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Table 5. Health workforce trends by cadre, 1988–2018
2. Health workforce supply
2.1 Health workforce supply
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There has been a persistent lack of reliable and accurate human resources for health (HRH) data over many years. It is the primary problem in health workforce development in Papua New Guinea and crucial for any effective policy planning and development. Health workforce data are not collected centrally, but some information is collected intermittently in a one-off survey. The Human Resources (HR) Branch within NDoH does not receive regular updated data from the provinces and districts regarding health worker (HW) numbers and pre-service training. The most recent reliable data come from the 2018 HR database compiled to establish a centralized HR information system, linked with the provinces and CHS, with support from the World Health Organization (WHO). The HR database has begun compiling demographic data on the health workforce including age, sex, province and cadre. NDoH no longer has a copy of the 2009 head count survey (HCS) as the data were stored on one computer and, due to a lack of handover procedures, were lost once the responsible employee ceased working at NDoH. Irregular censuses of HWs have occurred previously, but these are simply counts of cadres with no demographic information attached. These censuses were reliant on CHS, provincial hospitals, and provincial and district health authorities to supply data (National Department of Health, 2018c).
The 2018 HR database reported there were a total of 15 237 HWs in the health sector (including public service, churches and private health-care providers), which represents an increase of 16.6% since 2009 (National Department of Health, 2018d). This included a 58.8% increase in doctors to 602, and an over 600% increase in midwives to 677. More concerning is a drop in nurses, HEOs and dentists. Based on the estimated national population in 2018, however, the ratio of doctors, HEOs, nurses, midwives and CHWs per 1000 population was 1.03, an encouraging increase from 2009 when it was 0.55/1000 but still well below the WHO threshold of 4.45/1000 to meet the Sustainable Development Goals and universal health coverage (Table 5).
Table 5. Health workforce trends by cadre, 1988–2018
Cadre 1988 1998 2004 2009 2018
Medical doctors Dental professionals Health extension officers 384* 316* 524* 379 602 191 142 357 233 575 486 313
Nurses Midwives 2917** 2920** 3980** 3526 3264 92 677
Community health workers Pharmacy professionals Medical laboratory staff Allied health professionals 4982 3926 5358 4419 4469 115 159 150 254 258 288 283 372 440 318 395
Other/management, health administrative and support staff – 2874 1224 3394 4972
Total 9082 10 791 12 355 13 063 15 237
* Doctors and dentists are combined; ** nurses and midwives are combined. Sources: Morris & Somanathan, 2012; National Department of Health, 2018d.
