planning/statistical unit.
As to the handling of Federal categorical grants i.e. Cervical Cancer
Screening, Meals-on-Wheels, etc., this is even more unsure.
depends on negotiations between the U.S. and the MIG.
The outcome
It seems to be the
desire of the Marshallese to still be eligible for some of the categorical
grants, but they don't want the funds to be tied to a lengthy Health Systems
Agency certificate-of-need process.
It
would
seem more
efficient
and
politically palatable to the Marshallese if funds were allocated "globally"
in
block grants
(directly from government to government)
agreed-upon health
service needs.
to cover all
Administration and accounting of the
funds would be done by the Ministry of Health or its contractor directly
with the funding federal agency, without an intermediary “outside” Health
Planning agency dictating requirements.
Continuing relationships with TTPI for manpower training, consultation
on specialized medical problems, special grants, etc., would probably be
continued but preferably on a low-key “voluntary” basis.
A function which
is as yet unclarified is the whole licensing/credentialing process of both
institutions
(hospitals,
technicians).
lab,
etc.)
and
manpower
(nurses,
physicians,
Some officials in the MIG would like to assume that role
themselves, while others would like to keep this process tied to the U.S.
systems.
The outcome of this decision could determine a lot on how closely
the MIG will be tied to TTPI Bureau of Health Services and all the federal
categorial grants they control.
E.
Categorical U.S. Funded Programs
The present Ministry of Health Services has a Public Health Division
(under the hospital administrator) which performs most health promotion and
prevention
services.
It
includes among others:
environmental
health,
maternal and child health, health education, crippled children's services,
special
clinics
(i.e.
diabetes,
leprosy,
hypertension),
continuing education for health assistants, etc.
immunizations,
All of these administered
by the Majuro Hospital and funded partially by the MIG and partially by U.S.
categorical grants.
other
ministries
Many other health related services are administered by
of
the
government.
This
unfortunately
has
caused
considerable inefficiency and duplication of effort, not to mention fiscal
accounting problems.