X.
Planning and Evaluation Services
A.
Present Status
The present Vital Statistics Office is housed in the Medical Récords Section
of the Majuro Hospital.
There are only two employees.
The office iB in charge of
collecting all birth, death, feta! death, and health services utilipfation data in
the Marshall Islands.
(Examples of the forms used at present are i
Appendix N).
The office sends out forms to the health aides (who are suppose!
to register
births and deaths) and picks them up periodically when “field ships" make the
tour of the islands. The health aides fill in the needed data in Handwriting on
the forms, either in English or Marshallese, and then send them ba
to the main
office where a final original birth or death form is typed out
om the rough
handwritten one.
and symptoms
Generally the health assistant lists only sign
for “cause of death" on their form.
A medical officer in Majuro
#terprets the
signs and symptoms and attributes a “cause of death" (cause of death is seldom
determined by autopsy).
After an “original” death or birth certificate is typed
out copies are sent to the courthouse and until recently to Saigan where all
tabulations and analysis of data has been done.
Unfortunately, many
vital events
(particularly deaths) go unreported, and many forms are lost in transit from the
outer islands to the central office.
.
the
Basic health utilization data comes from the "sick call" forms
health
assistants
(see Worksheet for
Dispensary Reports in Appendix).
Sick Call
forms
and]
illed out by
the Monthly
Unfortunately, not much informatign is availale
from these forms and many of them get lost as well.
Immunization da a is recorded
on a patient-retained card (usually held by the mother of the chilH).
the staff in Majuro have introduced in the outer island clinics
Recently
fthe use of a
larger more complete personal/family medical form (see example inj Appendix N).
Not all clinics are using it yet,
furthermore accuracy and comp]
considerably among the health assistants.
eness varies
This latter form remains fat the clinic
and is not sent in like the sick call form.
Initially it was hopfd the health
Supervisory personnel traveling on the "field ship" tours would retrfleve relevant
health data from the clinic based form.
Unfortunately, tours
fo the outer
islands have been very sporadic and usually the short time spent onfeach atoll is
_used up conducting immunization clinics and other activities, leaving little or
no
time
to
evaluate
or
retrieve
data from
the clinic records.
(The Majuro
Hospital medical record system is discussed under a separate sectipn).