ABSTRACT
In 1973, Papua New Guinea's central government faced a political uprising from a number of provinces pushing for self-governance. These demands influenced the direction of Papua New Guinea's decentralization policy. The Organic Law on Provincial Governments and Local-Level Governments, enacted in 1977 and revised in 1995, formed the initial legal basis for decentralized governance in the country. The Provincial Health Authority (PHA) integrates the management of hospital services with that of rural primary health services (public health services) under a single health authority. The reform abolishes provincial health boards and public hospital boards established under the Hospital Administration Act. The PHA is a locally context-specific reform that addresses the unintended effects of the Organic Law on health service delivery across the country's 22 provinces. The PHA is only one lever among many strategies necessary to address the ills of the country's health system and promote health system efficiency.
