Impact of out-of-pocket expenditures on families and barriers to use of maternal and child health services in Papua New Guinea: evidence from the Papua New Guinea household survey 1996 and household income and expenditure survey 2009--2010; country brief

Summary
• Overall healthcare use is low in Papua New Guinea, with significant income-related inequalities in use, which is related
to inequalities in access.
• Infants and children account for 6% and 16%, respectively of all healthcare visits, and they rely more on services at non-hospital
public facilities (e.g., health centers and government aid posts) and public hospitals followed by church health facilities.
• Families report distance and transportation barriers as the main reason for not seeking medical treatment when their
children are sick. The poor also identified the cost of treatment as the second major barrier to accessing medical care.
• The cost of visits is greatest at private hospitals, while visits to public facilities are comparatively cheaper, and nonhospital public facilities are cheaper to access for most people than public hospitals.
• Levels of catastrophic expenditures due to medical out-of-pocket spending are low in Papua New Guinea, but they are
related to very low rates of healthcare use and limited availability of private services.
• Out-of-pocket healthcare spending is highly concentrated, with the richest 20% of Papua New Guineans accounting for
59% of all out-of-pocket healthcare spending.
• Addressing the physical barriers of access to functioning basic services and financial barriers outside the major urban centers
would benefit poor mothers and children more than attempting to reduce current high levels of spending by the non-poor.