Below is a 5-Year Implementation Roadmap for the Chief Nursing Officer (CNO) Office in Papua New Guinea, including phased rollout, KPIs, and a funding plan aligned with health workforce reform, maternal health priorities, and WHO health systems strengthening principles.
π΅π¬ 5-YEAR IMPLEMENTATION ROADMAP
Chief Nursing Officer (CNO) Office – Papua New Guinea
1. Overall Goal (5 Years)
To establish a fully functional National Nursing and Midwifery Leadership and Workforce System that improves:
- Workforce planning and distribution
- Rural retention of nurse-midwives
- Maternal and neonatal health outcomes
- Health workforce data systems
- Nursing education and quality standards
Aligned with:
National Department of Health Papua New Guinea
WHO Health Systems Framework (WHO, 2010; WHO, 2016)
2. IMPLEMENTATION PHASES
π¦ PHASE 1: ESTABLISHMENT (Year 1)
Objective:
Set up the Chief Nurse Office, governance structure, and initial workforce systems.
Key Activities:
- Appoint Chief Nursing Officer
- Establish CNO Secretariat
-
Create 5 core divisions:
- Workforce Planning
- Data & M&E
- Clinical Services
- Education & Training
- Policy & Governance
- Develop national nursing governance framework
- Conduct national nursing workforce audit
- Map all nursing positions nationwide
KPIs (Year 1):
- CNO office formally established (✔/✖)
- National nursing workforce audit completed
- Baseline nurse-to-population ratio established
- % of provinces reporting nursing workforce data (target: 60%)
- National staffing gap report produced
π© PHASE 2: SYSTEM BUILDING (Year 2)
Objective:
Build workforce data systems and strengthen planning mechanisms.
Key Activities:
- Develop Nursing Workforce Information System
- Introduce digital nurse registry
- Establish staffing norms per facility type
- Develop rural deployment strategy
- Launch pilot provincial reporting dashboards
- Begin retention incentive framework design
KPIs (Year 2):
- Workforce database operational (✔/✖)
- 70% provinces reporting workforce data monthly
- Staffing norms developed and approved
- Rural deployment framework endorsed
- Annual nursing workforce report published
π¨ PHASE 3: NATIONAL ROLLOUT (Year 3)
Objective:
Implement workforce planning systems nationwide.
Key Activities:
- Roll out workforce system to all provinces
- Implement rural retention packages
- Launch CPD tracking system
- Introduce workforce forecasting model (5–10 years)
- Strengthen midwifery deployment to high-risk districts
- Integrate nursing data into NHIS
KPIs (Year 3):
- 100% provincial workforce reporting coverage
- 80% facilities compliant with staffing norms
- Rural vacancy rates reduced by 20%
- CPD compliance rate ≥ 60%
- Skilled birth attendance increased (baseline +10%)
π§ PHASE 4: OPTIMISATION (Year 4)
Objective:
Improve efficiency, quality, and workforce retention.
Key Activities:
- Evaluate workforce distribution effectiveness
- Expand leadership training programs
- Strengthen clinical governance and quality systems
- Expand midwifery emergency obstetric training
- Introduce performance-based incentives
- Conduct national workforce mid-term review
KPIs (Year 4):
- Nurse attrition rate reduced by 25%
- Maternal mortality ratio reduced (trend improvement)
- Rural staffing coverage increased by 30%
- 80% nurses registered in CPD system
- Annual performance reports institutionalised
π₯ PHASE 5: CONSOLIDATION & SUSTAINABILITY (Year 5)
Objective:
Institutionalise systems and ensure long-term sustainability.
Key Activities:
- Full integration into national health governance system
- Policy review and refinement
- Expand digital health workforce analytics dashboard
- Strengthen research and academic partnerships
- Establish long-term workforce sustainability strategy
- Independent external evaluation
KPIs (Year 5):
- Sustainable workforce forecasting system operational
- 90% workforce data accuracy and reporting compliance
- Maternal mortality reduced (targeted national reduction trend)
- Rural skilled birth attendance ≥ 80%
- Full integration into national health planning cycle
3. NATIONAL KPI FRAMEWORK (5 YEARS)
Workforce Indicators
- Nurse-to-population ratio improved annually
- Midwife-to-population ratio increased
- Vacancy rate reduced by ≥ 40%
- Rural staffing coverage increased ≥ 50%
- Attrition rate reduced ≥ 30%
Maternal Health Indicators
- Skilled Birth Attendance increased ≥ 25%
- Maternal Mortality Ratio reduced (progressive decline)
- Neonatal mortality reduced
- Emergency obstetric referrals improved
System Performance Indicators
- 100% provincial reporting compliance
- Annual workforce reports published
- Workforce dashboard fully operational
- CPD compliance ≥ 85%
Governance Indicators
- Workforce planning policy implemented
- Staffing norms enforced nationally
- Quarterly performance reviews institutionalised
- Provincial accountability mechanisms functioning
4. FUNDING PLAN (5 YEARS)
4.1 Estimated Budget Structure
Year 1–2 (Establishment & System Build)
- Office setup, staffing, governance systems
- Workforce audit and ICT systems
- Initial training programs
Estimated Cost:
π° USD 3–5 million
Year 3–4 (National Rollout & Expansion)
- Nationwide deployment systems
- Workforce digital platform scaling
- Rural retention packages
- CPD system rollout
Estimated Cost:
π° USD 5–8 million
Year 5 (Consolidation & Sustainability)
- Evaluation
- System optimisation
- Long-term integration
- Research and innovation support
Estimated Cost:
π° USD 2–3 million
π’ TOTAL 5-YEAR ESTIMATE
π° USD 10–16 million (approx.)
4.2 Funding Sources
Domestic Government Funding
- National Health Budget allocation
- Provincial Health Authority contributions
Development Partners
- WHO technical support (systems + M&E)
- UNICEF maternal health support
- UNFPA midwifery strengthening programs
Donor and Bilateral Support
- Australian Government (PNG health workforce support)
- World Bank health systems strengthening programs
- Asian Development Bank (health infrastructure + digital systems)
Cost-Sharing Opportunities
- University partnerships (training + research support)
- Digital health public-private partnerships
4.3 Sustainability Strategy
To ensure long-term sustainability:
- Integrate CNO office into permanent government establishment
- Embed workforce systems into national health ICT systems
- Train provincial workforce officers
- Institutionalise budget line for nursing workforce planning
- Strengthen local training capacity to reduce external dependency
5. KEY SUCCESS FACTORS
- Strong political support from government leadership
- Legal establishment of Chief Nurse role
- Reliable workforce data systems
- Strong provincial coordination
- Continuous funding commitment
- Partnerships with development agencies
- Strong leadership capacity in nursing profession
6. STRATEGIC IMPACT FOR PNG
If fully implemented, this roadmap will:
- Transform nursing workforce governance in PNG
- Improve maternal and neonatal survival rates
- Reduce rural–urban health inequality
- Strengthen health workforce accountability
- Build a sustainable nursing leadership pipeline
- Support Universal Health Coverage (UHC) goals
7. ALIGNMENT FRAMEWORK
This roadmap aligns with:
- WHO Global Strategy on Human Resources for Health 2030 (WHO, 2016)
- WHO Health Systems Framework (WHO, 2010)
- WHO Nursing and Midwifery Strategy (WHO, 2021)
-
PNG National Health Plan 2021–2030
National Department of Health Papua New Guinea
References
National Department of Health PNG. (2021). Papua New Guinea National Health Plan 2021–2030. Port Moresby: Government of Papua New Guinea.
World Health Organization (WHO). (2010). Monitoring the building blocks of health systems. Geneva: WHO.
World Health Organization (WHO). (2016). Global strategy on human resources for health: Workforce 2030. Geneva: WHO.
World Health Organization (WHO). (2021). Global strategic directions for nursing and midwifery 2021–2025. Geneva: WHO.
United Nations Population Fund (UNFPA). (2021). State of the World’s Midwifery Report 2021. New York: UNFPA.
Greetings to you all, this year will be an exciting year for all nurses and nursing students in the St. Benedict's school of Nursing in Wewak, located on the west part of the Island of Papua New Guinea in the Pacific Ocean. This is my first year of teaching and I am grateful for the opportunity given to teach the digital age nursing students to make use of the available technologies right at their finger-tips. The aim of this blogging with students is to create a community of inquiry in higher education level for effective adult teaching-learning process. By the end of this semester (one) in the year 2020, students should achieve a GPA of 2.6 or above, as a result of this blogging for participatory and includes self-directed learning which also capture application of theory to practice in nursing education. Especially, transitioning from Student to Graduate nurse. 