title: Accelerating Maternal and Child Health Gains in Papua New Guinea: Modelled Predictions from Closing the Equity Gap Using LiST.
abstract: BACKGROUND
  Many priority countries in the countdown to the millennium development goals deadline are lagging in progress towards maternal and child health (MCH) targets. Papua New Guinea (PNG) is one such country beset by challenges of geographical inaccessibility, inequity and health system weakness. Several countries, however, have made progress through focused initiatives which align with the burden of disease and overcome specific inequities. This study identifies the potential impact on maternal and child mortality through increased coverage of prioritised interventions within the PNG health system.
  
  
  METHODS
  The burden of disease and health system environment of PNG was documented to inform prioritised MCH interventions at community, outreach, and clinical levels. Potential reductions in maternal and child mortality through increased intervention coverage to close the geographical equity gap were estimated with the lives saved tool.
  
  
  RESULTS
  A set community-level interventions, with highest feasibility, would yield significant reductions in newborn and child mortality. Adding the outreach group delivers gains for maternal mortality, particularly through family planning. The clinical services group of interventions demands greater investment but are essential to reach MCH targets. Cumulatively, the increased coverage is estimated to reduce the rates of under-five mortality by 19 %, neonatal mortality by 26 %, maternal mortality ratio by 10 % and maternal mortality by 33 %.
  
  
  CONCLUSIONS
  Modest investments in health systems focused on disadvantaged populations can accelerate progress in maternal and child survival even in fragile health systems like PNG. The critical approach may be to target interventions and implementation appropriately to the sensitive context of lagging countries.
authors.affiliation: The Nossal Institute for Global Health, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, VIC, 3010, Australia. abbey.byrne@redcross.no.|School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD, 4006, Australia. abbey.byrne@redcross.no.
authors.forename: Abbey
authors.initials: A
authors.lastname: Byrne
authors.affiliation: School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hodge
authors.affiliation: School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
authors.forename: Eliana
authors.initials: E
authors.lastname: Jimenez-Soto
mesh_terms: D002648:Child; D000067576:Child Health; D002662:Child Health Services / Q000458:organization & administration*; D046688:Child Mortality / Q000208:ethnology; D003695:Delivery of Health Care / Q000458:organization & administration; D005193:Family Planning Services / Q000458:organization & administration; D005260:Female; D006292:Health Priorities; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000068097:Maternal Health; D008427:Maternal Health Services / Q000458:organization & administration; D008428:Maternal Mortality / Q000208:ethnology; D010219:Papua New Guinea; D011159:Population Surveillance; D011237:Predictive Value of Tests
keywords: Child health; Equity; LiST; Maternal health; Papua New Guinea