some ‘improvement nas come with the Marshall Islands. initiation cf service from Air This is used and should continue to be ufed only as a supplementary means of distribution since it is signifficantly more expensive. Recommendations : l. The problem of not reimbursing suppliers should be [taken care of through the administrative structure suggested in sectfion IV. With these suggested changes it should then become more fefsible for the funds budgeted for supplies to be available for prompt payment of invoices. A separate department should be set up independent of thé hospitals for the organization, coordination, and control of the supply function for hospitals and clinics. The person in charge should ve sufficient expertise and experience to handle the inventory cont¥ol and supply system for a health care system of this size. The physigal location of this department can remain at the hospital provided adequate storage Space exists. Development and maintenance of standard inventory lists hospitals and outlying clinics. For each of the One list could be devel@ped for use in most of the clinics since their situations will most [likely be very similar to one another. Lists such as these would ma for the community health worker or heaith assistant to supplies they are in most need of. apply to the hospitals. it very easy determine which This same reasoning would also As new supplies are adopted additions and deletions should be made to keep the list up-to-date. 4. Development of usage patterns related to workload so aq to be able to establish standing orders of some supplies and anticipafe needs of all units. Biweekly communication between the central supply dep and outlying centers with regard to needed supplies so that the central supply depot can make use of al? opportunities to keep the outlying For example, a particular clinic may be running low medicine due to a local epidemic. If the central depo of the situation, alternate emergency shipments may @nits supplied. a particular is kept aware arranged for through private boats or through Air Marshall Islands. C57