planning/statistical unit.
As to the handling of Federal categorical grants i.e. C rvical Cancer
Screening, Meals-on-Wheels, etc., this is even more unsure.
depends on negotiations between the U.S. and the MIG.
The outcome
It s ems to be the
desire of the Marshallese to still be eligible for some of t e categorical
grants, but they don't want the funds to be tied to a lengthy
ealth Systems
Agency certificate-of-need process.
fficient
It would
seem more
and
politically palatable to the Marshallese if funds were alloca ed “globally”
in block grants (directly from government to government) to cover all
agreed-upon health service needs.
nting of the
Administration and acc
funds would be done by the Ministry of Health or its contr ctor directly
with the funding federal agency, without an intermediary “ogtside" Health
Planning agency dictating requirements.
Continuing relationships with TTP] for manpower training,
consultation
on specialized medical problems, special grants, etc., wou
probably be
continued but preferably on a low-key “voluntary” basis.
A
Function which
is as yet unclarified is the whole licensing/credentialing pfocess of both
institutions
(hospitals,
technicians).
lab,
etc.)
and
manpower
(nurseg,
physicians,
Some officials in the MIG would like to asqume that role
themselves, while others would like to keep this process tid to the U.S.
systems.
The outcome of this decision could determine a lot
the MIG will be tied to TTPI Bureau of Health Services and
fon how closely
al the federal
categorial grants they control.
E.
Categorical U.S. Funded Programs
The present Ministry of Health Services has a Public
(under the hospital administrator) which performs most healt
prevention services.
It
includes among others:
alth Division
promotion and
environfhental
health,
maternal and child health, health education, crippled children's services,
special
clinics
(i.e.
diabetes,
leprosy,
hypertension),
continuing education for health assistants, etc.
immunizations,
All of the e administered
by the Majuro Hospital and funded partially by the MIG and paftially by U.S.
categorical grants.
other
ministries
Many other health related services are administered by
of
the
government.
This
unfortunately
has
caused
considerable inefficiency and duplication of effort, not to[mention fiscal
accounting problems.
af