title: Human resources for health: lessons from the cholera outbreak in Papua New Guinea.
abstract: OBJECTIVE
  Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals.
  
  
  BACKGROUND
  Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services.
  
  
  METHODS
  We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt.
  
  
  RESULTS
  Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population.
  
  
  CONCLUSIONS
  In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.
authors: World Health Organization, Port Moresby, Papua New Guinea . ; School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia .
authors: Alexander
authors: A
authors: Rosewell
authors: Sibauk
authors: S
authors: Bieb
authors: Geoff
authors: G
authors: Clark
authors: Geoff
authors: G
authors: Miller
authors: Raina
authors: R
authors: MacIntyre
authors: Anthony
authors: A
authors: Zwi
mesh_terms: D002771:Cholera / Q000453:epidemiology* / Q000628:therapy*; D003140:Communicable Disease Control / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D006285:Health Planning / Q000458:organization & administration*; D006801:Humans; D010219:Papua New Guinea / Q000453:epidemiology; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies