Sof Two budget items require special comment, training and tion. mew construc- A major concern throughout the development of the progwam has been providing for the training of individuals so the Marshall Is] ds in time can use more and more of their own people. may appear For this reason i to be an over-budgeted item but in part is cost effective and ulturally desirable. The other item, construction, is a result of the fact t t from a practical point of view, housing is going to have to be provi d to the Medical Assistant/Health Assistant on the atolls. There is 13 le avail- able housing and in one instance they had to leave an atoll b ause of this. It becomes a major budget item in years two thru five this re- presents the timing for individuals coming off training progr C. Secondary/Tertiary Care As with any health delivery system, costs for this level of care are the highest single component of the system. Contributing to e cost are the short useful life of equipment and maintenance costs beca e of the hostile environment (climate). roved main- It is anticipated that with i tenance the average useful life of most equipment will be thr to four years. As discussed in the previous section, training and upgr ing of per- sonnel is something that must be included early in the progra We have not budgeted for any major renovation of the Maj ro Hospital, as it appears that a new one will be built. Since it seems t be beyond the scope of this study and there are funds already available or this new hospital, it was not included in this budget. nae and a Should plans c new hospital not be built, this could bea major addition to t health care delivery system. cost of the