Comments

I'm glad I stumbled onto this page and found people with common interests. I totally agree with Dr Watson. I represent the Christian Health Services in PNG. Most, if not all, of our health facilities are located in the remotest part of the country, and you can imagine the issues we are facing with Data Flow/Data Collection. For my case, SMS Data Collection is most definitely the way forward for us. The only problems I foresee is the User Training and the size/structure of data that can be allowed via text messaging. Time does not permit me to go into detail, but currently I am implementing DHIS2, a Health Management System, that has a module for SMS data collection. I just came here to say thank you for your article, and that it gave me the morale that I needed. Alistairs Christian Health Services PNG

Terence, the key point that Martin Ravallion made (at the conference and here at the ANU) is that the 'floor' (the % of very poor) has not moved much in 20+ years. Now that should be of concern to all aid practitioners as that is about the very large number being left behind (and yes most are women, so gender is a key issue in this).

Thanks for the summary - very useful. I'm glad to see DFAT heading in this direction. We've seen some great successes in Indonesia with health systems strengthening projects, so this is quite heartening.

An excellent write up and piece of work to keep people informed of the challenges in PNG related to data collection and of course how one can be able to manage these challenges to get the relevant data. The initiatives you have highlighted can become catalyst for relevant data for information analysis to inform better policy setting as you mentioned. A key challenge I believe is the ability of people with the data and the people requiring or demanding the data is for them to know that they can be able to utilize the methods you have discussed to better serve data collection in PNG for obvious purposes. This is probably a critical challenge and one that I personally think needs advocating across all public service sectors. Thus it will be good if we can integrate some of your discussions - especially generating data - into many of the other governance programs funded by development partners such as DFAT. I am sure these development (donor) partner programs will find it to their advantage to integrate some of the initiatives you have mentioned into their programs. You should talk to PLGP - a governance program targeting sub-national levels of government.. Once again - thank you. John A Piel Finance Adviser

Thanks Joel, this is a very useful overview. It's good to see some clarity from DFAT on current/future health aid directions. Some further thoughts: - The health systems strengthening focus is positive. I find the multiple references to what we've learnt from the Ebola crisis to be somewhat ironic (including that much of the crisis could have been avoided with better health systems investment) however given that (as you've written before) Australia's aid to Africa has fallen off a cliff. - It's positive to see chronic disease featuring much more prominently in this document. Nutrition is a good starting point, and it's good to see tobacco control, immunisation and hypertension mentioned. The NCDs focus still feels under-developed, however. For instance there's no mention of the role of sport/physical activity in Australia's aid program, which on top of being a central plank of the obesity response also provides opportunities for much broader health education, women's empowerment and disability inclusion. In the Pacific, Australia's Sport for Development investments are among the most successful and prominent, but there's no mention in this document. There's a vague reference to 'healthy lifestyle promotion' but that's it. Given the multisectorality of NCDs (see for instance the World Bank's Pacific multisectoral responses paper), a much more coherent strategy is still needed if DFAT is serious about addressing the actual burden of disease, and not just infectious diseases. - I see your point about Australia's unfortunate world leading status in over-nutrition, but would still suggest there's a potential role for Australian organisations in chronic disease that is being neglected. Through my work in Tonga I was able to help leverage Australia's domestic expertise in health promotion (VicHealth) and tobacco cessation (Cancer Council/Quit) to assist with building capacity to address NCDs. Incorporating funding for such twinning/capacity building initiatives into future programming/policy would be wise. - Research seems to be more prominent than it has been for a few years. It'll be interesting to see how that plays out. - On a related note, I'd like to see more reference to cross-government arrangements/collaboration. The brief reference to Health Department is a reasonable start, but what about NHMRC's funding of LMIC research/capacity building?

Great post Joel! The part that has most resonance with me is the 25 year window needed for health systems strengthening in the Lancet article. The challenge then remains how to move from short term-ism in our development partnerships with our near neighbours, to a longer term focus on building their health systems in financially feasible, culturally appropriate and politically nuanced ways...

Great work and information that should be shared throughout all sectors. Thank you.

It looks like the majority of Australians/respondents to these polls have the gov't that they deserve. The 'lucky country' indeed (stressing Horne's intent).

Thank you Dr. Amanda Watson for shining a light on our paper. Indeed, it is one of the most efficient methods if we have all contact data in place, all research participants are aware and there is excellent network coverage. If most data were collected from rural areas of PNG using this method to address Elementary Teacher Training Policy then I believe other sectors can also utilize this method.

Great summary of the potential for data collection using new technologies Amanda. Can vouch for the effectiveness in complex settings in PNG. With Amanda's technical and professional support for the leadership of Executive Director of Village Courts & Land Mediation Secretariat in Dept of Justice & Attorney General, we collected data from 35 District Courts in many provinces in PNG for Village Courts related matters over 6 months. We had tried for 2 years with a hard copy system with 1 response. Mobile phone data project was invaluable to DJAG and demonstrated openness and capability of PNG agencies when supported well and practicalities of remoteness are addressed. Thanks Amanda.

Hi Roy, Thanks for your comment. I'm not aware of the literature on resource conflict, but beyond that there are four reasons I can think of to be concerned with economic inequality. 1. Diminishing marginal utility to income (which I cover above). This provides compelling reason on its own. 2. That high inequality leads to slower economic growth. There have been some good recent papers on this by the OECD and IMF, suggesting that it does (in certain countries at least) but the evidence is not yet conclusive. 3. Spirit level type arguments that more unequal countries have higher crime, and more violence etc. These findings are still much debated although I find them quite persuasive. However, they apply for the most part (and are based on data from) OECD countries where severe absolute material deprivation is not very minimal. 4. That economic inequality leads to political inequality, which can lead to anti-poor politics. On 1 & 3 I would say that for aid work the foremost issue remains one of raising average levels of income in poor countries (as per the post). On 2 I think we need more evidence particularly with respect to countries that receive a lot of aid, before we conclude the issue gives us cause to be concerned. On 4 and your point about conflict, here we potentially see real issues, but I'm not sure the best way for aid to try and tackle them is to take aim at economic inequality per se but rather to try and address the issues directly (as best we can, if we think it's possible). Recall that I'm not saying that economic inequality doesn't matter, I think it does. But I think it probably isn't something aid can do a lot about in most instances. And I think there are other forms of inequality which matter more for aid work (most of the time). Thanks again Terence

Thank you Dr Amanda for this very resourceful information. The PNG government and policy makers need to take these methods into consideration because it it true that PNG needs concrete and real time data to make workable policies that will enhance equal distribution of wealth and services to citizens especially the majority in rural areas. Non-government organizations and international partners who are utilizing SMS technology to help people in the rural areas are helping and I commend them for that. Dr Amanda, your SMS projects in the justice, health and education sectors have proven greatly and this has to be promoted and supported by the PNG government and the departments concerned. A word of advice to individuals, non-government organizations and government agencies who do not know how to begin a SMS project to collect vital customer/client or population data/statistics. They ought to seek proper advice from experts like Dr Amanda before leaping into the mobile phone SMS technology for data collection. They could fall for a telecommunication company's 'marketing stunt' but remember, it's very costly and one might not get the data they needed. Thanks again Dr Amanda. ...Regards... Stanley Mark