PILOT INTEGRATED COMMUNITY CASE MANAGEMENT TRAINING EXPERIENCE, EASTERN HIGHLANDS PROVINCE, PAPUA NEW GUINEA

Abstract

The health care system in Papua New Guinea (PNG) is in dire need of strategic realignment to expand access to care. Due to the country’s rich biological, cultural, and linguistic diversity, rural health care needs have been largely unmet by the current government health system delivery model leading to poor outcomes, including neonatal mortality rates as high as 20/1,000 live births and under 5 mortality rates as a high as 49/1,000 live births (WHO, 2020). The primary research purpose was to assess the feasibility of a low-cost, vignette-driven, and multi-modular integrated community case management (ICCM) training for health care for children under the age of five in PNG. The training offered an active reinforcement approach in audiovisual and active dictation methods that provided a contextualized and culturally sensitive, and pragmatic approach to ICCM training. Modules for the training covered conditions highly prevalent in PNG, including malaria, pneumonia, diarrheal disease, meningitis, and malnutrition. The pilot Household Health Worker (HHW) training demonstrated modest improvements in the quantitative assessment of the knowledge, clinical skills, and self-efficacy. The feedback offered by HHWs through focus group discussions included comments about the strengths of the training, such as increased confidence in disease recognition and clinical skills. In addition, qualitative findings also informed areas of future improvement for the training, including more audiovisual content and more time for practice. In conclusion, there were positive outcomes related to the training and further improvements and additional considerations—such as funding for HHWs—that need to be made to successfully scale up the program nationwide in collaboration with the national government.