Health Services
A.

Administration
It is proposed that the administration of Health Services be provided

by two divisions - Division of Primary Care/Public Health and the Division
of

Secondary and Tertiary Care.

While

these

division's

services

are

related, their differences in program development, level of care, and unique
administrative

needs

suggest

a

more

efficient

program will

result

if

administered separately.
As

discussed

earlier,

we

are

suggesting

that

the Guam/Micronesia

Mission's contract be modified on implementation of 96-205 to take advantage
of their unique experience and skills in the management of secondary and
tertiary care facilities.
The division responsible for primary care and public health should be
administered by a public health physician with the appropriate support staff
Skilled in the areas of primary care and public health.
B.

Public Health
The recently drafted Five-Year Health Plan for the TT has put "public

health” needs as the number one priority in the Health Plan..

It classifies

public health programs into two categries (for ease of analysis only).
These are: 1) health promotion and protection services, and b) prevention
and detection services.

The primary focus of the first is the community,

while the focus of the second is the individual or family.

Obviously there

is considerable overlap, yet separation of the two is done purposely to
clarify function.
As was pointed out under Section V Health Status, many illnesses and
deaths in the M.I. (Particularly those of infants, children and women in
childbearing years), could be prevented by use of resources available to
almost every family: boiling and/or filtering of water; greater attention to
personal hygiene; improved food handling methods; improved waste disposal
methods; immunization of children; prenatal care; spacing of births; use of
basic first aid procedures; and improved nutrition.

These represent just a

few of the ways Marshall Island residents could improve their health.
However, before people can effectively use these mechanisms to promote
health, they must understand the relationship between health, illness and
daily living habits and they must be motivated to make the required changes

in lifestyle as expressed in the Five-year Health Plan (pp. 227):

Select target paragraph3