conducting HIV Drug Resistance WP01.PNG14.01 Number of operational research projects supported To prevent and reduce disease, disability and premature death from chronic noncommunicable diseases, mental disorders, violence and injuries and visual impairment WP01 Enhanced capacity of Member States for the development and implementation of policies, strategies and regulations in respect of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities WP01.PNG15 Public awareness, advocacy, capacity building and training on the prevention and management of noncommunicable diseases WP01.PNG16 Strengthened oral health programme in Papua New Guinea WP01.PNG15.01 Number of settings supported for multisectoral approaches for NCD (e.g. health promoting schools) WP01.PNG16.01 Number of trainings with dental health practitioners completed WP01.PNG16.02 Number of DMFT (decayed, missing, filled teeth) surveys completed. 1 3

5 04 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals WP01 Enhanced capacity of Member States to develop integrated policies, strategies, and plans towards universal access to effective interventions for improving maternal, newborn, child, adolescent and reproductive health WP01.PNG17 Strengthened capacity and improved programme management to reduce child mortality through better quality and coverage of the key child survival interventions with special focus on pneumonia, diarrhoea and malaria WP01.PNG17.01 Number of provinces implementing revised IMCI guidelines and having oxygen therapy available at referral care level facilities WP01 Capacity within Member States strengthened for implementing national plans for the reduction of maternal and newborn mortality, including achieving skilled care for every birth WP01.PNG18 Strengthened national capacity to implement strategies to reduce maternal and newborn mortalities WP01.PNG18.01 Number of districts developing and implementing plans to reduce maternal and newborn mortalities based on local situation analysis and maternal death audit outcomes WP01 Enhanced Member States' capacity for implementing evidence-based strategies, norms and standards for the prevention and care of diseases and health compromising behaviours in adolescents WP01.PNG19 Strengthened capacity to develop and implement programs to improve adolescent health outcomes WP01.PNG19.01 National Strategic Plan to improve adolescent health developed, costed and being implemented WP01.PNG19.02 Number of regional training to build capacity to implement adolescent health program conducted.

6 05 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact WP01 Establishment and implementation of national health emergency risk management plans and WHO readiness plans WP01.PNG20 Effective operation and response to declared emergency situation due to epidemic and pandemicprone diseases WP01.PNG20.01 Number of rapid response teams formed and trained WP01.PNG20.02 SOPs for rapid response teams developed To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex WP01 Strengthened countries' and areas' health promotion capacity across all relevant programmes, and to establish effective multisectoral and multidisicplinary mechanisms and collaborations to promote health and prevent and reduce behavioural and structural risk factors WP01.PNG21 Policy development for healthy lifestyles WP01.PNG21.01 Multisectoral committee for NCD established and in operation WP01.PNG21.02 Number of provinces with an established health promoting school programme. 0 Established and convened WP01 Strengthened risk factors surveillance by developing, validating and disseminating programme and evaluation frameworks, tools and procedures to countries and areas with high or increasing burden of premature death and disability due to behavioural risk factors WP01.PNG22 Development of risk factor surveillance systems for chronic diseases and behavioural risk factors WP01.PNG22.01 Number of cancer registries in operation WP01 Training and advocacy to countries and areas with high and increasing disease burden associated with tobacco use to strengthen institutions to address public health problems concerned. Support to the Paris Conference to the WHO FCTC for its implementation WP01.PNG23 Implementation of the WHO FCTC supported WP01.PNG23.01 Number of advocacy campaigns conducted.

7 07 To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches WP01 Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions WP01.PNG25 Strengthened country capacity to promote equitable, genderresponsive and human rightsbased health policies and programme WP01.PNG25.01 Number of activities supporting the development of provincial capacity to promote more equitable and pro-poor policies, programmes and interventions. 08 To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health WP01 Enhanced capacity of countries and areas for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings and among vulnerable population groups WP01.PNG24 Strengthening of assessment and management of environmental health risk WP01.PNG24.01 Number of policies related to sustainable health, food safety, and water and sanitation developed WP01.PNG24.02 Number of provincial and district staff trained in environmental health activities To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development WP01 Enhanced capacity of Member States for the development, strengthening and implementation of nutrition programmes aimed at improving nutrition throughout the life-course, in stable as well as humanitarian crisis situations WP01.PNG26 Plans to improve nutrition of children and women in reproductive age and to improve food safety and security of the population developed and implemented WP01.PNG26.01 Number of provinces implementing programs to support infant and young child feeding WP01.PNG26.02 Number of scholarships provided to support post graduate training in human nutrition and diet.

8 10 To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research WP01 Improved coordination of the various mechanisms (including donor assistance) that support Member States in their efforts to achieve national targets for health system development and global health goals WP01.PNG27 Commitment from major stakeholders in support of national health policies and strategies facilitated WP01.PNG27.01 Frequency of participation in Health Sector Partnership Committee meetings WP01.PNG27.02 Independent Annual Sector Reviews completed WP01.PNG27.03 ASR compiled on time every year WP01.PNG27.04 District health staff trained on the NHIS, data collection, analysis and use in each district and 2 in each province WP01 Strengthened country health information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals WP01.PNG28 Support provided to strengthen the health workforce information and knowledge base, build up capacity of Papua New Guinea for policy development and planning, and enhance research, networking and information sharing on HR WP01.PNG28.01 Number of provinces which have updated their health workforce data base at least quarterly WP01.PNG28.02 Staff in the first phase PHA provinces redeployed to reduce inequalities in distribution WP01.PNG28.03 Number of PNG nationals awarded fellowships WP01.PNG28.04 HRH strategy implemented provinces WP01 Better knowledge and evidence for health decision-making through consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas and leadership in health research policy and coordination, including ensuring ethical conduct WP01.PNG29 Improved data collection, analysis, sharing and utilization for decision making and policy formulation WP01.PNG29.01 Status of development of a NHIS Policy, Strategy and Plan. No policy, strategy or plan. Policy, strategy and plan developed.

9 WP01.PNG32 Legislation, regulatory policy formulation and policy implementation strengthened WP01.PNG29.02 Percentage of provinces that conduct quarterly reviews and produce reports on time WP01.PNG32.01 Number of policies and programmes developed (e.g. Public -Private Partnership Policy; Public Medical (Health) Institute; Human Resource Policy; Policy for provisional registration of Graduates of Maternal Child health/midwifery programs developed) WP01.PNG32.02 Number of provinces where PHA managers have been oriented on government policies, integrated planning and performance monitoring. TBD 80% WP01 Competent support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces WP01.PNG30 Strengthening of training institutions and providers of health care services WP01.PNG30.01 Number of training institutions strengthened (according to the pre/post assessment checklist) for the production of quality maternal health care workers WP01.PNG31 Planning and management skills of district health managers and health facility managers strengthened WP01.PNG31.01 Number of district health managers and health facility managers trained WP01.PNG31.02 The quality and number of supervision visits to district health facilities improved. 0 56% At least 80% of health facilities in PHA provinces receive scheduled supervision visits (and feedback reports compiled and acted upon) WP01 Health system financing improved in terms of the availability of funds, social and financial risk protection, equity, access to services and efficiency of resource use WP01.PNG33 Conduct of National Health Account study and development of national health insurance scheme supported WP01.PNG33.01 Policy Framework on national Health Insurance developed.

10 WP01.PNG33.02 Evaluation Report on Direct Facility Funding in ARB completed and provides evidence for roll out of Direct Funding Facility WP01.PNG33.03 National Health Accounts study completed. 0 Report completed and disseminated (NHA 2012 conducted) 11 To ensure improved access, quality and use of medical products and technologies WP01 National policies to improve access, quality and use of essential medicines developed, implemented, monitored or revised WP01.PNG36 Improvement in availability of essential medicines for the rural population WP01.PNG36.01 Percentage of key medical supplies available at facility level. 47% 80% WP02 Revised national policies to improve access, quality and use of blood products, medical devices and laboratories WP02.PNG34 Support for planning, organization, development and strengthening of public health and clinical laboratories including quality assurance provided WP02.PNG34.01 Number of laboratories with functional microscope services WP01 Internationally accepted norms, standards and guidelines for the quality, safety, efficacy and costeffectiveness of essential medicines implemented, and national regulatory and quality assurance systems strengthened WP01.PNG37 Institutional capacity for forecasting of needs and reduction of ad-hoc purchasing strengthened WP01.PNG37.01 Percentage of available essential drugs at facility level WP01.PNG37.02 Percentage of pharmacies participated in the post marketing surveillance of drugs quality. 47% 75% 0% 60% WP01.PNG39 Improvement in rational prescribing and dispensing practices to reduce misuse and overuse of medicines and drug resistance WP01.PNG39.01 Number of staff trained in rational drug prescription in 4 selected provinces. 0 3 per district in 4 provinces

11 WP02 Improved regulatory and quality assurance systems for blood products, medical devices and laboratories WP02.PNG35 Planning, development and strengthening of Blood Transfusion Service to improve access to adequate safe blood and blood products WP02.PNG35.01 Percentage of blood units collected from voluntary nonremunerated blood donors. 65% 75%