in Majuro under Alec Keju. This program is presently shut down due to lack of funds either for training new health assistants or continuing education. Many health assistants in the field have not had a continuing education session for as long as ten years. h. An attempt was made sometime in the past to have health assistants deliver services through well-baby, pre-natal, etc. regularly scheduled special clinics i.e. This generally broke down due to the smal] numbers of patients seen and inefficient use of the health assistant's time. Most health assistants have fallen back to going to the patient when called for by a family member scheduled times. instead of holding clinics at It appears that the community generally knows where to find him if he is needed. 2) General Recommendations a. Expanded role of worker: In the section on “public health" (see section B} an outline of the various service needs in the areas of preventive, promotive, and curative health was presented i.e. health education, maternal and child health, social C problems, etc. It was recommended there that separate specialized supporting technical staff be provided at the central planning and managing these services i.e. level to be responsible for a “health educator" to plan and direct health education activities, a “sanitarian" in environmental health, “public health nurse“ in maternal and child health and immunizations, etc. Yet at the implementation level in the outer island clinics the emphasis will be on having the main primary care worker assume the “integrated” role of delivering all types of services - health promotion and prevention as well as curative services. Furthermore, it is felt that specific kinds of services (be they curative or preventive} should not be delivered by means of specialized clinics at limited times and days i.e. "well baby clinics" on one day and “family planning“ on another day. In summary, the health worker at the primary care level is to serve an “integrated/expanded" role ~- he is to be the implementor of all health activities at the local level, and the patient will be able to receive a full-range of services at any particular time the clinic is utilized during its regular hours. In practice this will mean the primary care worker will spend his time in the following manner: A certain specified number of hours each week will be spent at the clinic during which time an individual patient may come and receive general health services including: QQ of both preventive and curative types