Another nigh prioirty in the data gathering/s*atistics area should be the implementation of a Marshall Islands Population Health Needs Assessment Survey. This should be done to establish a baseline of data on knowledge, attitudes and practice in the health area for use in monitoring and evaluating whatever programs are implemeted as a result of P.L. 96-205. This initial health assessment survey should be but the first in a regularly planned sequence of sample surveys to assess change in the health service system and the health status of the population. Carefully designed sample surveys will probably for the foreseeable future be the best source of data available in the Marshalls. It is also recommended that a major evaluation be conducted five years implementation to measure change after revisions in the health care system. in health status and to make This evaluation shyould involve several types of scientists: sociologists/anthropologists, health planners, ecologists, and epidemiologists. Data processing of all statistical data collected should probably in the near future be hand tabulated, even though purchase of a computer is being considered. This is recommended primarily because clerical labor is not in short supply and is relatively inexpensive. Furthermore the required technical expertise to make a computerized system work effectively is not present. sorted data system should be maintained as a back-up. If nothing else a hand- The use of a small desk-top computer for analysis of data might be utilized. 4. Evaluation in Manpower Training It is recommended that the Planning/Evaluation Unit work very closely with the continuing education/manpower training personnel in designing instruments for evaluating and assessing the skill levels of the health aides in the outer island clinics. Present transportation and communication problems have meant very little assessment of skill level or health worker attitudes and acceptance has been done. Furthermore, vital statistical data is processed so slowly it has marginal use as a monitoring tool for management or administrative purposes.