in Majuro under Alec Keju.
This program is presently shut fo due to
lack of funds either for training new health assistants orfcontinuing
education.
Many
health
assistants
in the field have not
had
a
continuing education session for as long as ten years.
h.
An attempt was made sometime in the past to have health!
deliver
services
through
well-baby, pre-natal, etc.
regularly
scheduled
special
assistants
cfinics
i.e.
This generally broke down due
fo the small
numbers of patients seen and inefficient use of the healthf
assistant's
time.
Most health assistants have fallen back to going tq the patient
when called for by a family member
scheduled times.
instead
of
holding
clinics
at
It appears that the community generally knows where to
find him if he is needed,
2)
General Recommendations
@.
Expanded role of worker:
In the section on “public health" (see section 8) an
qutline of the
various service needs in the areas of preventive, promotivey#
and curative
health was presented i.e. health education, maternal and childfhealth, social
problems, etc.
~
It was recommended there that separate specialfzed supporting
technical staff be provided at the central level to be
planning and managing these services i.e.
responsible for
a “health educatér" to plan and
direct health education activities, a “sanitarian” in environmental health,
“public health nurse” in maternal and child health and immunizations, etc.
Yet at the implementation level in the outer island clinics the emphasis
will be on having the main primary care worker assume the “Integrated” role
of delivering all types of services - health promotion and pyevention as well
as curative services.
Furthermore,
it
is
felt
that
specific kinds
of
services (be they curative or preventive} should not be delipered by means of
specialized clinics at limited times and days i.e. “well baby
day and “family planning“ on another day.
clinics” on one
In summary, thef health worker at
the primary care level is to serve an “integrated/expanded®
role - he is to
be the implementor of all health activities at the locqd] level, and the
patient wil] be able to receive a full-range of services Jat any particular
time the clinic is utilized during its regular hours.
In practice this will mean the primary care worker
in the following manner:
will spend his time
A certain specified number of hqurs each week will
be spent at the clinic during which time an individual pdtient may come and
receive
general
health
services
including:
i9
of
both
preventive
dnd curative types