{/— IX. HEALTH MANPOWER A. Introduction There are various levels of medical practitioners based on function and responsibilities involving both the medical and nursing cadres. Primary medical care is usually rendered by the health assistant whose training varies from minimal instruction and continuing education given practitioner to a more formal duration. course, a mid level often of approximate] six months Approximately 55 health assistants have been trained for duty in the Marshalls. The largest problem at present in terms of manpower fis the high attrition due to retirement and lack of a recruitment system| to encourage young people to enter the system. Incentives to enter the hea Ith system are very low compared to other types of government service. Withih a few years severe shortages of all types of health manpower are to be expergienced unless something is done soon. In developing medical manpower programs it is important tbh establish a scheme of service to enable every qualified person to advance] according to his ability, interest and effort. All training procedures, work assignments, salary scales, etc. scheme of service or career ladder. progranp, licensing should reflect such After appropriate periods service and work recommendations, selected health assistants could advande assistants and from there potentially to medical officers. a to medical LikBwise nursing assistants should be able to advance to practical nurses and from there to graduate nurses and on to become bachelor or master degree ng@rses many of whom would become specialists in specific nursing arg@as administration, education, public health, midwifery, critical In general there are sufficient educational such as fare, etc. institutfons for the various health manpower needs in the South Pacific areas such that it should not be necessary to establish any new schools for manpower training programs. B. Administrative The administrative employees will current understand the problems supervisors. structure is that of must line be clearly defined and staff organization. insufficient authority of] [so that al] One of the Marshallese Many of the nursing personnel report sick orf are late in returning from vacation, sometimes even months late, yet continue to receive ql