Papua New Guinea: real progress towards MDG 4 and real challenges.

With a mortality rate in the under-5 s of 93 per 1000 live births reported in the 1996 Demographic and Health Survey (DHS), Papua New Guinea (PNG) was at the time one of only four countries with stalled progress in child survival, and seemed destined to fail its national Millennium Development Goal (MDG) 4 target. However, accurate estimates have shown reductions in under-5 and infant mortality rates of 19% and 17% respectively, over 10 years from 1996 to 2006. In that period PNG adopted an integrated and coordinated approach to child health that includes all the essential interventions outlined in the Lancet's child survival series, under a framework consistent with the Western Pacific Regional Child Survival Strategy, associated with significant improvements in leadership and coordination of child health services by paediatricians at the provincial and national level. The reduction in child mortality since the mid-1990s is strong encouragement that such an approach can translate to real improvements. This paper outlines the recent advances in child health in PNG, identifying successful areas, and the challenges that lie ahead. There has been increased immunization coverage, introduction of vitamin A supplementation, bed-nets to prevent malaria, interventions to reduce mortality from acute respiratory infection, and improvements in the education of girls. These and improved leadership and coordination help to explain the recent significant gains in child survival.

Thiamine (vitamin B1) status of boarding school students in the Southern Region of Papua New Guinea.

Thiamine pyrophosphate (TPP) is the major biologically active form of thiamine (vitamin B1). This cross-sectional study assessed whole-blood thiamine pyrophosphate concentration (WBTPPC) in boarding school students in the Southern Region of Papua New Guinea. Sample size for each of the five boarding schools was calculated using the 'proportionate to population size' cluster sampling technique. The 'Clin-Rep' reagent kit was used for the extraction of thiamine pyrophosphate from whole blood. Reverse phase high performance liquid chromatography with post-column derivatization was used to determine the thiamine pyrophosphate concentration. Informed consent was obtained from 468 students, mean age 17.7 +/- 1.5 years. The gender distribution of these students was 274 (58.5%) males and 194 (41.5%) females. The median and interquartile range of WBTPPC for all students was 95.41 microg/l (82.27-113.55). Severe to marginal status of thiamine deficiency was present in 6.4% of all the students. The mean WBTPPC for female students was significantly lower than that for the male students (p < 0.001), with a mean difference of 14.17 microg/l (95% CI of the difference: 9.85-18.50). Severe to marginal status of thiamine deficiency was present in 9.8% of female students and 4.0% of male students. The data strongly support the need for effective implementation and monitoring of food fortification legislation in Papua New Guinea. Withdrawal of fortification or suboptimal thiamine fortification of rice and other cereal products in Papua New Guinea would have serious negative public health implications, especially among students in boarding schools.

Nutrition communication in the Pacific.

This paper summarises the findings of a scoping study to analyse and guide nutrition communication in some countries in the Pacific region. Nutrition is fundamental to achieving good health and preventing the rising prevalence of non-communicable disease. Dietary patterns are influenced by many factors and complex interactions, such as income, food prices, individual preference and beliefs, cultural traditions, as well as geographical, environmental and social factors. These interactions, the quantitative and qualitative changes in the diet, and the accompanying lifestyle changes seen in recent years, make a collaborative approach to behaviour change essential. This study suggests that by supporting nutritionists to promote nutrition, improve public awareness and by addressing key areas influencing nutrition communication, gains towards improving public health can be made at a regional level.

Nutrient and Energy Intake of People Living with HIV/AIDS in Port Moresby, Papua New Guinea: a 24-hour Recall Study

People living with HIV/AIDS have greater energy needs than uninfected persons. Extent of increase energy needs depends on progression and stage of HIV infection. Paucity of data on nutrient and energy intake of PLWHA in PNG necessitated the purpose of this study.