Public transport and its influence on healthcare access, engagement, and delivery during the COVID-19 pandemic in Papua New Guinea

Introduction Transport, including public transit, is essential for promoting health and preventing illness and death. The connection between geography, travel, transportation, and health has consistently been linked to health equity. This qualitative study examines the relationship between transport and access to and delivery of health care during the COVID-19 pandemic in Papua New Guinea. Methods In total, 131 healthcare workers, healthcare clients, community members, leaders, and stakeholders in health policy and management were recruited to participate in semi-structured interviews across seven provinces. Data analysis employed both deductive and inductive thematic approaches to explore transport accessibility, availability, and affordability during the pandemic. Results In PNG, COVID-19-related transport shutdowns, movement restrictions, decreased passenger numbers on public transport, and an aging or unavailable healthcare fleet created substantial barriers to accessing and delivering healthcare. These transport barriers impact not only rural and remote populations but also urban and peri-urban communities. The mobility of healthcare workers was also hindered, directly affecting healthcare delivery—an issue not observed in previous pandemics. Conclusion These findings support the immediate prioritisation of transport in health planning, frameworks, and budgets, as well as the development of collaborations and partnerships with public transport to better prepare for and respond to future health pandemics and emergencies.