There are major challenges to the delivery and accessibility of health services in the region. Mountainous topography, coupled with high rainfall, means patients and medical outreach staff face long and arduous journeys across inhospitable terrain by road, river or air to medical facilities.

On top of this, statistics show that access to health services in the region has declined in recent years.

From 2003 to 2007 there was a 35% decline in the conduct of medical outreach clinics for children under 5, with the largest decrease in North Fly. In 2007, 56% fewer health centres were visited by a medical officer compared to 2006. (2)

Reduced levels of childhood immunisation

Reduced access to health services has impacted on childhood immunisation rates, with a 4% drop in the number of children under one immunized for diphtheria, tetanus, and pertussis, from 55% in 2006 to 51% in 2007. The national immunization rate is 68%. (2)

The province’s measles vaccination rate continues to remain under 50%, compared to the national average of 53%. (2)

High fertility rate, yet inadequate access to antenatal care

The fertility rate, at 5.6 children per woman, is higher than the national average of 4.6. (1)

About 30% of women in the province do not receive any antenatal care. This means no monitoring during pregnancy, no birth planning, and no treatment or prevention of malaria or neonatal tetanus*. However, the province fares better than the rest of the country, where on average 40% of women do not receive antenatal care. (2)

*Neonatal tetanus occurs in non-sterile home deliveries, and is mostly fatal source

Significant infant mortality rate

The province’s current infant mortality rate is 6.6% (66 deaths per 1,000 live births); a dramatic improvement on its 2000 rate of 8.3% but still higher than the national rate of 5.4%. (1)

Reduction in childhood malnourishment

Over the period from 2003 to 2007 there were less severely malnourished children under five (those weighing less than 60% of the expected weight for their age). (2)

While under-nutrition, that is to say children under five weighing only 80% of the expected weight for their age, continues to decline in the province, high levels of childhood under-nutrition are still seen in the South Fly district. (2)

Fluctuations in low birth weight trends

Birth weight is a reflection of the health of the mother during pregnancy and an important indicator of an infant’s health. While there was an overall improvement in infant birth weights in 2006, this wasn’t sustained in 2007. Low birth weight is seen most frequently in the South Fly district. (2)

Malaria

Despite a slight drop in the incidence of malaria in 2007, the overall number of deaths increased slightly that year. Western Province has the fourth highest number of nationally reported cases of the deadliest strain of malaria, p.falciparum. (2)

Second highest incidence of leprosy in PNG

All but eradicated in most of PNG, leprosy remains a serious problem in Western Province, which has the country’s second highest incidence of the disease after West Sepik.

Extremely high prevalence of lymphatic filariasis (elephantiasis)

Lymphatic filariasis is endemic to PNG, which has the highest infection rate in the world. Nationally, about half the population are infected, while Western Province has an infection rate of up to 80%, rising to 98% in some areas.

High risk factors for HIV/AIDS infection

HIV prevalence rates, at 1.05%, are significant in Western Province, whose numerous transport and migration routes and mining and logging sites make it a high-risk area for HIV infection. Other risk factors include access to urban centres, lack of awareness programs and testing facilities, and ongoing stigma and discrimination. (1)

Reflecting national trends, married women are the most likely group to be exposed to HIV/AIDS, and also the most difficult demographic to reach in order to raise awareness of the disease.

References:

1. Pre Program Assessment for Health in Western Province, report prepared for the PNG Sustainable Development Program Limited
2. Western Province 2008 Annual Sector Review