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

Select target paragraph3