f community health worker for every inhabited island and for those islands with larger numbers of people that there be one worker fom approximately every 50-75 inhabitants living in the area surrounding] the community health worker. | Their training would primarily be that of “on-the-job training" usually with a one month course of instruction at the beg{nning of their career followed by ongoing continuing education given py the medical assistant along with his supervisory role such that they dventually have the equivalent of approximately six months of training. [Selected well- qualified community health workers should receive suffifient training to be eligibie to become health assistants. 2. Health Assistant At present primary care is delivered on the outer igl]ands by about 55 health assistants, the majority of which were trained after World War II by Navy corpmen in a short (6 to 9 month) emergency medical course in Majuro. Many of them are elderly and approaching retifement. Their educational level is low, averaging 3-5 years of elementary schooling, and their perceived role is limited almost exclusively|to "clinical" medicine. In recent years some additional health afsistants were trained through the public health division on Majuro. assistants are younger, These health have a secondary school education and will probably stay in the system much longer. approximately 9 months also. Their course training was All of the health assistants work in the small clinics on the islands and see very few patients. Health assistants are able to provide more primary than that of a community health worker but stil] must care services the support and consultation of medical assistants who pervise them. ly heavily on They will utilize more medications in treatment becaus of a greater ability to diagnose the simple and common health problems Many of them are able to care for minor wounds including suturing, co uct obstetric deliveries and care for minor orthopedic injuries as well as carry out the preventive services such as immunizations, health education, wel] child care, antenatal and post partum care, family pla ing services, and the prevention, detection, and treatment of malnutr? jon, The superviston of the health assistant is the samefas that of the community health worker with whom they have daily intfalagoon radio