Assessing women's understandings of health in rural Papua New Guinea: Implications for health policy and practice

Abstract

In Papua New Guinea (PNG), women's health is addressed by applying biomedical solutions which often ignore the complexity of women's histories, cultural contexts and lived experiences. The objective of this study was to examine adult and older women's perceptions of health and well-being to identify priority areas for public service interventions. Rapid ethnographic assessment was conducted in the Wosera district, a rural area of PNG from mid-2005 to early 2006, to examine the health concerns of women. Twenty-seven adult women and 10 older women participated in the study. Health was not limited to one aspect of a woman's life, such as their biology or maternal roles; it was also connected with the social, cultural and spiritual dimensions of women's daily existence. Participants also identified access to money and supportive interpersonal relationships as significant for good health. A disconnect was found to exist between women's understandings of good health and socio-political health policies in PNG, something likely to be repeated in health service delivery to different cultural groups across the Asia Pacific region. Health and development practitioners in PNG must become responsive to the complexity of women's social relationships and to issues relating to the context of women's empowerment in their programmes.

Knowledge, Attitudes, and Practices Concerning Malaria in Pregnancy: Results from a Qualitative Study in Madang, Papua New Guinea

“…Similarly, as has previously been reported in PNG for health and illness in general, malaria and the associated pregnancy complications were sometimes seen as caused by family disputes or conflicts that can be cured with incantations over herbal drinks or betel nuts as well as conflict resolution. [ 45 , 46 ]…”

Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea

“…Decisions and actions of men and women within dividual settings are therefore not autonomous but heteronomous as determined by their relationships with each other in the couple unit and with their families and wider community [ 33 ]. Furthermore there is a long standing and rigid role dichotomy between men and women in PNG which results in men having a stronger seat of influence within the decision making process than women [ 17 – 20 , 33 , 34 ]. Christian missionisation throughout PNG brought new ideas concerning gender by focusing on the nuclear family as the basic unit of society rather than the traditional extended family posited around a ‘big man’, but in itself this new value system has not overridden traditional approaches to decision making around family planning [ 17 , 20 , 33 , 34 ].…”

“…1) and that deeply entrenched gendered perceptions allow men's direct sphere of influence to be more powerful than women's within this process. Improving implant uptake is therefore dependent on enhancing the receptiveness of the men's direct sphere of influence to accept information about the device [20,34].…”

“…Men's general disengagement with biomedical health information can be explained by their preference to value economically incentivised messages over health messages alone [20,22,34]. Men in our focus groups stated economic disruption as the main reason for not engaging with health services.…”

Maternal deaths and their impact on children in Papua New Guinea

“…17,18 There is also a desperate shortage of doctors, nurses and midwives. [19][20][21] In 2009, there were only 330 doctors nationwide (0.05 per 100,000 people) and about 2,800 nurses, and it was estimated only 41% of births were attended by skilled health personnel. 22,23 Even when health facilities or services are available, they are frequently not used.…”