Malum Nalu: Papua New Guinea health workforce crisis: A call to action

World Bank

(i) the current severely constrained training system for new health workforce cadres;

(ii) the rapid aging of the existing workforce – over half of the current health workforce will retire within a decade;

(iii) the expanding demand for services over the next 10 to 20 years due to sustained increase of the population.

The National Headcount Survey in 2009 shows that the size of the health workforce financed by the public sector has grown from 10,791 in 1998 to 13,063 in 2009. Since 2004, however, the pace of growth has slowed down markedly. The number of nurses, for example, dropped from 3,980 in 2004 to 3,618 in 2009.

To respond to the health workforce crisis, the PNG government’s needs to deal with:

(i) the immediate supply-side crisis (quantity);

(ii) the qualitative side, including preservice and in-service training (especially for emergency obstetric care for existing staff);

(iii) incentives to ensure staff are able to be deployed where needed, particularly in rural areas which is home to 80 percent of the population.

Armed with information of supply and demand, the report provides five scenarios to draw out the implications for each health cadre and for all service delivery staff, including affordability. The five scenarios vary from no change in existing supply capacity to four alternative scenarios with supply adjusted to meet the postulated demand.

The scenario most recommended envisages a new mix of direct service-delivery staff, which is not only affordable but also responds to the demand requirements for staff from the health system while leaving space in the recurrent health budget to boost quality. This scenario is driven by: (i) the growth in the resource envelope likely to be available for health and service-delivery staff; and (ii) the feasibility and speed with which preservice training can be ramped up to meet the demands of workforce attrition and the needs of a growing population.