Transitioning from Episodic Cardiac Missions to Sustainable National Cardiac Surgery Services in Papua New Guinea: A...

Background: Access to cardiac surgery remains severely limited in many low- and middle-income countries, where care is often delivered through short-term missions or overseas referrals. Papua New Guinea (PNG) is undergoing a transition towards sustainable national cardiac surgical capacity. Methods: We conducted a mixed-methods evaluation of a March 2026 Singapore-PNG cardiac surgery mission at Port Moresby General Hospital. Quantitative data were collected using Likert-scale surveys assessing key domains of mission performance. Qualitative data were analysed using thematic analysis. Findings were used to identify pragmatic strategies to improve cardiac surgical delivery within existing system constraints. Results: Twenty-eight participants completed the evaluation. Overall mission experience was rated highly (mean 4.61 ± 1.07). Strengths included multidisciplinary collaboration, education and increasing local leadership. However, key challenges were identified in post-operative care (protocol clarity mean 2.86 ± 1.33), ICU coordination and supply chain reliability. Workforce gaps and communication inefficiencies further impacted care delivery. Conclusion: Mentorship-based cardiac missions can support local capacity development, but sustainable service delivery requires targeted improvements in post-operative care systems, workforce capability and operational processes. These findings highlight practical strategies to strengthen cardiac surgical services in resource-constrained settings.