{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T21:09:10Z","timestamp":1771362550018,"version":"3.50.1"},"reference-count":63,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023278","name":"Darwin Initiative","doi-asserted-by":"publisher","award":["DAR26002"],"award-info":[{"award-number":["DAR26002"]}],"id":[{"id":"10.13039\/501100023278","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001312","name":"University of Brighton","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100001312","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sussex Sustainability Research Programme","award":["SSRP2016-023"],"award-info":[{"award-number":["SSRP2016-023"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,8,31]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Determine community needs and perspectives as part of planning health service incorporation into Wanang Conservation Area, in support of locally driven sustainable development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Clinical and rapid anthropological assessment (individual primary care assessments, key informant (KI) interviews, focus groups (FGs), ethnography) with treatment of urgent cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Wanang (pop. c189), a rainforest community in Madang province, Papua New Guinea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      129 villagers provided medical histories (54 females (f), 75 males (m); median 19 years, range 1 month to 73 years), 113 had clinical assessments (51f, 62m; median 18 years, range 1 month to 73 years). 26 \u226518\u2009years participated in sex-stratified and age-stratified FGs (f&lt;40\u2009years; m&lt;40\u2009years; f\n                      <jats:underline>&gt;<\/jats:underline>\n                      40\u2009years; m\n                      <jats:underline>&gt;<\/jats:underline>\n                      40\u2009years). Five KIs were interviewed (1f, 4m). Daily ethnographic fieldnotes were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 113 examined, 11 were \u2018well\u2019 (a clinical impression based on declarations of no current illness, medical histories, conversation, no observed disease signs), 62 (30f, 32m) were treated urgently, 31 referred (15f, 16m), indicating considerable unmet need. FGs top-4 ranked health issues concorded with KI views, medical histories and clinical examinations. For example, ethnoclassifications of three ((A) \u2018\n                      <jats:italic>malaria<\/jats:italic>\n                      \u2019, (B) \u2018\n                      <jats:italic>sotwin<\/jats:italic>\n                      \u2019, (C) \u2018\n                      <jats:italic>grile<\/jats:italic>\n                      \u2019) translated to the five biomedical conditions diagnosed most ((A) malaria, 9 villagers; (B) upper respiratory infection, 25; lower respiratory infection, 10; tuberculosis, 9; (C) tinea imbricata, 15) and were highly represented in declared medical histories ((A) 75 participants, (B) 23, (C) 35). However, 29.2% of diagnoses (49\/168) were limited to one or two people. Treatment approaches included plant medicines, stored pharmaceuticals, occasionally rituals. Travel to hospital\/pharmacy was sometimes undertaken for severe\/refractory disease. Service barriers included: no health patrols\/accessible aid post, remote hospital, unfamiliarity with institutions and medicine costs. Service introduction priorities were: aid post, vaccinations, transport, perinatal\/birth care and family planning.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study enabled service planning and demonstrated a need sufficient to acquire funding to establish primary care. In doing so, it aided Wanang\u2019s community to develop sustainably, without sacrificing their forest home.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075946","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T06:59:30Z","timestamp":1696834770000},"page":"e075946","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Health service needs and perspectives of a rainforest conserving community in Papua New Guinea\u2019s Ramu lowlands: a combined clinical and rapid anthropological assessment with parallel treatment of urgent cases"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5951-6608","authenticated-orcid":false,"given":"Jo","family":"Middleton","sequence":"first","affiliation":[{"name":"Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK"}]},{"given":"Gavin","family":"Colthart","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK"}]},{"given":"Francesca","family":"Dem","sequence":"additional","affiliation":[{"name":"New Guinea Binatang Research Centre, Madang, Papua New Guinea"}]},{"given":"Alice","family":"Elkins","sequence":"additional","affiliation":[{"name":"Department of Ecology and Evolution, University of Sussex, Falmer, UK"}]},{"given":"James","family":"Fairhead","sequence":"additional","affiliation":[{"name":"Department of Anthropology, University of Sussex, Falmer, UK"}]},{"given":"Richard J","family":"Hazell","sequence":"additional","affiliation":[{"name":"Department of Ecology and Evolution, University of Sussex, Falmer, UK"}]},{"given":"Michael G","family":"Head","sequence":"additional","affiliation":[{"name":"Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, UK"}]},{"given":"Joao","family":"Inacio","sequence":"additional","affiliation":[{"name":"School of Applied Sciences, Cockcroft Building, University of Brighton, Brighton, UK"}]},{"given":"Mavis","family":"Jimbudo","sequence":"additional","affiliation":[{"name":"New Guinea Binatang Research Centre, Madang, Papua New Guinea"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-1157","authenticated-orcid":false,"given":"Christopher Iain","family":"Jones","sequence":"additional","affiliation":[{"name":"Medical Statistics, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK"}]},{"given":"Moses","family":"Laman","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research, Port Moresby, Papua New Guinea"}]},{"given":"Hayley","family":"MacGregor","sequence":"additional","affiliation":[{"name":"Health and Nutrition Research Cluster, Institute of Development Studies, Falmer, UK"}]},{"given":"Vojtech","family":"Novotny","sequence":"additional","affiliation":[{"name":"Department of Zoology, Faculty of Science, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic"},{"name":"Institute of Entomology, Biology Centre, Czech Academy of Sciences, Ceske Budejovice, Czech Republic"}]},{"given":"Mika","family":"Peck","sequence":"additional","affiliation":[{"name":"Department of Ecology and Evolution, University of Sussex, Falmer, UK"}]},{"given":"Jonah","family":"Philip","sequence":"additional","affiliation":[{"name":"New Guinea Binatang Research Centre, Madang, Papua New Guinea"},{"name":"Wanang Conservation Area, Wanang, Papua New Guinea"}]},{"given":"Jason","family":"Paliau","sequence":"additional","affiliation":[{"name":"New Guinea Binatang Research Centre, Madang, Papua New Guinea"},{"name":"Department of Environmental Engineering & Renewable Energy, School of Environment and Climate Change, Papua New Guinea University of Natural Resources and Environment, Kokopo, Papua New Guinea"}]},{"given":"William","family":"Pomat","sequence":"additional","affiliation":[{"name":"PNG Institute of Medical Research, Goroka, Papua New Guinea"}]},{"given":"Jessica A","family":"Stockdale","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK"}]},{"given":"Shen","family":"Sui","sequence":"additional","affiliation":[{"name":"New Guinea Binatang Research Centre, Madang, Papua New Guinea"}]},{"given":"Alan J","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Ecology and Evolution, University of Sussex, Falmer, UK"}]},{"given":"Ruma","family":"Umari","sequence":"additional","affiliation":[{"name":"New Guinea Binatang Research Centre, Madang, Papua New Guinea"},{"name":"Wanang Conservation Area, Wanang, Papua New Guinea"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-8376","authenticated-orcid":false,"given":"Stephen L","family":"Walker","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Hospital for Tropical Diseases, and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0777-0385","authenticated-orcid":false,"given":"Jackie A","family":"Cassell","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK"}]}],"member":"239","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"2025120618304527000_13.10.e075946.1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1016\/S0140-6736(16)31467-2","article-title":"Measuring the health-related sustainable 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