DECENTRALIZATION OF HEALTH-SERVICES IN WESTERN HIGHLANDS PROVINCE, PAPUA-NEW-GUINEA - AN ATTEMPT TO ADMINISTER HEALTH-SERVICE AT THE SUBDISTRICT LEVEL

In 1990, Western Highlands Province in Papua New Guinea, decentralized the administration of health services from the province (population 2 64,000) to 14 districts (equivalent to subdistricts elsewhere). Two ye ars later interviews were conducted with health workers and district a nd provincial heads. Productivity data were obtained from the provinci al health information system and financial data from the provincial an d national budgetary report. Health workers had a predominately negati ve opinion of the results of the decentralization The most common comp laints listed were lack of qualifications of District Assistant Secret aries, a diversion of funds to other programs, unavailability of trans portation, a lack of equity in personnel between districts and a lack of adequate professional supervision. The problems which developed in this attempt at further decentralization related to a lack of professi onal support and oversight of health professionals, a lack of role def inition for provincial and district administrators, lack of management training for district officials, inadequate oversight by local electe d officials and inadequate budgets.