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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.