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 (LiST).
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.