Minister for Health and National Emergency Services Hon. Dr. Billy Joseph says it is time for a frank, evidence-based assessment of Provincial Health Authorities to determine if the 2007 reform has delivered better health outcomes for Papua New Guineans.
Dr. Joseph made the call on Monday while opening the 2026 Papua New Guinea Medical Symposium at the Papua New Guinea University of Technology.
The symposium theme is
“Provincial Health Authorities Establishment Review: Past, Present and Future PHAs Forward and Back.””
He said PHAs were created to address fragmentation in the health system by placing responsibility for an integrated provincial health service under one authority.
“But reform is not achieved simply by changing structures or passing legislation. The real test is whether reform produces better management, better services, greater accountability, and better health outcomes,” Dr. Joseph said.
The Minister presented key health indicators showing limited progress over 20 years.
He said supervised birth attendance dropped from 53 per cent in 2006 to 44 per cent nationally in 2025, with only NCD meeting the 71 per cent national target.
Immunisation coverage has also stagnated. Measles coverage was 43 per cent in 2007 and 45 per cent in 2026. Pentavalent 3 coverage dropped from 52 per cent to 49 per cent.
HIV prevalence was estimated at 0.8 per cent in 2011 and 1.5 per century in 2025. TB incidence remains above 400 per 100,000.
“After almost 20 years, we have not achieved the sustained improvement in routine immunisation coverage that our children deserve. We have not yet achieved the sustained reduction in TB transmission that we need,” Dr. Joseph said.
He acknowledged that the health system has expanded. There are now approximately 3,733 facilities and 20,929 health workers, up from 2,965 facilities and 11,739 workers in 2007. Government health funding has also increased from K346 million to more than K3.2 billion.
“But this has not translated into better health outcomes,” he said.
Dr. Joseph said the National Department of Health is undertaking a review of PHA performance and has established a Ministerial 120-Day Plan focused on 10 priority areas. These include medical supply chain reform, health infrastructure, workforce, tertiary care policy, pre-hospital care, and disease prevention.
“The 120-Day Plan will only succeed if we translate priorities into action at provincial, district, and facility levels,” he said.
He challenged symposium participants to turn dialogue into action and to produce a clear record of recommendations and agreed actions.
“As many of you are aware, the Prime Minister, Hon. James Marape has directed all of us to improve performance and demonstrate accountability. Every kina appropriated by Parliament belongs to the people,” Dr. Joseph said.
The Minister said the review must answer whether PHA reform has delivered better health outcomes, and if not, what changes are required in leadership, governance, financing, workforce, infrastructure, service delivery and accountability to build a stronger health system for the next 50 years.