Rural Outreach Services

Hospital Programs

Rural Outreach program is one of the programs that Goroka General Hospital revitalized within its establishment since 2005, which thereafter actively executes its vision and objectives. Progressively the hospital restructured its positions in 2006 and created Rural Outreach Unit to support Primary Health Services to fulfill one of its functions as stipulated in the National Health Plan. The hospital management was supportive and declared; “2007 as the year of Rural Outreach”.

Hospital Board

The Hospital Board is fully behind this program and endorses any planned activities that are carried out by the outreach team. It is the relay of the direction from the board to see Goroka General Hospital serves the majority of the population through this outreach programs.

Vision

Goroka General Hospital has a vision to extend its specialist clinical and curative health services to the bulk of rural population of Eastern Highlands Province through rural outreach programs as its vehicle to reach out more than seventy percent of the rural population in the next ten years.

Mission

The Rural Outreach Mission is to “provide affordable clinical services and equip rural health staff and the communities of Eastern Highlands with relevant health information, awareness, knowledge and skill for prevention and self-care”.

The Goroka General Hospital under the current management in 2006 has restructured the positions, which included for the first time a Rural Health and Extension Services functions in the Directorates of Medical and Nursing Services respectively within the hospital structure.

It was no doubt a major achievement for the hospital as it was the first hospital in the country to create a full rural health positions within the hospital to support the Primary Health Services in the province.

The officers employed under these positions include specialist medical officers, general medical officers in the four major disciplines as well as Health Extension Officer and specialist nursing officers. They will be based at the hospital but perform primary health duties through regular outreach visits.

The duties and the activities of the rural health services are coordinated through the office of the Rural Outreach Coordinator who reports to the Director Medical Services.

The main goal of which all of us will have to work towards in achieving is; for the hospital to coordinate and provide integrated essential health services to the rural population of Eastern Highlands. This can be achieved through treating and testing those who are sick, minimizing the spread of infectious diseases through proper health education and equipping both the local communities and rural health workers with appropriate health information.

Programs

Currently the Rural Outreach Program is drawn into six major programs to make it easier and more effective to carry out the outreach program. The six programs are;

Program 1: Weekly day visits to Rural Health Centers
Program 2: Urban Clinic visits
Program 3: Rotational Medical Officer Visits
Program 4: Camp outs to District Health Centers
Program 5: Health Fair
Program 6: Specialist Medical Officers Visits to Kainantu

KMOP 1: Rural Health Center Visits
In this program there the rural outreach team makes Weekly day visits to rural health facilities that are accessible by good road network on every Wednesdays. The Wednesdays visits are particularly made to health centers or health sub-centre levels.
The team comprises of outreach team with the supportive staff. The specialized section such as physiotherapy, biotechnical and visiting nurses, doctors and students from overseas are also included. The source of funding is from the Provincial Health Office through HSIP

KMOP 2: Urban Clinics Visits
When we tried to look at the rural majority the urban poor were dying in settlements and in their makeshifts due to high cost at the public hospitals. Therefore this program is drawn up to also serve the urban poor and the outreach team makes three times a week visits to North Goroka Urban, Lopi and Bihute CIS clinics every Mondays, Tuesdays and Thursdays. Three medical officers, 1 HEO and three nurses are stationed at three urban clinics from morning hours (8-12MD) to carry out outpatient duties. This has helped minimize the overcrowding at the hospital’s outpatients. With this plan, gradually outpatient services in Goroka General Hospital will be phased out over time. The Goroka General Hospital funds this program in terms of fuel and transport.

KMOP 3: Rotational Medical Officer Visits
In this program Medical officers are stationed at Lufa, Kainantu and Okapa Rural Hospitals for one months interval and rotate around.

The four (4) rural medical officers’ normally engage in one-month rotation between;
Goroka General Hospital (different wards of the hospital)
Kainantu Rural Hospital
Okapa Rural Hospital
Lufa District Health Center
The rotation is aimed at strengthening the two rural hospitals with Lufa being the distant as well with poor road infrastructure.

Each time, the medical officers rotate to Goroka General Hospital; they are placed in different wards to have wide experiences in different discipline of medicine.
The Medical Officers at Okapa, Lufa and Kainantu also perform their normal clinical and public health duties while at the same time prepare patients that need to be reviewed by the full outreach team that come into camp out for one week at a quarterly basis. The source of funding are through the Provincial Health Office from the HSIP funding.

Table shows itinerary rotational schedule of rural Medical Officers:

KMOP 4: Campouts Visits
At the end of each quarter, all specialist medical officers, nurses and other supportive staff camp-out and review patients and perform operations in Lufa, Okapa and Kainantu.

Full team of Rural Health SMOs, specialist nurses and hospital support clinical staff camp out at the end of each quarter at Okapa, Lufa and Kainantu and possibly two-week period at Marawaka Health Center depending on the availability of fund. The team review patients that are prepared by the rotational medical officers, perform minor operative procedures and conduct health education while at the same time conduct in-service training for the health center staff. In this program the fundings are made available by the PHO and GGH through the HSIP.

KMOP 5: Health Fairs
Health Fairs are held at large communities or aidposts levels in conjunction with Clinton Foundation or other stakeholders. The team participates in world or special events occurring within the province to provide public health and clinical cover. The health fairs are normally conducted on every Thursdays or special event’s days. Clinton Foundation team provide VCT and follow up with ART while outreach team performs normal clinical duties. This program was incooperated inconjuction with the Clinton Foundation and the fundings are made from the Clinton Foundation.

KMOP 6: Specialist Medical Officer visits to Kainantu Rural Hospital
In this program Specialist Medical Officers from each of the four discipline are sent to Kainantu Rural hospital eacch month. Kainantu Rural Hospital serves the huge population of Kainantu, Obura/Wonenara, Henganofi and Okapa and therefore needs specialist support.
Specialist Medical Officers from each discipline from Goroka General Hospital posted to Kainantu Rural Hospital for one week to perform clinical and operative duties.

They involve also in conducting teaching and in-services to the staff. The anaesthetic staff and medical registrars or resident medical officers normally accompany the SMO to Kainantu to assist in clinical duties. The fundings for this program are made available from the HSIP through the PHO.

These programs are unique and different to any failed programs carried out in the past because we have functional units set up within the directorates to effectively carry out the duties.
The Goroka General Hospital is always stable in the delivery of quality services throughout the years. With this program in placed we hope to bring much of the hospital based curative services closer to the rural population.

Furthermore, on a positive note, the Hospital Board endorsed to exempt any referrals made by this team from normal user fees imposed and as well give priority over others in hospitalization and operations.

The 2005, 2006, and 2007 annual activity reports were encouraging with many health facilities covered within short period.
The implementation of the strategies contained in these programs will ultimately increase the provision of specialist medical care to the doorstep of the disadvantaged rural population.

Dr John Warai
Coordinator Rural Health Services
Goroka General Hospital
Eastern Highlands
Papua New Guinea