yd
outside agencies which they do not have much control over (as has been the case
with the Trust Territory Health Services Administration in the past).

Thus, it

is recommended that the proposed planning unit be administratively tied directly
to the Ministry of Health Services and that it work closely with the Nitijela,
the Health Coordinating Council (it if remains functional), and the Secretary of
Health Services

(see Organization

Chart,

Section

IV

A).

As

noted

in

the

Organization Chart, the Planning/Evaluation Unit will be on the same level as the
other main divisions.

This will assume it has both the independence and clout

needed to fulfill its role.
It should be stressed that the planners (if expatriate) must be willing to

adapt their planning methodologies to the traditional political system found in
the M.I.

Complicated Health Services Administration-type planning methodologies

as used in the U.S. are not approriate here.
health

planning

for

developing

The planners must have experience in

countries

and

the

support

and

backup

by

consultants of various categories will be needed, i.e. social scientists, survey
statisticians and epidemiologists.
2.

Manpower

There is not available locally personnel who have the statistical, planning,
and epidemiological expertise needed to adequately supervise the system.

It is

recommended that for at least five years a full-time expatriate planner/evaluator
and a statistician/epidemiologist be hired.

As soon as possible, promising

Marshallese should be sent for advanced training in statistics and planning so
that the expatriates can be phased out.
There is also need for an expatriate hospital medical records technician to
assist

in

revamping

that

system.

This

person

could

also

assist

in

the

planning/evaluation unit particularly in the design and upkeep of the clinicbased patient record keeping system.
3.

Vital Statistics Gathering

It is recommended that this unit make as its first priority the testing of

other alternatives to the existing vital statistics and medical record system
i.e. a patient-retained record system.

The latter would be to counteract the

double problems of a highly mobile population and the custom of frequent name
changes.

The possible utilization of the radio for selective data gatering

should also be tested.

In addition the design of a planned schedule of periodic

sample surveys to assess program effectiveness needs to be done.

Select target paragraph3