well.
A sample of a child home based medical record is in the
Appendix.
2.
Medical supplies and equipment (i.e. teaching/counselling aides,
contraceptives, food supplements) must be immediately on hand in
the premises.
Furthermore,
the resupply and
inventory system
should be tied directly to the patient-care record system.
3.
The primary care worker must be trained in al] the skill areas
expected and given the opportunity to practice such an integrated
approach under appropriate supervision.
It will be difficult for
this concept to be put in practice by the primary care worker
unless he has seen it work, is convinced it is better, and has the
chance of trying it out.
4.
The
need
for
continuing
and
timely
positive
support
and
constructive supervision from the central office by specialists of
several
kinds is mandatory i.e. health educators, public health
Nurses, sanitarians, nurse-midwives, etc.
5.
Upgrade the communications system to allow for guaranteed contact
with a higher trained health professional, whenever that contact
is deemed necessary by the clinic worker.
This may be through a
walkie-talkie type radio contact with the main clinic where a
"beeper" or other device is always being monitored by someone (the
wife) who can go call the medical assistant.
The medical assistant
in turn will be the main contact person with the central facility
in
Majuro
or
Ebeye
if
consultation is required.
an
emergency
call
for
referral
or
At all times of the day the medical
assistant will have a supervisory medical officer or physician on
call at Majuro or Ebeye to answer questions and to decide whether
referral is needed.
3)
Community Health Activities
Besides specified hours allotted at the clinic for “walk-in" curative
and preventive services oriented to the individual patient, there will also
be other regular periods scheduled for specified community health activities
(these may be on a daily, weekly, monthly or other schedule as befitting
local needs).
It will be the duty of the primary care worker to lead out in
such activities as:
“at