S/
.Q summarize, the present vital and Lealth service data collection sytem in
Majuro has
been functioning primarily as
Territory offices based in Saipan.
a clerical
service
for
Its staffing (two people) and the level of
training of the personnel mitigate doing more than clerical work.
resulting are many:
the Trust
The problems
quality and accuracy of data are low, particularly that
gathered by the health assistants.
Sporadic and inefficient mail and transport
services has led to a high occurrence of lost forms and missing data.
Many deaths
are not recorded (particularly of old people on the outer islands).
Data on
cause of death and health service utilization by cause is also unreliable or
missing.
Birth registration data is complicated by a common local custom of
people changing their first names several times during their lifetimes (this is
more common during childhood years).
As a result, one person may have several
records on himself all under different names.
Utilization of the health service data collected as feedback into the health
system for management or health status
existent.
the
evaluation
purposes
is
all
but non-
Now that the Marshall Islands are becoming a Freely Associated State,
Saipan
connection
analysis/planning/evaluation
is
being
function
phased
without
a
out,
leaving
the
designated
home.
The
Marshallese Health Services is the logical one to pick it up but it lacks the
personnel with appropriate expertise.
ability of the health
Thus, a very critical breakdown in the
system to monitor change and plan for the future is
occurring.
B.
Recommendations
The Secretary of Health Services and the head of the Vital Statistics Office
on
Majuro
believe
that
the
development
of
capability must be established soon on Majuro.
an
inhouse
planning/evaluation
It must be able to assume the role
previously performed by the TT Health Systems Agency in Saipan.
The medical and
other vital statistics forms designed by TT are quite good and probably will
suffice for now (some revision or addition of items to the forms is all] that is
needed).
What is more serious is the transport, communications, and supervisory
breakdowns which have caused the system as originally designed to not meet its
objectives of providing timely and accurate data upon which to measure change.
1.
Administrative
It is recommended that the Planning/Evaluation Unit assume the role now
performed by Saipan of preparing five-year health plans and annual implementation
plans.
There is a general dislike by the Marshallese for plans developed by