.O Summarize, the present vital and fiealth service data collect on sytem in
Majuro has been functioning primarily as a clerical
G
.
ot
Territory offices based in Saipan.
service fo
Its staffing (two people) and
he level of
training of the personnel mitigate doing more than clerical work.
‘resulting are many:
the Trust
he problems
quality and accuracy of data are low, parti ularly that
gathered by the health assistants.
Sporadic and inefficient mail ahd transport
services has led to a high occurrence of lost forms and missing data. Many deaths
are not recorded (particularly of old people on the outer islands}.
Data on
cause of death and health service utilization by cause is also u reliable or
missing.
Birth registration data is complicated by a common loc 1 custom of
people changing their first names several times during their lifeti es (this is
more common during childhood years).
ave several
As a result, one person may
records on himself all under different names.
Utilization of the health service data collected as feedback in
system for management or health status evaluation purposes
existent.
the
a 1
is
but non-
Now that the Marshall Islands are becoming a Freely Assoc jated State,
Saipan
connection
analysis/planning/evaluation
ty
the health
is
being
function
phased
without
a
le ving
out,
designated
me.
Marshallese Health Services is the logical one to pick it up but
personnel with appropriate expertise.
the
The
t lacks the
Thus, a very critical brea down in the
ability of the health system to monitor change and plan for t
future jis
occurring.
B.
on
Recommendations
The Secretary of Health Services and the head of the Vital Stat
tics Office
Majuro
/evaluation
believe
that
the
development
of
capability must be established soon on Majuro.
an
inhouse
planni
It must be able to as ume the role
previously performed by the TT Health Systems Agency in Saipan.
Th
medical and
other vital statistics forms designed by TT are quite good and
obably will
suffice for now (some revision or addition of items to the forms i
all that is
needed).
What is more serious is the transport, communications, an
supervisory
breakdowns which have caused the system as originally designed to
ot meet its
objectives of providing timely and accurate data upon which to mea
re change.
1.
Administrative
It is recommended that the Planning/Evaluation Unit assume
fhe role now
performed by Saipan of preparing five-year health plans and annual implementation
plans.
There is a general dislike by the Marshallese for plans Ideveloped by