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MHI in PNG Lessons Learned to Inform Good Practice

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MHI in PNG Lessons Learned to Inform Good Practice Mining Health Programs in Papua New Guinea Lessons Learned to Inform Good Practice Submitted to AusAID by Mining Health Initiative (Montrose and Health Partners International) June 2013 CONTENTS Contents ......................................................................................................................................... 2 List of Acronyms ............................................................................................................................. 4 List of Tables ................................................................................................................................... 6 List of Figures .................................................................................................................................. 6 Executive Summary ......................................................................................................................... 7 1 Introduction .............................................................................................................................. 9 1.1 Background and context ...................................................................................................................... 9 1.2 Risks and opportunities linking mining and health ............................................................................. 9 2 Overview of mining in PNG ..................................................................................................... 10 3 Overview of health in PNG ...................................................................................................... 12 3.1 Overview ............................................................................................................................................ 12 3.2 Key issues and challenges faced by the health sector ....................................................................... 13 4 Governance and regulatory framework .................................................................................. 15 4.1 Institutional infrastructure ................................................................................................................ 15 4.2 The health and mining regulatory frameworks ................................................................................. 15 4.2.1 Overall direction ......................................................................................................................... 15 4.2.2 Key laws and regulations ............................................................................................................ 16 4.3 Governance of mining revenue ......................................................................................................... 18 4.3.1 Royalties ...................................................................................................................................... 18 4.3.2 Taxes ........................................................................................................................................... 18 4.3.3 Tax Credit Scheme ...................................................................................................................... 18 4.3.4 Sovereign Wealth Fund ............................................................................................................... 19 4.3.5 Extractive Industry Transparency Initiative ................................................................................ 19 4.4 Stakeholder consultation and coordination ...................................................................................... 20 4.4.1 Mine approval and the development forum process ................................................................. 20 4.4.2 Agreements ................................................................................................................................. 21 4.5 Decentralisation to Provincial Level .................................................................................................. 21 4.6 Challenges in implementing the regulatory framework ................................................................... 21 4.6.1 Out-dated regulatory framework ............................................................................................... 21 4.6.2 Roles, responsibilities and capacity of provincial and local government ................................... 22 4.6.3 MRA capacity constraints ........................................................................................................... 23 4.6.4 Buy-in from other government departments ............................................................................. 23 4.6.5 Lack of standard procedures and guidelines .............................................................................. 23 4.6.6 Lack of NDOH involvement ......................................................................................................... 23 4.6.7 Mismatch between legal commitments and budgetary space ................................................... 24 4.6.8 Limits on use of Sovereign Wealth Fund resources .................................................................... 24 4.6.9 Regulation of small-scale mining ................................................................................................ 24 5 Mining health programming in practice .................................................................................. 26 5.1 Reasons for investing in health ......................................................................................................... 27 5.2 Assessment, planning and financing ................................................................................................. 28 5.2.1 Health needs and impact assessment ........................................................................................ 28 5.2.2 Planning ...................................................................................................................................... 29 5.2.3 Financing ..................................................................................................................................... 30 5.3 Stakeholder consultation and coordination ...................................................................................... 30 5.3.1 Stakeholder consultation ............................................................................................................ 30 2 5.3.2 Coordination ............................................................................................................................... 31 5.4 Partnerships ....................................................................................................................................... 32 5.5 Provincial and Local Government ...................................................................................................... 33 5.6 Monitoring progress and evaluating impact ..................................................................................... 35 5.7 Exit strategies and sustainability ....................................................................................................... 36 6 Lessons learned and recommendations .................................................................................. 38 6.1 Lessons learned ................................................................................................................................. 38 6.1.1 Program design ........................................................................................................................... 38 6.1.2 Sustainability ............................................................................................................................... 39 6.1.3 Key challenges ............................................................................................................................. 39 6.1.4 Opportunities .............................................................................................................................. 40 6.2 Recommendations ............................................................................................................................. 41 7 Bibliography ............................................................................................................................ 43 8 Annexes .................................................................................................................................. 48 8.1 Annex 1. List of individuals contacted ............................................................................................... 48 8.2 Annex 2. Case study summary – Ok Tedi........................................................................................... 50 8.3 Annex 3. Case study summary – Lihir Gold Mine .............................................................................. 60 8.4 Annex 4. Additional information on governance and regulatory Issues ........................................... 69 8.5 Annex 5. Other health mining programs and partnerships in PNG ................................................... 72 3 LIST OF ACRONYMS ADB Asian Development Bank AusAID Australian Agency for International Development BCL Bougainville Copper Limited CHW Community Health Workers CHS Christian Health Services CSR Corporate Social Responsibility DHO District Health Office DHS Demographic Health Survey DNP&M Department of National Planning and Monitoring DOM Department of Mining DMPGM Department of Mineral Policy and Geohazard Management DOPE Department
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