{/—

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

Select target paragraph3