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Annual Paediatric Symposium Paediatric Symposium 2019 Paediatric Symposium Below are the program and presentations from the 2019 symposium. Click on the links to download. PNG Paediatric Society Symposium booklet Day 1: Paediatric education and workforce planning Prof Vince Postgraduate training in Child Health 2019 Dr James Amini Paediatric workforce needs Dr Francis Pulsan Does PBL MBBS curriculum prepare RMOs for paediatric practice? Dr Maylin Karko My expereience in Kaviang To see the MMed and DCH trainee research projects, go to Registrars and Research 2019 Day 2: Child heath program areas Dr Mobumo Kiromat and Dr James Amini Key Result Area 4 in the National Health Pplan 2021-2030 Dr James Amini and Prof Duke Revision of the Child Health Plan 2021-2030 Dr Gamini Vali Paediatric HIV update Mr Petrus Kombea Early Infant Diagnosis of HIV Sr Esther Pisaro Prevalence of HIV in HIV-exposed babies at 18 months by PCR Dr Roland Barnabas Early Essential Newborn Care update HEO Monica Poasa Kangaroo Mother Care at Mt Hagen Hospital Dr Mary Paiva Child Abuse and Child Protection In Focus Sr Jean Kupo Child abuse and Family Support Centres in Kundiawa Day 3: Quality improvement and clinical topics Prof Duke Lessons from the PHR 2018 Dr Paulus Ripa and Dr Jonah Kurubi Clinical Governance, mortality reviews and clinical accountability Prof Duke T National Paediatric Quality Improvement program Dr Rhondi Kuana and Dr Doreen Panauwe Bubble CPAP use in Wabag Hospital Dr Kone Sobi Advanced Paediatric Life Support 2022 - June - Paediatric Symposium Mid year meeting: Strategising the implementation of the Child and Adolescent Health Plan 2021-2030 Sogeri June 6-10 In June 6-10 the Paediatric Society of Papua New Guinea met together for the first time in nearly 3 years. The purpose of the meeting was to strategize the implementation of the Child and Adolescent Health Policy and Plan 2021-2030. The program and detailed abstracts, the recommendations, and the presentations can be downloaded below. PNG Paediatric Society mid-year meeting program and abstracts booklet 2022 Recommendations mid-year meeting June 2022 The meeting was attended by 40 paediatricians with diverse experience in clinical and academic paediatrics, public health, and health administration within Provincial Health Authorities. In addition we welcomed other participants: 5 senior child health nurses from Port Moresby General Hospital; 2 health extension officers; and representatives from the National Department of Health, the Society of Obstetrics and Gynaecology, WHO and UNICEF. Day 1 Dr Cornelia Kilalang Child and Adolescent Health Policy and Plan 2021-2030 Prof Trevor Duke Changing nature of child health epidemiology and what it means for paediatrics Dr Dale Frank National Health Plan 2021-2030 in Milne Bay PHA Dr Roland Barnabas High risk newborns and EENC Dr Mary Bagita Perinatal Mortality at the Port Moresby General Hospital Dr Rupert Marcus COVID-19 in children PMGH 2022 Day 2 Dr Moses Laman Malaria and Lymphatic filariasis Dr Diana Olita’a Rheumatic Heart Disease Ms Martha Pogo Measles situation in PNG Dr. Satish Gupta Stategies to improve routine immunization Dr Debra Preventing re-emergence of polio in PNG Dr Garba Safiyanu Going back to Primary Health Care UNICEF Nutrition program Day 3 Ms Modalen Wobiro Social work role in child abuse Dr Allanie Rero Child protection and abuse Dr Beryl Vetuna Services for the disabled child Dr Fiona Kupe Urban child health NCD Dr Gilchrist Oswyn Community paediatrics in Milne Bay Province Dr Mary Paiva Adolescent Health and wellbeing Dr Mary Paiva Social and community child health – the paediatricians role Dr Monica Hagali Mental health in children and adolescents Dr Vila Watch Paediatric palliative care Ms Francesca Vangun Child abuse a social workers perspective Chemotherapy practical demonstration Jayne Harrison Day 4 Mr Edilson Yano Paediatric Hospital Reporting Dr Gwenda Anga Childhood cancer in PNG Dr Rupert Marcus Pediatric critical care in PNG Prof Trevor Duke PHR brief data 2021 Dr James Amini Paediatric workforce projections Prof Vince Postgraduate training Programme in Child Health 1979-2022 Prof Trevor Duke Current paediatric trainees and future needs 2022 Sr Merelyn Pindau Paediatric nursing Dr Doreen Panauwe Child and Adolescent Health programs in Enga 2022 - September - Paediatric Symposium 46th Annual Paediatric Society Symposium Recommendations Links to presentations from the Paediatric Society meeting are below. Dr Cornelia Kilalang National Standards Dr Roland Barnabas EENC Dr Jason Vuvu Nutrition Programs in order to achieve the NHP Dr Diana Olita’a Cardiology Dr Francis Pulsan Standard in Child Health Training Mr Ambrose Kwaramb Paediatric Healthcare Facilities Design Standards Prof T Duke RCTs child health and developing countries 2022

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Privacy Policy Privacy Policy Effective Date: 01/06/2025 The Paediatric Society of Papua New Guinea ("we", "our", or "us") is committed to protecting the privacy of our website visitors. This Privacy Policy outlines how we collect, use, and safeguard your personal information when you visit https://pngpaediatricsociety.org . 1. Information We Collect We may collect the following types of information: Personal Information: Such as your name, email address, and professional details if you voluntarily submit them through contact forms, event registrations, or membership applications. Non-Personal Information: Such as your browser type, IP address, device type, and pages visited. This helps us improve website performance and user experience. 2. How We Use Your Information We use the information we collect to: Respond to inquiries and provide requested information Manage membership applications and communications Share updates about society activities, events, and child health resources Improve our website and services Ensure the security and integrity of our website 3. Cookies and Tracking Our website may use cookies to enhance your browsing experience. You can choose to disable cookies through your browser settings, but this may affect some features of the site. 4. Sharing Your Information We do not sell, trade, or rent your personal information. We may share information with trusted third parties only when necessary to operate our website or services, or if required by law. 5. External Links Our website may contain links to external websites. We are not responsible for the content or privacy practices of these third-party sites. We encourage users to read the privacy policies of those websites. 6. Data Security We take reasonable measures to protect your personal data from unauthorized access, misuse, or disclosure. However, no method of internet transmission or electronic storage is 100% secure. 7. Children’s Privacy This website is not intended to collect personal information from children under the age of 13. If we discover such information has been provided without parental consent, it will be deleted promptly. 8. Changes to This Policy We may update this Privacy Policy occasionally. All changes will be posted on this page with a revised effective date. 9. Contact Us If you have any questions or concerns about this Privacy Policy or how your information is handled, please contact us at: Email: info@pngpaediatricsociety.org Website: https://pngpaediatricsociety.org

About Us About About the Paediatric Society of Papua New Guinea Established in the 1970s, the Paediatric Society of Papua New Guinea has evolved into a vital professional body committed to improving the health and well-being of children and adolescents across the country and the Pacific region. From its modest beginnings with just 10 to 20 members in the 1980s and 1990s, the Society now boasts a membership of over 80 dedicated professionals. While most members are paediatricians and postgraduate paediatric trainees, the Society also welcomes paediatric nurses, health extension officers, and other child health practitioners, reflecting its inclusive and collaborative approach. The Society plays a pivotal role in shaping the future of child health in Papua New Guinea. It maintains strong partnerships with key institutions such as the National Department of Health and the School of Medicine and Health Sciences at the University of Papua New Guinea. The Society also includes active members from neighboring Pacific Island nations, especially the Solomon Islands and Vanuatu, fostering regional collaboration. Core responsibilities of the Paediatric Society include developing and regularly updating clinical and public health guidelines based on the latest scientific evidence. As the custodian of national paediatric clinical standards, the Society ensures that healthcare providers across the country have access to best-practice protocols. The Society advises the Department of Health on a broad spectrum of child and adolescent health issues, from clinical care and disease prevention to social and environmental health factors. It also plays a critical role in public education, raising awareness on vital topics such as breastfeeding, immunization, nutrition, and school attendance. Further, the Society works closely with medical and nursing education institutions to ensure health training programs align with national child health policies. It supports continuous professional development by organizing training opportunities for paediatricians and child health nurses, helping them maintain up-to-date skills and knowledge. Beyond its technical work, the Society serves as a collegial body, offering professional and peer support to its members, and fostering a shared commitment to the health of future generations. The roles of the Paediatric Society include the following: To develop and maintain standards of paediatric clinical care and public health, according to the latest evidence. The Society is the custodian of clinical guidelines, and ensures they are kept up to date. To provide guidance to the Department of Health on all aspects of child and adolescent health, including clinical practice, quality and safety and outcomes, social, environmental and preventative health, vaccine-preventable diseases, and emerging or neglected child and adolescent health issues. The advice is based on scientific evidence and professional experience and wisdom. To provide advice to the community on important aspects of child health, for example through involvement in public awareness about breastfeeding, immunization, nutrition and school attendance. To work closely with training institutions to provide input on health training curricula, so that nursing, under-graduate medical training and courses for other health workers reflect the national child and adolescent health policies and guidelines. To develop continuing professional development for paediatricians and child health nurses to ensure the maintenance of professional skills, knowledge and standards To be a collegiate society providing professional and peer support to members This web-site contains information relevant to child health in PNG and other Pacific Island countries. COVID-19 Resources COVID-19 Guideline for Paediatric Health Care Workers August 4th 2020 Download Hospital Reporting Program Weekly Paediatric Lectures - 2022 Every child deserves a chance to grow, thrive, and shine — and we’re here to make it happen. Our Mission Our Mission To advance child and adolescent health in Papua New Guinea and the Pacific by: Promoting evidence-based clinical care and public health practices. Providing expert guidance to health authorities and communities. Supporting ongoing education and training for health professionals. Advocating for child health policies that reflect equity, quality, and sustainability. Fostering collaboration among healthcare workers, institutions, and regional partners to strengthen paediatric care at every level. Our Vision A Papua New Guinea where every child and adolescent enjoys the highest standard of health, supported by compassionate care, informed policies, and empowered health professionals. Together, for a Brighter, Healthier Future

CME Continuing Medical Education Q&A 2018 2017 2016 2015 Because Every Child Counts

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Research 2020 Research 2020 Master of Medicine Dr Edwina Baleo. Parents’ perspectives of adolescent sexual reproductive health in Port Moresby A study of parental perception on adolescent sexual reproductive health in Port Moresby, Papua New Guinea. The study demonstrated that there is a need for parental support in improving adolescent sexual reproductive health of young people, as revealed by lack of awareness of adolescent sexuality rights, poor knowledge depth and communication capacity among parents interviewed. While parents were aware that adolescence was an important stage in a child’s life, during which guidance in decision making relating to sexuality is paramount, their depth of understanding of the aspects of sexuality that require attention in a child’s life were limited, including an obligation to ensure contraceptives are encouraged and made available to their children. Most parents based their preventative measures on messages of abstinence which has shown to be an ineffective preventative method. Hence there is a need for comprehensive sexual and reproductive health education amongst parents and adolescents in Port Moresby. Dr Ian Kintwa. Factors associated with mortality in children with acute malnutrition at the Mt Hagen General Hospital in 2019 A prospective study of 150 children with severe malnutrition, investigating clinical and laboratory risk factors for death, measurable at the time of presentation. Children with a capillary refill greater than 3 seconds, tachypnoea, hypoxaemia, reduced conscious level and dysnatraemia (hypernatremia or hyponatremia) were significantly more likely to die. 13 children had prolonged capillary refill the odds ratio for death was 9. 18 children had hypoxaemia and the odds ratio for death was 30. 20 children had a GCS<13 and the odds ratio for death was 56. 28 children had dysnatraemia and the odds ratio for death was 4. To reduce acute malnutrition mortality, children presenting with capillary refill greater than 3 seconds, hypoxaemia, reduced conscious level or dysnatraemia should be identified promptly and given special attention. Clinical and laboratory features of children with malnutrition in Mt Hagen MMed 2020 Dr Violet Nigiria. “Tied for life”: Children with thalassaemia receiving blood transfusions in Port Moresby in 2020 A descriptive longitudinal-qualitative review of thalassaemia patients receiving blood transfusions in Port Moresby general Hospital in Papua New Guinea was carried out. 21 patients who were receiving blood transfusions and their parents were interviewed. There are important impacts of thalassemia on quality of life, as seen in school attendances and self-perception to illnesses. The genuine sacrifices and burden faced by the family were substantial. Issues faced by these families included their knowledge of thalassaemia, end of life discussions, parental concerns, family coping strategies and aspects of positivity about their illness. Most children were from southern coasts of Papua New Guinea. The affected families sacrificed a lot and migrated near hospitals that have blood bank services. Regular blood transfusions had increased the patient’s life span, however this can be improved further by regular monitoring of post-transfusion haemoglobin to maintain a hyper-transfusion state, combined with the introduction of chelation agent. Papua New Guinea need to develop prevention strategies of any birth defects by having the health policy makers aware of the global and local toll of birth defects with associated disabilities and family burdens and develop a genetic screening services for selected birth defects in hospitals, for risk assessment, genetic counselling and education of the family so reliable database for the country can be collected. Finally, provision of holistic and comprehensive care for patients and families with thalassaemia is essential including other children with birth defects. Thalassaemia in children at Port Moresby Hospital MMed 2020 Dr Joseph Ande. Approach to the diagnosis of tuberculosis meningitis in children admitted to the Port Moresby General Hospital In Papua New Guinea childhood TB is a large burden and contributes substantially to child mortality, malnutrition and impaired neurological and cognitive development. Diagnosing tuberculous (TB) meningitis or central nervous system TB in low resource setting is very challenging. The study assessed the current practice of diagnosing children admitted to Port Moresby General Hospital in 2020. 50 children who were admitted with a diagnosis of CNS TB with no underlying prior cerebral lesions were enrolled in this study. The data were collected by interviewing the parents or guardians and from the admission charts. The median age was 45 months. The CSF microscopy result showed the typical picture of CNS TB or TB Meningitis with a very high lymphocytes with very high protein and normal glucose. More than 50% of the population studied had chest x-ray changes suggestive of TB. Gene x-pert detected more mycobacterium TB in CSF more than other samples collected for testing. Based on these results a standardised algorithm in diagnosing TBM in PNG can be designed to further improve detection, management and prevent comorbidities and deaths relating to TBM. Diagnosis of tuberculous meningitis in children MMed 2020 Diploma of Child Health Dr Thomas Johns. The prevalence and risk factors for malnutrition in children attending outpatient clinics in Goroka town In this study, amongst children attending urban clinics in Goroka, 14% had malnutrition. The risk factors associated with malnutrition were; village delivery and residence in a rural area. Other characteristics linked to higher probability of malnutrition were among children who resided in a settlement area, were being raised by a single parent, were adopted, lived in homes where the primary water source was from river supply, and partially vaccinated child and introduction of first feed less than 6 months. However these were not significant. Improvements to reducing rates of malnutrition can be achieved greatest through changes in socioeconomic status of women, ensuring children have a supervised delivery in a health facility where they are provided adequate counselling for basic nutrition amongst other necessary basic health advice, improving accessibility of primary health care to women and children has the potential to reduce the rates of malnutrition that we see in the province and the nation as a whole. Malnutrition in urban clinics in Goroka DCH 2020 Dr Tracey Jeff. The severity and duration of hypoxemia in children with pneumonia in Mount Hagen Hospital Pneumonia and bronchiolitis are the commonest cause of admission to the paediatric ward in Mt Hagen General Hospital associated with hypoxemia for the patients aged 1 month to 5 years. Many patients with pneumonia and bronchiolitis patients presenting with hypoxaemia seem to require longer hospital stay being on oxygen, and this is more commonly seen in the highlands. This study aimed to determine the time taken for hypoxaemia to resolve in children aged 1 month to 5 years, with pneumonia or bronchiolitis at Mount Hagen Hospital Western Highlands Province, Papua New Guinea, and to study the factors predicting prolonged hypoxaemia (SpO2<90% for more than 7 days) and the effect of comorbidities. Among 152 patients, 70 had clinical pneumonia, 20 had clinical bronchiolitis, and the rest had acute lower respiratory infection indistinguishable between pneumonia and bronchiolitis. The median SpO2 in air on admission was 78% (IQR 66-83%). The median days to resolution of hypoxemia was 2.5 days (IQR 1.5 to 5 days), 19.1% still required oxygen at 7 days, and hypoxaemia in all patients had resolved by 18 days. Hypoxaemia was more likely to be prolonged for those with underlying comorbidities. Most children who have just pneumonia or bronchiolitis do not require prolonged hospital stay for supplemental oxygen, while some do but their hypoxaemia resolves within 3 weeks. Better understanding of associated comorbidities and their management will help improve education on the use of oxygen therapy, understand disease progression and complexity and improve management of children with hypoxaemia. Severity and duration of hypoxaemia in children with pneumonia in Mt Hagen DCH 2020 Dr Vanessa Binene. Oxygen saturation reference values measured by pulse oximetry among children living at high altitude in Wabag The use of pulse oximetry is now common in most clinical settings throughout PNG, and it is recognized as a fifth vital sign. The purpose of this research was to determine a reference value of healthy individuals from the age of 1 to 60 months living in Wabag District at about 2300m above sea level, and to determine any factors that can contribute to a lower oxygen saturation in children living that this altitude. There were 266 subjects analysed, the data were normally distributed. The lowest measured SpO2 was 82% and the highest 99% with a mean of 94.8% (SD 2.8%). The 95% CI was 94.5% to 95.1%. Younger children had a lower mean SpO2 than older children living at this altitude, which suggests physiological adaptation to altitude over time, even beyond infancy. Sleep had a lowering effect on arterial oxygen saturation, and babies in bilums whether awake or asleep had lower SpO2 compared to other children. While the clinical significance of this is uncertain, certain young babies may be more at risk of hypoxia and adverse events if asleep in a bilum, and if parents also smoke, and this requires further research. Normal oxygen saturations in children in Enga DCH 2020 Dr Ruth Jaye. Bacteria causing intravenous cannula-related thrombophlebitis and fever, and antibiotic resistance patterns, among paediatric patients at Angau Hospital Thrombophlebitis and fever secondary to the use of intravenous cannula (IVC) is a common occurrence in children at Angau Hospital, and might be a cause of nosocomial infection and avoidable morbidity and mortality. This study was done to identify the causative organisms by doing cultures on IVC tips and identifying the antibiotic sensitivity and resistance of bacteria isolated. The study included children who had IVC during their hospital admission. All IVC tips were collected using a sterile procedure (wearing sterile gloves, sterile scissors to cut the cannula tip, and transport media). Cultures were done on all IVC tips and antibiotic sensitivities done on all isolates. The organisms in the IVC tips that are responsible for causing thrombophlebitis were identified, Gram negative bacteria were most common, especially Escherichia coli and Klebsiella species. These bacteria were resistant to many standard antibiotics.

Quality Improvement Quality Improvement This page contains tools for Quality Improvement in Paediatric Care. Assessment Checklist for Quality Improvement Quality Check List for Paediatrics Above is a link to a ‘self-assessment’ checklist, to identify areas where improvements are needed. It is not meant to be too detailed, just key quality indicators that you can run through, to highlight strengths, identify gaps, and make changes. Improving Monitoring and Identification of the Deteriorating Patient Paediatric Monitoring and Response Chart 2023 These charts have thresholds for escalation (Red you must call a doctor – registrar or above – to review the child ASAP; Orange , you should also be alert and escalate to a senior nurse or RMO). These charts require trained nurses who understand how to plot the charts, and RMOs and registrars who can come to review patients and make assessments if observations are in the Red zone. Depending on the frequency of observations, each chart can last 2 days (if 2nd hourly observations), 3 days (if 3rd hourly observations) or 4 days (if 4 hourly observations). The frequency of observations is prescribed by the doctor, depending on the severity of the patient, and this changes as the child improves. PNG Paediatric Quality Improvement Program The components of this program include: A quality improvement team in each hospital Use of a Quality Improvement Checklist for paediatric health services Regular mortality and morbidity audits Training on the care of seriously ill children, through the WHO Hospital Care for Children training Establishment of intensive care areas in the paediatric wards for the care of the most critically ill children Paediatric monitoring and response charts with early warning indicators and escalation processes Infection control and antibiotic stewardship , including hand hygiene Improved systems for managing children with chronic conditions (cerebral palsy or developmental problems, epilepsy, chronic cardiac, respiratory, cancer) Improved laboratory support and diagnostic tests , especially diagnostics to guide antibiotic use Continuing medical education for paediatricians and paediatric nurses Communication about seriously unwell patients – improving handover ISBAR communication tool for seriously ill patients March 2019 Clinical handover using ISBAR Registrars should be present at handover every morning Report on admissions overnight – numbers, diagnoses Say specifically which beds the sickest patients are in (all new admissions and children who have deteriorated), whether in the wards or still in emergency department Report on patients who have deteriorated or been admitted to the PICU area overnight. Start a PICU handover as part of the morning handover, with a status update of the patients in the PICU or high dependency area on your ward in provincial hospitals. For the handover of the sickest patients, and any seriously ill children who present overnight and might still be in the emergency department, hospitals may use a communication tool called ISBAR (introduction / situation / background / assessment / recommendation). Investing in Children’s Health is Investing in the Nation

Research 2021 Research 2021 Diploma of Child Health Dr Geraldine Lagani Paediatric referrals from Gerehu Hospital Dr Shedrick Wadigi Child injuries in Angau Hospital Dr Dorothy Namba Antibiotic audit in Mt Hagen Master of Medicine Dr Mathilda Aloich Polio vaccine in Sandaun Province Dr Tina Yarong Knowledge and Perceptions of HIV among parents in Port Moresby Dr Andree Zumanu Intravenous cannula complications in children at Port Moresby Hospital Dr Anna Toti Birth defects in Rabaul Dr Winnie Sadua Thiamine status of malnourished children in Port Moresby