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John W Bolnga is a senior specialist Obstetrician and Head of Obstetrics and Gynecology services at the Madang Provin... moreJohn W Bolnga is a senior specialist Obstetrician and Head of Obstetrics and Gynecology services at the Madang Provincial Health Authority,Madang which is a busy teaching hospital in Papua New Guinea. As Professor of O&G at the Divine Word University and Honorary lecturer and external examiner with the School of Medicine and Health sciences with the University of Papua New Guinea, he does lots of teachings, supervisory roles for Doctors,midwives,HEO's,paramedics,general nurses and also heads a small but vibrant clinical research unit. His area of interest is in clinical research in resource limited settings, leading to implementation and policy changes. As a senior clinical reserach fellow with PNG Institute of Medical Research and established researcher,he collaborates widely internationally and locally and has won many prizes ,awards, scholarships and also research grants individually and with collaborations with national and international institutions.He continues to contribute as a reviewer to many international peer reviewed journals and academic supervisory roles. edit
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Medicine and Childbirth
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Medical Microbiology, Biology, Malaria, Papua New Guinea, Adolescent, and 14 moreMedicine, Population, Humans, Young Adult, Middle Aged, Adult, Plasmodium falciparum, Internal medicine Doppler ultrasonography, Fetus, Middle Cerebral Artery, Cohort Studies, Umbilical Artery PH, Malaria Falciparum, and Fetal Growth Retardation
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Contraception, Papua New Guinea, Adolescent, Medicine, Pregnancy, and 15 moreHumans, Female, Patient Satisfaction, Middle Aged, Outreach, Adult, Public health systems and services research, Rural Area, Cross Sectional Studies, Pregnancy Rate, Surveys and Questionnaires, Levonorgestrel, Contraceptive Implant, Rural Population, and Paediatrics and reproductive medicine
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Research Interests:
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Medicine and New Guinea
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Medicine and Childbirth
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Introduction: Human papillomavirus (HPV) testing is transforming cervical screening globally. The World Health Organization (WHO) now recommends same-day HPV screen-and-treat for primary cervical screening in low- and middle-income... more
Introduction: Human papillomavirus (HPV) testing is transforming cervical screening globally. The World Health Organization (WHO) now recommends same-day HPV screen-and-treat for primary cervical screening in low- and middle-income countries (LMIC) but there is a lack of evidence on women’s lived experience of testing positive for oncogenic HPV and receiving same-day treatment. This study aimed to address this knowledge gap among women participating in a same-day HPV screen-and-treat (HPV S&T) program in Papua New Guinea. Methods As part of a larger qualitative study, this paper explores the lived experiences of 26 women who tested positive for oncogenic HPV and were treated the same day. We analysed the data using the interpretative phenomenological analysis method. All data were managed using Nvivo 12.5. Results The interpretative phenomenological analysis led to three superordinate themes: 1) alleviating initial worries, (2) transforming the disclosure process, and (3) connecting...
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Background: A field trial to evaluate a self-collect point-of-care HPV screen-and-treat (HPV S&T) program was implemented in two Well Women Clinics in Papua New Guinea (Papua New Guinea). Assessing the acceptability of a health... more
Background: A field trial to evaluate a self-collect point-of-care HPV screen-and-treat (HPV S&T) program was implemented in two Well Women Clinics in Papua New Guinea (Papua New Guinea). Assessing the acceptability of a health intervention is a core element of evaluation. In this study, we examined women’s acceptability of both self-collection and HPV S&T intervention in Papua New Guinea. Methods: Sixty-two semi-structured interviews were conducted with women who had undergone cervical screening in the same-day self-collected HPV screen-and-treat program in Madang and Western Highlands Provinces, Papua New Guinea. Data were thematically analysed using the Theoretical Framework of Acceptability (TFA) and managed using NVivo 12.5. Results: Self-collection was highly acceptable to women as it meant they could forgo what was deemed a culturally embarrassing cervical examination. The provision of same-day results, and treatment if indicated, was particularly valued by the women because ...
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Poor access to contraception contributes to persistently high maternal mortality rates in Papua New Guinea (PNG). Since 2012 contraceptive implants have been provided to women in rural areas of PNG through outreach services but follow-up... more
Poor access to contraception contributes to persistently high maternal mortality rates in Papua New Guinea (PNG). Since 2012 contraceptive implants have been provided to women in rural areas of PNG through outreach services but follow-up data in these communities on continuation and acceptability is lacking. To gain insight into women's experience with contraceptive implants by assessing the acceptability, satisfaction, 12 month continuation rates and efficacy of contraceptive implants among women in rural PNG. We undertook a cross-sectional survey of women in two rural provinces who had received a contraceptive implant at least 12 months prior using a structured questionnaire. We sought information on device continuation rates, satisfaction scores, side effects and failure rates. Of the 860 women surveyed, 97% (n = 836) still had the device in situ after 12 months and 92% (n = 793) were very happy with it. Seventy-six percent of women (n = 654) reported no side effects. Irregul...
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Contraception, Papua New Guinea, Adolescent, Medicine, Pregnancy, and 15 moreHumans, Female, Young Adult, Follow-up studies, Patient Satisfaction, Middle Aged, Adult, Public health systems and services research, Cross Sectional Studies, Delayed-Action Preparations, Pregnancy Rate, Surveys and Questionnaires, Levonorgestrel, Rural Population, and Paediatrics and reproductive medicine
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We report an extremely rare case of lithopedion or a mummifi ed baby that presented a diagnostic dilemma and perplexed us during diagnosis and surgery. This is the fi rst published report of a lithopedion case in Papua New Guinea.
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In recent years, there have been increased efforts to reduce the high maternal mortality ratio (MMR) in Papua New Guinea. This retrospective study conducted at Modilon Hospital in Papua New Guinea documented maternal and perinatal... more
In recent years, there have been increased efforts to reduce the high maternal mortality ratio (MMR) in Papua New Guinea. This retrospective study conducted at Modilon Hospital in Papua New Guinea documented maternal and perinatal mortality over the 6 years from 2009 to 2014. In-hospital maternal mortality, though still high, significantly declined by over 50% from 24/2598 (924 per 100,000) in 2009 to 12/3217 (373 per 100,000) in 2014 (p <0.001) while stillbirth rates and early neonatal death rates remained unchanged. There is a need for an approach with interventions aimed at reducing both maternal and perinatal mortality. While monitoring and auditing of maternal deaths should be possible throughout the entire country, in settings where there is limited capacity to monitor population-based perinatal and neonatal mortality, an emphasis on improved data quality as part of hospitaland health centre-based surveillance can provide important information.
reproductive age. Tubal EP is well described in industrialised countries, but less is known about its impact in low-resource countries, in particular in the South Pacific Region. Methods: We undertook a retrospective review of women with... more
reproductive age. Tubal EP is well described in industrialised countries, but less is known about its impact in low-resource countries, in particular in the South Pacific Region. Methods: We undertook a retrospective review of women with tubal EP treated at a provincial referral hospital in coastal Papua New Guinea over a period of 56 months. Demographic and clinical variables were obtained from patients ’ medical records and analysed. The institutional rate of tubal EP was calculated, and diagnosis and management reviewed. Potential risk factors for tubal EP were identified, and delays contributing to increased morbidity described. Results: A total of 73 women had tubal EP. The institutional rate of tubal EP over the study period was 6.3 per 1,000 deliveries. There were no maternal deaths due to EP. The mean age of women was 31.5+/−5.7 years, 85% were parous, 67 % were rural dwellers and 62 % had a history of sub-fertility. The most commonly used diagnostic aid was culdocentesis. O...
To undertake a retrospective perinatal death audit and assessment of avoidable factors associated with stillbirths among a cohort of women in two provinces in Papua New Guinea.
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Background Despite targeted interventions to improve contraceptive implant acceptability and uptake in rural Papua New Guinea (PNG), ongoing use of this method remains limited. Previous literature has suggested community attitudes and... more
Background Despite targeted interventions to improve contraceptive implant acceptability and uptake in rural Papua New Guinea (PNG), ongoing use of this method remains limited. Previous literature has suggested community attitudes and intrinsic factors within the decision-making process may be negatively impacting on implant uptake, however these elements have not previously been studied in detail in this context. We set out to explore community attitudes towards the contraceptive implant and the pathways to decision making around implant use in a rural community on Karkar Island, PNG. Methods We conducted 10 focus-group (FGD) and 23 in-depth interviews (IDI) using semi-structured topic guides. Key sampling characteristics included age, exposure or non-exposure to implants, marital status, education and willingness to participate in discussion. Four FGDs were held with women, four with men and two with mixed gender. IDIs were carried out with five women (current implant users, forme...
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Background: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and bacterial vaginosis have been associated with preterm birth and low birth weight, and are highly prevalent among pregnant women in many low- and... more
Background: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and bacterial vaginosis have been associated with preterm birth and low birth weight, and are highly prevalent among pregnant women in many low- and middle-income settings. There is conflicting evidence on the potential benefits of screening and treating these infections in pregnancy. Newly available diagnostic technologies make it possible, for the first time, to conduct definitive field trials to fill this knowledge gap. The primary aim of this study is to evaluate whether antenatal point-of-care testing and immediate treatment of these curable sexually transmitted and genital infections (STIs) leads to reduction in preterm birth and low birth weight. Methods: The Women and Newborn Trial of Antenatal Interventions and Management (WANTAIM) is a cluster-randomised crossover trial in Papua New Guinea to compare point-of-care STI testing and immediate treatment with standard antenatal care (which includes ...
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Background In Papua New Guinea, TB is considered to be a major public health problem, but little is known about the prevalence and prognosis of presumed TB in children. Methods As part of a prospective hospital-based surveillance on the... more
Background In Papua New Guinea, TB is considered to be a major public health problem, but little is known about the prevalence and prognosis of presumed TB in children. Methods As part of a prospective hospital-based surveillance on the northern coast of mainland Papua New Guinea, the authors investigated the admission prevalence and case fatality rate associated with presumed TB over a 6-year period (2011–2016). All children admitted who were diagnosed with TB were followed-up until discharge or death. Results Of 8992 paediatric admissions, 734 patients (8.2%) were diagnosed with presumed TB and there were 825 deaths, with TB accounting for 102 (12.4%). Extrapulmonary TB was the final diagnosis in 384 admissions {prevalence 4.3% [384/8992 (95% CI 3.9–4.7)]} with a case fatality rate of 21.4% [82/384 (95% CI 17.4–25.9)]. TB meningitis, disseminated TB and pericardial TB had high case fatality rates of 29.0% (53/183), 28.9% (11/38) and 25% (4/16), respectively. Severe malnutrition wa...