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.
🇵🇬 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
🟦 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
🟩 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
🟨 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%)
🟧 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
🟥 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:
💰 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:
💰 USD 5–8 million
Year 5 (Consolidation & Sustainability)
- Evaluation
- System optimisation
- Long-term integration
- Research and innovation support
Estimated Cost:
💰 USD 2–3 million
🔢 TOTAL 5-YEAR ESTIMATE
💰 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.
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