Health services in Papua New Guinea run by the Catholic Church face a major shake up after cuts in their funding from the government.
Catholic Health Services provides up to a third of PNG's medical services through more than 200 sites around the country - many in remote areas of the Highlands.
It relies on government funding but the Peter O'Neill administration has cut this back, and this will mean staff layoffs and others leaving because salaries will be lower.
The director of Catholic Health Services, Justine McMahon, said the government has reduced its support to the level paid in 2014 and for some staff this will mean 40 percent pay cuts.
She said they will lose staff.
"Staff will have to be put off but other staff will leave because they will not put up with that level of cut."