6. Governance for human resources for health 6.1 HRH policies and plans The 2013 Health Sector Human Resource Management Policy sets operation guidelines, processes and procedures for effective and efficient HR management in the health sector. The main HRH plan is the Health Workforce Enhancement Plan 2013–2016 (HWEP), which has been extended until 2019 (National Department of Health, 2013b). It was developed as a response to a 2009 World Bank review of the health workforce situation, and its objectives and actions are guided by the recommendations in the World Bank report – namely, the implementation of Scenario 5 – increases in pre-service training and in-service training, staff for support services and quality-enhancing non-salary budget expenditures (Morris & Somanathan, 2012). Other national plans that include health workforce priorities are Papua New Guinea Vision 2050, Papua New Guinea Development Strategic Plan 2010–2030, National Health Plan 2011–2020, medium-term development plans, and the National Health Standards 2011–2020. A review of HWEP was undertaken in 2018, which reported that initial implementation was slow due to a lack of leadership to operationalize it. The implementation of the plan only began after the HR Branch, with support from WHO, initiated the activities. There were 16 objectives in HWEP, of which each had at least one action.
6.2 Policy development, planning and managing for HRH The main responsibility for policy development lies with the Strategic Policy Division of NDoH (see Appendix), in coordination with other branches. Stakeholders including donor partners are also critical in supporting the development and implementation of HRH plans and policies. The HWEP was criticized in the Mid-term Review of the National Health Plan 2011–2020 for failing to “grasp the magnitude and urgency required to address critical manpower numbers and skill sets” and noting that “there is a profound disconnect between the workforce supply [in the HWEP] and expectations of service improvement in the NHP [National Health Plan] 2011–20” (Matheson, et al., 2015). The disagreement 28
Human Resources for Health Country Profiles
between these national policies highlights a core issue in health workforce planning: that aspirational goals need to be supported by long-term commitments of funding to ensure these goals are attainable. HWEP is not costed and targets set would not be reached until after the expiration of the current NHP (Matheson, et al., 2015). There is currently no guarantee of a longterm significant funding increase needed to increase training capacity in educational institutes. While the production rate of doctors, nurses and CHWs has increased over the past five years, in order maintain the positive trend in training, more resources need to be committed.
6.3 Professional regulation 6.3.1 Medical Board The Medical Registration Act 1980 enabled the development of the Papua New Guinea Medical Board, which is responsible for the registration of public and private sector medical, dental and allied health practitioners (including physiotherapists, medical imaging and laboratory scientists, nutritionists and psychologists, eye health, environmental health officers, and anaesthetic technicians), HEOs and CHWs. It is made up of a disciplinary committee, medical education standards committee and registration committee. Generalist and specialist medical practitioners are registered separately. There are three levels of registration: probational, provisional and full. New medical and dental graduates from recognized universities initially hold a two-year provisional licence. After two years of clinical practice, they are eligible to move to full registration. Probational registration is given to HWs who were trained at an unrecognized training institution, or were previously fully or provisionally registered but has not had any clinical practice in the previous three years. Some allied HWs are initially provisionally registered for one year, and after 12 months of full-time employment in an approved health facility or under the supervision of a registered allied HW, can upgrade to full registration. Environmental health officers, anaesthetic technicians and CHWs are the only cadres that do not require a provisional licence before applying for full registration. There is a 30-day grace period between 31 March and 30 April each year to renew licences. It was
