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Abstract online early

The evolution of the Community Health Worker program in Papua New Guinea     [ Rural Health History ]

Submitted: 22 March 2016
Revised: 14 March 2017
Accepted: 28 March 2017

Author(s) : Pilang CL, Gray MA, Oprescu FI.


Papua New Guinea has a special history in regards to the
training of Community Health Workers (CHWs) and is currently
preparing its frontline health workforce to serve the 85% of
the 7.3 million people who live in rural and remote settings.
This article identifies and explains the five major
developmental stages (Figure 1) in the current CHW training
program, as well as the changes that have occurred over the
past century. The developmental stages are: 1. Traditional
stage; 2. Early contact stage; 3. Innovation; 4. The 80s
stage; and 5. New Millennium stage. These developmental stages
will be discussed in the context of the early literature and
investigation by the primary author and examination of the
lived experiences of early missionary health workers and local
people. This paper documents the development of a CHW program
in PNG from the colonization period, which began in 1883, to
the present day. As a developing nation, PNG has gone through
many challenges and changes to its health care system and has
gradually developed an effective programme to train its
frontline PHC workforce. This article contributes new
information with regards to the past and current development
of CHW programs in PNG as well as in other developing
countries. The training of competent CHWs with the essential
skills and knowledge may help deliver quality and cost-
effective PHC health services to the rural majority and the
urban disadvantaged thereby fulfilling the PNG government’s
National Health Plan for 2011-2020. Systematic evaluation of
the effectiveness of the CHW program will provide guidance for
continued development of this frontline health workforce.
Improving and introducing a competency-based curriculum is an
essential step towards building a healthier nation.

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