Cost analysis of provincial investment in specialist training: a case study from Milne Bay Provincial Health Authority

Introduction A resilient health system depends on skilled human resources capable of addressing interconnected health challenges at the community level. In Papua New Guinea (PNG), specialist medical training has been managed by the National Department of Health (NDoH). However, rising demands in provincial settings have compelled Provincial Health Authorities (PHAs) to take on a more active role. Milne Bay Provincial Health Authority (MBPHA) initiated its own sponsorship program in 2013, aiming to build local specialist capacity. This study investigates the financial investment by MBPHA in specialist training, recognising that the availability of trained personnel improves patient outcomes, reduces external referrals, and strengthens local health systems. Methodology A retrospective cost analysis was conducted on six specialist trainees supported by MBPHA across seven training programs at the University of Papua New Guinea (UPNG). Data were collected through structured questionnaires and validated by MBPHA’s Human Resources and Finance departments. All direct costs incurred during the training period were analysed. Results The total expenditure for the six candidates amounted to PGK5,228,833.00 (USD1,254,919.92). Costs include: salaries and allowances, PGK2,769,560.00 (USD664,694.40); rental accommodations, PGK1,724,739.00 (USD413,937.00); tuition fees, PGK139,808.00 (USD33,553.92); gratuities, PGK338,000.00 (USD79,687.18); recreational leave, PGK33,400.00 (USD7,874.41); relocation costs, PGK79,100.00 (USD18,648.69); books and equipment costs, PGK28,000.00 (USD6,801.20); conferences participation, PGK63,200.00 (USD15,168.00); overseas attachment costs, PGK15,000.00 (USD3,628.89); and graduation costs, PGK38,026.00 (USD9,126.00). On average, the cost per specialist was PGK871,472.17 (USD209,153.32). Conclusion PNG needs more medical specialists therefore investing in training is a sustainable model for the workforce. This is an expensive exercise with MBPHA investing in excess of PGK5 million training just six specialists. It will, however, be beneficial for MBPHA in the long term as the specialists will provide good clinical outcomes.