Papua New Guinea Field Epidemiology Training Program

Program overview

The Field Epidemiology Training Program of Papua New Guinea (FETPNG) was implemented to address a critical shortage in field epidemiology expertise to help address national public health challenges. In March 2012, an initial needs assessment was conducted and the results presented to leadership at the National Department of Health (NDOH) and World Health Organization in Papua New Guinea (WHO-PNG). After this presentation, a summit was held to reach consensus on the structure of the program and an initial five-year plan was developed. A unique field epidemiology training model with mandatory public health intervention projects was strongly endorsed.

The program goals of FETPNG were as follows:

  • Developing a program customized for PNG’s public health situation
  • Including a rough mix of two-thirds provincial staff and one-third national staff in each cohort
  • Producing public health analyses and interventions that were useful in local and national settings
  • Identifying and developing FETPNG alumni as program staff and faculty
  • Creating a sustainable program with increasing investment by NDOH and increasing program teaching and mentoring from NDOH and provincial staff
  • Producing at least one graduate working in each of PNG’s 22 provinces
  • Producing at least one graduate in each of PNG’s 89 districts
  • Supporting alumni of the program via an alumni association

The first FETPNG cohort commenced training in April 2013. There have been FETPNG cohorts each year since. Each cohort runs for nine months and includes three classroom training units interspersed by field based research and intervention projects. After five cohorts, the program has graduated a total of 69 field epidemiologists currently working in all 22 provinces of Papua New Guinea. The program is a collaboration of the PNG National Department of Health, the World Health Organization, Hunter New England Health and the U.S. Centers for Disease Control and Prevention.

Since 2017, an advanced field epidemiology training program has been in development. This advanced program, entitled ‘Accelerating the Development of Evidence-based Policy and Practice’ (ADEPPt), will commence in March 2019. ADEPPt will re-engage FETPNG graduates in a structured two-year program of field epidemiology and operational research. The ADEPPt Project aims bring together senior policymakers with trained frontline health care practitioners (ADEPPt fellows) to strengthen health systems in PNG.

Achievements

FETPNG has trained a network of field epidemiologists across Papua New Guinea. The majority (80 percent) of the 69 graduates from 2013-2017 are based at the District and Provincial levels, providing expertise at the front line of public health. Graduates have been called upon to respond to natural disasters and numerous disease outbreaks. In 2018, FETPNG alumni were deployed in response to a 7.5 earthquake in Hela Province, a national polio outbreak, a measles outbreak, a pertussis outbreak and a typhoid outbreak. FETPNG fellows have presented their work at numerous TEPHINET meetings and international conferences and published in peer review journals. 

Fellows have undertaken a wide array of intervention-based research projects which have positively impacted public health in PNG. The following sample of projects highlights the diversity and impact of these projects and interventions.

  • Tuberculosis:
    • Enhanced screening and case following to improve cure rates and decrease defaulter rates
    • Identified barriers to completing treatment in patients with multi-drug-resistant tuberculosis (MDRTB) leading to a redesign of health services to overcome key barriers. 
  • HIV:
    • Fellows increased HIV screening of mothers visiting antenatal care units from 75 to 99 percent and increased linkage to care for HIV-positive mothers from 76 to 100 percent.
  • HIV/TB co-infection
    • Significant increases in screening coverage of TB patients for HIV identifies new co-infections for anti-retroviral (ARV) therapy
    • New processes see ARV therapy uptake in TB/HIV co-infected patients increase from 50 to 90 percent in integrated HIV/TB sites and from 20-32 percent to 70 percent in non-integrated sites
  • Malaria
    • Through education and process improvements, fellows reduced inappropriate antimalarial prescription treatment (based on negative RDT tests) from 26 to three percent.
  • Immunization
    • Developed numerous interventions to increase coverage of key childhood vaccines
    • Conducted a household immunization survey that revealed significant issues with national population estimates