Issues in the health care system in Madang Province, Papua New Guinea

Prideaux, Murray (2014) Issues in the health care system in Madang Province, Papua New Guinea. The Business Review, Cambridge, 22 (1 - Summer 2014). pp. 59-65.

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Papua New Guinea (PNG) has one of the most underperforming health systems in the Asia-Pacific region, despite several incentives undertaken in the past decade. This paper explores non-clinical leadership and management context, barriers and issues of health delivery in Madang Province, PNG. Health services are decentralised with leadership and management roles, finance and service delivery devolved to provincial and district governments. Provincial authorities retain significant autonomy and compelled to follow national policy directives. Findings point to important leadership and management barriers including ineffective leadership and management competencies and weak political and institutional capacity. There is the paucity of research in health services leadership and management in developing nations in the Asia-Pacific region. This research engages a qualitative design based on semi-structured interviews with health leaders and managers in Madang Province. Interviews were recorded, subject to discourse analysis then findings were evaluated against extant literature. This study contributes to the literature by exploring health leadership and management at provincial and district levels in one of PNG's twenty provinces. The findings help to better understand the complex interplay of factors in health delivery in a developing country. Leadership, supported by competent management are intuitively recognised as important drivers of change and innovation and often cited as critical elements in achieving successful health outcomes (Buttigieg & West, 2013). Much of the extant leadership and management literature attempts to identify how leaders and managers influence organisational outcomes primarily Western corporate business life. Underpinned by psychology and positivist social science methodologies research has characterised traits, styles, attributes, competencies and behaviours of individual managers and leaders (Evans et al., 2014). More recently, context barriers and issues have received increasing research attention in recognition that different situations require different leadership and management approaches (Jepson, 2009; Prideaux, 2013). This study examines non-clinical leadership and management in Papua New Guinea (PNG) to extend our understanding of context, barriers and issues in the health sector in a developing nation. The healthcare sector continually faces the challenge of delivering high quality care to those who need it, at an affordable cost (Littlejohns, Weale, Chalkidou, Faden, & Teerawattananon, 2012); is crucial to improving population health and reducing premature mortality (Macinko, Starfield, & Shi, 2003), and contributes to a nations quality of life. Further, the sector is undergoing significant transformation (Gaynor & Hass-Wilson, 1999; Kumar, Subramanian, & Strandholm, 2002) which demands leadership and management capacity at least equalling the ongoing change context. In this regard, PNG is no exception. The sector is staffed by clinical and non-clinical professionals who need the appropriate capacity, competencies and frameworks to deliver advocated health outcomes. Health professions, chiefly clinical staff are traditionally one of the most studied professions. Notwithstanding, many studies focus on medical specialists and nurses (Chan, Chien, & Tso, 2009; Prows & Saldanna, 2009) or on health executives only. However, there are few studies of non-clinical health service leaders and managers (non-executives) working in healthcare facilities in rural areas of developing countries (Carvalho, 2012; Mohd-Shamsudin & Chuttipattana, 2012). The majority of health service leaders and managers in Madang Province live and work in non-urban areas, often with limited communication facilities and basic infrastructure. Nonetheless, they are responsible for planning, organising, staffing, directing and controlling health care systems at the local level (Jarunee, 2007; Ministry of Health, 2001) with inadequate resources, training or support. This study aims to explore the factors influencing leadership and management of health delivery from a non-clinical perspective. By shedding light on the context, barriers and issues impacting on health sector leaders and managers, the dynamic and complex interplay of influences can be examined and may provide important insights for health system improvements. The study investigates leadership and management in first-aid posts, regional and district health centres at the provincial and district levels as an indicator of the broader PNG context. Previous studies have concentrated on the PNG health system from the national perspective rather than at the regional level. A review of the health system in PNG is presented first, and then extant literature is briefly reviewed to derive themes impacting on health delivery. Next, the methods adopted for this study are outlined, and findings discussed. Finally, implications and directions for future research are given.

Item ID: 38196
Item Type: Article (Scholarly Work)
ISSN: 1553-5827
Keywords: leadership; Papua New Guinea; health services; health management
Date Deposited: 18 May 2015 23:50
FoR Codes: 15 COMMERCE, MANAGEMENT, TOURISM AND SERVICES > 1503 Business and Management > 150308 International Business @ 75%
15 COMMERCE, MANAGEMENT, TOURISM AND SERVICES > 1503 Business and Management > 150399 Business and Management not elsewhere classified @ 25%
SEO Codes: 91 ECONOMIC FRAMEWORK > 9104 Management and Productivity > 910402 Management @ 80%
92 HEALTH > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified @ 20%
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