1. Sogeri Field Trip Max Brinsmead MB BS PhD May 2015

2. Objectives: Understand the difficulties faced by rural families in PNG in accessing Reproductive Health (RH) Services Understand the difficulties faced by rural families in PNG in accessing Reproductive Health (RH) Services Compare RH services provided at PMGH with those of a typical Rural Health Centre (RHC) Compare RH services provided at PMGH with those of a typical Rural Health Centre (RHC) Learn basic RH epidemiological indices Learn basic RH epidemiological indices Plan service improvement using an evaluation of these indices in a typical RHC Plan service improvement using an evaluation of these indices in a typical RHC Understand population dynamics in rural PNG as it relates to patient, family, clan, district and province Understand population dynamics in rural PNG as it relates to patient, family, clan, district and province

3. Compare and Assess RH Facilities Antenatal Antenatal Intrapartum Intrapartum Postpartum Postpartum Family Planning Family Planning STD, PID and HIV STD, PID and HIV Using the following criteria: Using the following criteria: Accessibility Accessibility Components available Components available Advantages and disadvantages CF PMGH Advantages and disadvantages CF PMGH

4. Basic RH Indices Population (number) Population (number) % Population <15 years of age % Population <15 years of age Population of Reproductive Age Population of Reproductive Age (Females 15 – 45 years of age) (Females 15 – 45 years of age) Total Fertility Rate Total Fertility Rate Population growth rate Population growth rate Population doubling time Population doubling time Contraceptive prevalence rate (CPR) Contraceptive prevalence rate (CPR) Maternal Mortality Rate Maternal Mortality Rate

5. Advanced RH Indices Proportion of pregnancies that receive AN care Proportion of pregnancies that receive AN care Proportion of births that are supervised by a medically-trained attendant Proportion of births that are supervised by a medically-trained attendant Contraceptive’s Couple Protection Years (CYP or Sip) Contraceptive’s Couple Protection Years (CYP or Sip) All need to be analysed over time All need to be analysed over time

6. You will study... Birth register Birth register Including outcomes and referrals Including outcomes and referrals Antenatal Clinic attendances Antenatal Clinic attendances Family Planning attendances Family Planning attendances Evaluate by method prescribed Evaluate by method prescribed Inpatient Admissions Inpatient Admissions Evaluate by diagnosis and outcome including death or referral Evaluate by diagnosis and outcome including death or referral Outpatient attendances Outpatient attendances Evaluate by diagnosis Evaluate by diagnosis Particularly those that relate to STD, PID, HIV etc. Particularly those that relate to STD, PID, HIV etc.

7. And assemble data that reports... % pregnancies that have AN care % pregnancies that have AN care % births that are supervised % births that are supervised Couple Years Protection (CYP) Couple Years Protection (CYP) For Pills (COC) For Pills (COC) For Injections (Depo) For Injections (Depo) For tubal ligation For tubal ligation Inpatient Admissions Inpatient Admissions Outpatient Attendances Outpatient Attendances All over time All over time

8. On the second day you will... See all patients who attend for AN services See all patients who attend for AN services Survey contraceptive use and plans Survey contraceptive use and plans Estimate maternal mortality Estimate maternal mortality Explore attitudes to pregnancy and childbirth Explore attitudes to pregnancy and childbirth All the above using the survey forms provided All the above using the survey forms provided

9. Resources Faculty handout notes Faculty handout notes Mola and King “Primary Mother Care and Population for Papua New Guinea” Mola and King “Primary Mother Care and Population for Papua New Guinea” Section 3 & especially 3.14 Section 3 & especially 3.14 Section 5.17 Section 5.17 Records kept at Sogeri Clinic Records kept at Sogeri Clinic The staff at Sogeri The staff at Sogeri Faculty staff Faculty staff

10. In your Reports we expect recommendations concerning… Staffing Staffing Facilities Facilities Transport Transport Use of Aid Posts Use of Aid Posts Staff Staff Facilities Facilities Guidelines for referral to PMGH Guidelines for referral to PMGH Advice about data collection & use Advice about data collection & use Your experience and advice for subsequent students Your experience and advice for subsequent students