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Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases

Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases
Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases

INTRODUCTION: Our project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data.

METHODS AND ANALYSIS: The study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author.

ETHICS AND DISSEMINATION: Challenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.

anthropology, epidemiology, primary care, protocols & guidelines, public health, qualitative research
2044-6055
e041784
Middleton, Jo
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Abdad, Mohammad Yazid
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Beauchamp, Emilie
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Colthart, Gavin
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Cooper, Maxwell J.F.
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Dem, Francesca
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Fairhead, James
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Grundy, Caroline L.
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Head, Michael G.
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Inacio, Joao
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Jimbudo, Mavis
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Jones, Christopher Iain
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Konecna, Martina
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Laman, Moses
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MacGregor, Hayley
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Peck, Mika
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Paliau, Jason
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Philip, Jonah
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Pomat, Willie
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Roberts, Chrissy H.
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Sui, Shen
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Walker, Stephen L.
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Cassell, Jackie A.
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Middleton, Jo
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Abdad, Mohammad Yazid
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Beauchamp, Emilie
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Colthart, Gavin
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Cooper, Maxwell J.F.
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Dem, Francesca
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Fairhead, James
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Grundy, Caroline L.
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Head, Michael G.
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Inacio, Joao
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Jimbudo, Mavis
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Jones, Christopher Iain
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Konecna, Martina
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Laman, Moses
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MacGregor, Hayley
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Novotny, Vojtech
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Peck, Mika
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Paliau, Jason
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Philip, Jonah
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Pomat, Willie
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Roberts, Chrissy H.
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Sui, Shen
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Stewart, Alan J.
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Walker, Stephen L.
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Cassell, Jackie A.
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Middleton, Jo, Abdad, Mohammad Yazid, Beauchamp, Emilie, Colthart, Gavin, Cooper, Maxwell J.F., Dem, Francesca, Fairhead, James, Grundy, Caroline L., Head, Michael G., Inacio, Joao, Jimbudo, Mavis, Jones, Christopher Iain, Konecna, Martina, Laman, Moses, MacGregor, Hayley, Novotny, Vojtech, Peck, Mika, Paliau, Jason, Philip, Jonah, Pomat, Willie, Roberts, Chrissy H., Sui, Shen, Stewart, Alan J., Walker, Stephen L. and Cassell, Jackie A. (2020) Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases. BMJ Open, 10 (10), e041784, [e041784]. ().

Record type: Article

Abstract

INTRODUCTION: Our project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data.

METHODS AND ANALYSIS: The study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author.

ETHICS AND DISSEMINATION: Challenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.

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Accepted/In Press date: 2 September 2020
e-pub ahead of print date: 31 October 2020
Published date: 31 October 2020
Additional Information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: anthropology, epidemiology, primary care, protocols & guidelines, public health, qualitative research

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Local EPrints ID: 445058
URI: http://eprints.soton.ac.uk/id/eprint/445058
DOI:
ISSN: 2044-6055
PURE UUID: 8b584126-4839-4f39-8c6e-49d003446f5b
ORCID for Michael G. Head:

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Date deposited: 18 Nov 2020 17:33
Last modified: 23 Nov 2020 17:31

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Contributors

Author: Jo Middleton
Author: Mohammad Yazid Abdad
Author: Emilie Beauchamp
Author: Gavin Colthart
Author: Maxwell J.F. Cooper
Author: Francesca Dem
Author: James Fairhead
Author: Caroline L. Grundy
Author:
Author: Joao Inacio
Author: Mavis Jimbudo
Author: Christopher Iain Jones
Author: Martina Konecna
Author: Moses Laman
Author: Hayley MacGregor
Author: Vojtech Novotny
Author: Mika Peck
Author: Jason Paliau
Author: Jonah Philip
Author: Willie Pomat
Author: Chrissy H. Roberts
Author: Shen Sui
Author: Alan J. Stewart
Author: Stephen L. Walker
Author: Jackie A. Cassell

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