For example,

the Ministry of Public Works

builds and maintains

the

wastewater and drinking water systems, but the Ministry of Health Services

tests the water for potability.
apparent.

Very little coordination between the two is

The Public Health Division is responsible for nutrition education

through the section of Health Education.

Nevertheless, nutrition education

is also covered by the School Lunch Program run under the Ministry of
Education and additional
department as well.

nutrition work is done by the the agriculture

Further uncoordination is seen in the area of mental

health and susbstance abuse (alcoholism, drug abuse, suicide, etc.).

These

services are generally provided by separate entities in the Ministry of
Social Services as well as that which is provided by the Ministry of Health
Services.
In

summary,

health

promotion

and

protection

services,

and

health

prevention and detection services are scattered throughout the government.
Their location in the government structure reflects the disparate sources of

federal

grants-in-aid which

started

them.

As

a

result

considerable

duplication of services and inefficiency is common..
Recommendations
It is not the purpose of this report to recommend changes in the whole MIG
Structure.

What is needed though, is that the Ministry of Health Services not

add to the problem by being uncoordinated within its own organization.
Thus, it is recommended that all Federal categorical grant programs i.e.
crippled

children's,

traditional
control,

meals-on-wheels,

hypertension,

"public health" programs i.e.

maternal

and

child

health,

be

as

well

as

the

more

immunizations, communicable disease
put

Care/Public Health Services (see Org. Chart).

under

one

Division

of

Primary

Besides the above mentioned public

health activities, this division will manage the entire primary care (dispenary)
system on the outer islands (see section VI-B).

10

Select target paragraph3