Peripheral health workers are central to primary health care: lessons from Papua New Guinea's aid posts.

ABSTRACT

This paper examines the nature of the service offered by Papua New Guinea's primary health workers and analyses the factors that influence their performance. The structural position of these peripheral health workers in the health care system set limits to the effectiveness of current Health Department policy in determining the quality and availability of local services. Instead a variety of factors are found to be important. These include the individual attributes of health workers, the expectations that their clients have of them, local priorities in health, the relationship between attitudes to health and illness and the perceived value of Western medicine, and aspects of local social organization. The implications for policy of the findings are discussed.