Table of contents for Strategic directions for human development in Papua New Guinea.

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Table of Contents
ABBREVIATIONS	i
ACKNOWLEDGEMENTS	vii
Executive Summary	viii
Chapter 1.	Introduction	1
Rationale for the Report	1
Why Human Development?	2
Why Produce the Report Jointly?	3
What Questions?	3
Outline of the Report	3
Chapter 2.	Health in Papua New Guinea: A Situation Assessment and Proposed Strategic directions¿¿¿¿¿¿.	5
Introduction	5
Health Outcomes	6
Health System Infrastructure and Performance	7
Health Sector Workforce: Size and Deployment	10
Health Finances and Expenditures	13
Decentralization, Accountability, and Integrity of Government Systems	16
Recent Government Response	17
Recent Donor Response	20
Where to from Here?	21
Annex 2A: Health Sector Workforce	24
Annex 2B: Comparison of Health Related Revenue Streams to Provinces	27
Annex 2C: Technical Options and Delivering Health Priorities	28
Chapter 3.	Control of HIV/AIDS in Papua New Guinea: A Situation Assessment and Proposed Strategic options	35
Introduction	
The Current Status of the HIV/AIDS Epidemic in PNG	35
HIV/AIDS, Sex, and Culture	38
Sexually Transmitted Infections (STIs)	42
HIV/AIDS and the Economy	42
The Response of the Government of PNG to HIV/AIDS	44
The Response of Key Development Partners	47
The Response of Non-governmental Organizations and Churches	48
The Response of the Private Sector	49
Financing the Response	49
Major Lessons Learned and Priorities for Further Action	50
Proposed Strategic Directions for HIV/AIDS	56
Annex 3A: The Estimated Size of At-risk Groups in and near Selected Existing Enclave Developments	58
Annex 3B: Main PNG HIV/AIDS Control Activities	59
Annex 3C: Papua New Guinea's Response to the HIV/AIDS Epidemic	60
Annex 3D: Rationale for Putting Prevention First	
Integrated Behavioral Change Programs for High-risk Groups	
Chapter 4.	Education in Papua New Guinea: A Situation Assessment and Proposed Strategic options¿¿¿.	64
Introduction	64
National Education Reform (1993)	65
Expenditure and Financing	65
The New National Education Plan: Addressing General Education Issues	66
Governance, Management and Community Participation	71
General Education Challenges: The Need to Enhance the NEP 2 Framework	73
NEP 2 and Achieving Universal Basic Education	77
Vocational Education and Skills Development	78
Where to from Here? Proposed Priorities and Strategic Directions	79
The proposed strategic directions for education include the following six key elements:	81
Conclusion	83
Annex 4A: Principal Responsibilities of the Key Stakeholders in the PNG Education and Skills Development System	84
Annex 4B: Teacher Workforce	89
Key Policies	89
Strategic Data and Observations	89
Students in Training	92
Table B3: Staff Projections by Level ¿ Selected Years	92
Annex 4C: Geographic, Income and Gender Inequities in the PNG Education	96
Chapter 5.	Common Cross-cutting Themes	104
Introduction	104
The Fragility and Inequity of Current Outcomes	106
The Need for a ¿Whole of Government¿ Approach	107
Decentralization and Devolution	108
The Long-term Decline in the Integrity of Core Government Systems	111
Restoring the Integrity of Budget Systems and Institutions	113
Budget Allocations and Their Composition: Less Than Optimal	114
Conclusion	120
Annex 5A Human Development Expenditures 1996-2004	122
Chapter 6.	Next Steps: An Approach to Revised Strategic Directions for Human Development¿¿.	125
Introduction	125
Proposed Sectoral Strategy Formulation Process by Government	125
The Importance of the MTDS and MTEF	127
Implementing the MTEF and the Sectoral Strategy Plans	128
Developing and Executing Implementation Plans	129
Creating Fiscal Space and a Compact to Implement Expenditure Reforms	129
Developing a Financing Plan for Each Sector	130
The Role of Development Partners in Support of Government Sectoral Plans	132
A Sectoral Compact between the Government and its Development Partners	133
Knowledge Gaps	134
A Final Word	135
References	136
Figures
Figure 2.1: Infant Mortality Rate by Region	7
Figure 3.1: Projected number of people living with HIV (PLWHA) in Papua New Guinea under three scenarios	
Figure 3.2:	37
Figure 3.3:	38
Figure 3.4:	38
Figure 3.5: Proportion of South Africans 15-19 by Age of Sexual Partner	
Figure 3.6 : HIV Prevalence of South African Females 15-19 by Age of Sexual Partner	
Figure 3.7:. Sexual Coercion and HIV Incidence Among Women Under 25 Years in Rakai Uganda, 2004.	41
Figure 3.8:. HIV Prevalance Among People Consuming Alchol and Among Non-Drinkers, Carletonville (Mine), South Africa.	42
Figure 3.9: HIV Infection by Risk Group and WHO Region	53
Figure 3.10:. Thailand¿s HIV Estimates With and Without Prevention Interventions 1985-2010	55
Tables
Table 2.1: Composition and Growth of the Health Workforce, 1988-2004	10
Table 2.2: Ministry of Health Work Force 2004 by Cadre and Major Health Function	12
Table 2.3: Total Real Health Expenditures: Recurrent and Development 1996-2004	14
Table2.4: Total Real Recurrent Health Expenditures by Input Category 1996-2004	15
Table 2.5: Real Health Development Expenditures by Input Category 1997-2004	15
Table2.6: Health Recurrent and Development Expenditures by Health Program, 2004	16
Table 3.1: HIV Prevalence at Sentinel Surveillance Sites in PNG	36
Table3.2: Results of 1998 Eastern Highlands Youth Survey	39
Table 3.3: The Cost-effectiveness of Different Types of HIV Interventions	52
Table 5.1: Human Development Expenditures as Share of Total Expenditures and of GDP	114
Table 5.2: Pacific Island, Low and Middle Income and East Asia Country Expenditures on the Human Development Sectors 1997-2003.	115
Table 5.3: Trends in Human Development Recurrent Expenditures 1997-2004	116
Table 5.4: Real Human Development Sector Recurrent Expenditure Growth Rates	117
Table 5.5: Trends in Composition of Education and Health Recurrent Expenditures	118
Table 5.6; Trends in Real Human Development Recurrent and Development Expenditures 1997-2004	119

Library of Congress Subject Headings for this publication:

Public investments -- Papua New Guinea.
Public health -- Papua New Guinea -- Finance.
HIV infections -- Papua New Guinea -- Prevention.
AIDS (Disease) -- Papua New Guinea -- Prevention.
Education -- Papua New Guinea -- Finance.