Papua and New Guinea medical journal
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Comparative Study
Oxygen supplies for hospitals in Papua New Guinea: a comparison of the feasibility and cost-effectiveness of methods for different settings.
Oxygen therapy is essential in all wards, emergency departments and operating theatres of hospitals at all levels, and oxygen is life-saving. In Papua New Guinea (PNG), an effective oxygen system that improved the detection and treatment of hypoxaemia in provincial and district hospitals reduced death rates from pneumonia in children by as much as 35%. The methods for providing oxygen in PNG are reviewed. ⋯ While these considerably add to the establishment cost when changing from cylinders to concentrators, a battery-powered system should repay its capital costs in less than one year, though this has not yet been proven in the field. Bedside oxygen concentrators are currently the 'best-buy' in supplying oxygen in most hospitals in PNG, where cylinder oxygen is the largest single item in their drug budget. Oxygen concentrators should not be seen as an expensive intervention that has to rely on donor support, but as a cost-saving intervention for all hospitals.
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Children less than 13 years of age account for 27% of the case mix at the Emergency Department (ED) of the Port Moresby General Hospital (PMGH). The ED is busy, usually overcrowded, understaffed and under-equipped, resulting in less than optimal patient management. Children are a highly vulnerable group of patients and have the potential to deteriorate rapidly. ⋯ The major causes of inadequate management were delayed treatment, under- or over-dosing, under- or over-treatment, omission of appropriate investigations, misdiagnosis and failure of judicious consultation with the paediatric team. Many patients were nursed on the floor. Recommendations emanating from the study include ensuring adequate staffing levels and the training of all staff working in ED in the rapid identification of sick children to improve triage and subsequent management.
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This paper provides an overview of the literature regarding public-private partnerships (PPPs) by examining several case studies from around the world and documenting the lessons learned across different PPP models. In addition, it focuses on experience in the facilitation of two PPPs between the public and private sectors in Papua New Guinea (PNG) and discusses the potential benefits that may be delivered to PNG communities through pursuing further such PPPs for health.
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A prospective study was undertaken to document the importance of urinary tract infection (UTI) as a cause of fever without a focus (FWF) in children less than 3 years of age presenting to the Children's Outpatients Department (COPD) of Port Moresby General Hospital (PMGH). 98 children, 55 males and 43 females, with a median age of 17 months and an interquartile range of 5-31.25 months, were recruited. In addition to a history and physical examination each child had a full blood count, a malaria parasite smear, and a urine sample (obtained by clean catch or midstream methods) for dipstick testing, microscopy and culture. Blood culture was performed where practicable. ⋯ Other causes of FWF were classified as non-specific viral infection (31 children), lower respiratory tract infection (11), malaria (7), meningitis (4), bacteraemia (1 neonate) and other or unknown causes. The finding of UTI in 9% of the children is consistent with data from other tropical countries. Checking for urinary tract infection, which can be done using noninvasive methods of urine collection, is an important part of the investigation of infants and children with FWF.
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The aim of this study was to assess the rate of seatbelt use by drivers and front-seat passengers in Port Moresby, 12 years after the seatbelt legislation in 1993. Before the legislation, the rate of seatbelt usage was only 13.3% for drivers and 11.4% for front-seat passengers. Use of seatbelts was assessed by observers at the main city roundabout. 50% of male drivers, 78% of female drivers, 49% of Papua New Guinean drivers and 69% of expatriate drivers wore seatbelts. ⋯ Female drivers and female front-seat passengers were more likely to wear seatbelts than males (OR 2.55 [95% CI 1.53-4.23] and 2.34 [95% CI 1.32-4.14]). The front-seat passengers were more likely to be wearing seatbelts if the drivers wore theirs (OR 2.70 [95% CI 1.60-4.55]). Proportionately more drivers and front-seat passengers were wearing seatbelts than during the pre-legislation period, but more seatbelt education and awareness is needed because of the increasing number of road traffic accidents in Papua New Guinea.