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Papua New Guinea (PNG) is one of Australia’s closest neighbours, but for many women, the realities of pregnancy and childbirth are often dramatically different from what most Australians experience.
While maternal mortality has reduced from 470 per 100,000 live births in 1990 to 171 per 100,000 live births in 2019, PNG’s maternal and newborn mortality rate remains one of the highest in the Western Pacific region. Only about 45 percent of women gave birth at health facilitates in 2023 and only 5 percent of health centres are equipped to provide emergency obstetric care 24/7. This means many women and newborns are going without the care they need.
This stark reality is primarily driven by limited access to healthcare. With much of the population residing in remote and rural areas reaching health facilities can be a monumental and difficult task. Even for those who can, clinics often suffer from a severe lack of essential infrastructure like running water and electricity and are chronically short on vital medical supplies, equipment, and crucially, trained healthcare professionals, especially skilled midwives.
This World Rural Development Day (6 July), we are spotlighting the incredible work of Village Health Assistants in PNG, who are actively bridging the gap between communities and health services.
We sat down with ChildFund Australia’s Health Advisor, Nusrat Jahan, to learn more about the critical role ChildFund-trained Village Health Assistants (VHAs) play in improving access to essential healthcare services for families in hard-to-reach areas in PNG.
What is a Village Health Assistant?
A Village Health Assistant is a trained community member who provides basic health services, delivers community health education and facilitates referrals to nearby health facilities. ChildFund, in partnership with local health authorities, mobilises and trains community members to serve as VHAs.
With strong social and cultural ties, they serve as trusted intermediaries between their communities and the formal health system, playing a transformative role in extending healthcare access and ensuring essential health services reach remote areas.
What type of healthcare support do they provide?
Village Health Assistants play a vital role in connecting remote communities to essential healthcare through mobile outreach clinics – a one-stop access point for basic health services. These clinics provide pregnancy care, support for new mothers, routine childhood immunisations and growth monitoring, family planning and TB screening.
ChildFund equips VHAs to deliver healthcare directly to communities that would otherwise go without. Their duties in these outreach clinics include essential tasks such as bringing communities together in one place, record keeping, making referrals and promoting health awareness while people receive various health services. A major part of their role is providing health education – engaging women in practical conversations about breastfeeding, nutrition and child health, often within culturally safe spaces where women can access accurate information and family planning advice. VHAs also regularly refer pregnant women to health facilities for safe deliveries, identify children needing vaccinations, and assist with births when health facilities are unreachable.
On a recent visit to an outreach clinic in rural PNG, I saw this work in action. I met Alice Lagani, one of the VHAs who identified early symptoms of TB in a pregnant woman in her community and referred her to the health facility. Thanks to Alice’s referral, she was screened, diagnosed and quickly began treatment – a powerful example of the life-changing impact just one volunteer can have.
From safe births to early detection of illness, VHAs are improving health outcomes in some of PNG’s most remote and underserved communities.
Josephine’s Story
Josephine has been a Village Health Assistant in her community for over 12 years. She’s a respected leader. There for her community, day and night. She regularly runs groups for pregnant mums in the village, teaching them the early signs of labour so they can alert her in time to make it to the health centre.
The closest Health Centre to Josephine’s village closed over a year ago, leaving her community without easy access to essential healthcare.
Josephine, a Village Health Assistant, with Wendy and her newborn in their community in Papua New Guinea.
Recently, she assisted a young woman called Wendy, who went into labour in the middle of the night. Josephine immediately sprang into action, calling for an ambulance, helping Wendy cross the river in a dinghy and waited with her until help arrived. Without Josephine, Wendy might not have had the chance deliver her baby safely at a health centre.
“Wendy’s labour pains began around 5am in the morning so there was no transport for us to bring her to the health centre in Kwikila. I was struggling and calling the ambulance. Unfortunately the dinghy to get us across the river was gone. I got on the canoe to bring Wendy over to the ambulance.”
– Josephine
Health services in PNG are overstretched, under-resourced and simply not meeting the needs of the most vulnerable people. For women and children living in remote areas, where the nearest health centre is often a long and arduous journey away, community health volunteers like Josephine are a lifeline.
Every child deserves to be protected against preventable, life-threatening diseases.
Yet, every year countless children are going without access to the vaccinations they need to have healthy childhoods. It is estimated that 20 million children continue to go without access to life-saving childhood vaccinations each year. This is despite immunisation being one of the most successful and cost-effective health interventions in the world saving 6 lives every minute since 1974.
There has been significant progress across the world in closing the gap on childhood vaccinations; however, for children in the world’s most marginalised communities, vaccinations are still not always available, accessible, or affordable. In addition, the COVID-19 pandemic contributed to the largest sustained backslide in childhood immunisation in 30 years with 67 million children missing out on routine childhood vaccinations. Concurrently, we’ve seen vaccination hesitancy grow throughout the pandemic leading to a decline in public perception on the importance of childhood vaccines in many countries.
According to the World Health Organisation (WHO), a staggering22 million children missed their first measles vaccine in 2023. This can lead to a range of serious complications, including ear infections and pneumonia, as well as long-term health problems, including blindness and deafness. For some, contracting measles can even lead to death.
Vaccines help save lives. But a single-shot is not enough. The future of immunisation means not only reaching millions of unvaccinated children, but protecting entire communities. What does this look like? A world where grandparents are vaccinated against influenza, babies from malaria and RSV, pregnant mothers from tetanus, and young girls from HPV.
This World Immunisation Week, join us in promoting the importance of vaccines to protect people of all ages against life-threatening but preventable diseases, such as diphtheria, tetanus, whooping cough and measles. Donate today to support all children living in poverty to access life-saving childhood vaccinations.
A health crisis on Australia’s doorstep
Australia’s closest neighbour, Papua New Guinea (PNG), has one of the lowest vaccination rates in the region. In recent years, the country has seen the re-emergence of previously eradicated diseases such as polio due to critically low vaccination rates and the emergence of vaccine resistant strains of the virus.
Low vaccination rates in PNG are a result of a variety of factors, including:
Long distances between rural communities and health centres alongside high transportation costs making it difficult for people living in remote communities to access health facilities.
An under-resourced health system, which has led to staff shortages, long wait times and inadequately trained staff.
The reliance of remote communities on government-led mobile outreach programs that are often impacted by funding shortfalls, broken vehicles, or low vaccine stocks.
How ChildFund is helping to improve childhood immunisation rates in PNG
When I heard that the ChildFund team were coming to my village, I was excited and immediately rearranged my daily chores so that I could attend the mobile clinic. This was a great opportunity for my family and I to receive medicine, especially for my youngest child, Kila, to get immunised.
Mrs Abadi, a mum of nine living in a remote village in Central Province in PNG
ChildFund’s Mobile Health Clinics have had a profound impact on the ability of people living in remote communities to access much needed healthcare facilities. The clinics provide a one stop shop for a variety of health services, including vaccinations, maternal healthcare, and tuberculosis treatment, enabling people in remote communities to receive the healthcare they need without travelling long distances to nearest health clinic.
Since 2022, ChildFund Papua New Guinea in partnership with the Provincial Health Authorities in Central and Northern Provinces has delivered 16,545 vaccines to children living in remote and rural communities. ChildFund PNG has also trained 257 volunteers on how to provide vaccinations for preventable and treatable diseases like tuberculosis, polio and COVID-19.
For women like Mrs Abadi, who lives with her nine children and husband in a remote village in Central Province in PNG, ChildFund’s mobile clinics are a lifeline. Previously, she had to travel long distances to the nearest health facility to ensure her family got the healthcare they needed.
“In the past, it was incredibly difficult for me to bring my children to the Kwikila Health Facility due to the poor road conditions and the unaffordable transport fares,”
“When I heard that the ChildFund team were coming to my village, I was excited and immediately rearranged my daily chores so that I could attend the mobile clinic. This was a great opportunity for my family and I to receive medicine, especially for my youngest child, Kila, to get immunised,” Mrs Abadi shared.
Mr Abadi added that the ChildFund team also shared information on different health topics, some of which were new to her and would help her to keep her family safe and healthy.
“I am grateful for the outreach health services that provide immunisations, as I know that this has been instrumental in keeping Kila safe from the sicknesses I hear about in awareness messages from ChildFund,” Mrs Abadi added.
