Papua New Guinea (PNG), one of the most populated countries in the Pacific, also has one of the highest maternal death rates in the Asia and Pacific regions. The current downward trend of women accessing health facilities or having a skilled birth attendant present during childbirth is alarming. An estimation from 2018 showed that two out of three women in PNG had no access to contraceptives due to geographic, cultural, and economic barriers. These concerning estimates are expected to be further derailed as a result of the COVID-19 pandemic.
The pandemic brought a direct life-threatening impact to PNG’s unprepared health care systems. Many people live with pre-existing vulnerabilities such as lack of access to basic services and healthcare facilities, or who live in natural disaster-prone areas. At the centre of this situation are vulnerable women and girls, especially those with little or no access to sexual and reproductive health and rights (SRHR) services, including contraception - a vital health component that is often deprioritised in crisis settings.
Against this backdrop, the International Planned Parenthood Federation (IPPF) is currently supporting the Papua New Guinea Family Health Association (PNGFHA) to extend essential SRH services from its eight static clinics in hard-to-reach communities via the mobile clinics outreach program.
The main objective of this response is to mitigate the impact of COVID-19 on mortality and morbidity due to adverse SRH conditions. This will include the delivery of crucial Minimal Initial Service Package (MISP) services; the continuation of comprehensive SRH services; the provision of public health information to communities; and COVID-19 infection prevention and control education.
Funded by the Australian government through the SPRINT program, the community outreach mobile clinics are working in 12 districts across four provinces including East New Britain, Eastern Highlands, Morobe, and National Capital District. The National Department of Health is the main coordinator, alongside provincial health authorities, UNFPA, health protection clusters and IPPF Humanitarian for PNGFHA.
Throughout the pandemic, PNGFHA has continued operating its eight static clinics and it has set up an additional 12 mobile clinics since July 2020 with a total of 26 clinical and non-clinical staff.
Access to sexual and reproductive health
Accessibility is the key factor behind this initiative. 85% of the population is estimated to live in rural areas in PNG and have no or minimal form of public transportation to get to public health facilities. With government-imposed stay at home orders, many people are unable or reluctant to travel amid fears of becoming infected at the health facilities.
Women at the Tuna Bay settlement outside of the capital, Port Moresby, have little access to health facilities within their local area. Many women like Vavine Kila fear for their own and their children’s health and wellbeing but are unable to access the healthcare they need due to the high cost of transportation.
“We don’t normally get access to these services in our community,” said Vavine. “When we go out to other locations, sometimes we wait until late, and also it is expensive to travel up and down. It is very vital to bring the services into the community so our people can benefit from it, for the betterment of our children.”
The PNGFHA’s eight mobile clinics across PNG cut down locals’ travelling and healthcare costs. These clinics also extend underserved communities’ access to SRH services including family planning services, contraception, immunisation, and other health treatments.
Local and safe spaces
Local, and primarily female, aid workers are at the core of this response to the COVID-19 pandemic.
Christine Atu is one of the aid workers that joined PNGFHA from the PNG public healthcare system. She is working alongside youth apprentices like midwife Dalyn Maira at the mobile clinics. Their exchange of experience, expertise and insights into the local culture and context ensure the smooth delivery of essential service to the local communities.