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Ministry of Health MINISTRY OF HEALTH ACRONYMS IAEA International Atomic Energy Agency PACS Picture Archiving & Communication System NP Nurse Practitioner DLS Diagnostic Laboratory Services PIHOA Pacific Islands Health Officers Association PCSI Program Collaboration Service Integration Conference APNLC American Pacific Nursing Leaders Conference VIA Visual Inspection with Acetic Acid NCCCP National Comprehensive Cancer Control Program OIHCS Outer Islands Health Care Services CHC Community Health Center UDS Uniform Data System OHPPS Office of Heath Planning, Policy and Statistics RMI Ministry of Health FY2016 Annual Report 1 | Page I. MESSAGE FROM THE MINISTER AND SECRETARY OF HEALTH We are pleased to present the Annual Report for the Ministry of Health for Fiscal Year 2016. Although there is so much data and statistics collected for every single program and services in the Ministry, this report is presented for a better understanding of the type of resources allocated for the Ministry such as human and financial resources, and the utilizations of its resources or expenditures incurred during the fiscal year. Section on data and vital statistics presents the health status of RMI in terms of morbidity and mortality just for that fiscal year. Non‐ communicable Diseases (NCDs) or lifestyles diseases, tuberculosis and leprosy remain the three prioritized areas, and update on activities and data are included in this report. The last section is the Cost Analysis and Expenditures for the fiscal year in selected areas or services. It is important to note that actual costs of services provided by the Ministry are not charged accordingly. If the Ministry was to charge patients according to the costs of services, high revenues will be generated every fiscal year. Because of the high rates of lifestyles diseases or chronic diseases and identified communicable diseases, the Ministry continues to shift its focus on preventive or primary health care’s services in compliance with the Declaration of Primary Health Care by World Health Organization (WHO) on September 12, 1978 in Alma Ata. The Declaration called for urgent action by all governments, all health and development entities and the world community to protect and promote quality health practices for all peoples. Health is a shared responsibility between the RMI Government, communities, non‐ governmental organizations, churches, women’s groups, business communities, civil society, RMI Ministry of Health FY2016 Annual Report 2 | Page families and individuals. We are all responsible for our own health because we can make choices to take care of our own health through eating the right kind of food for better health, increase physical activities/exercise, stop smoking, and drink less alcohol. The risk factors related to lifestyles diseases such as tobacco use, alcohol consumption, lack of physical activities and poor diet contribute in high prevalence and incidence rates of NCDs in our nation. RMI fully supports the NCD Declaration by the Pacific Islands Health Officers Association (PIHOA) because NCDs are affecting lives of so many people in our region and around the world including the RMI. We are all Marshallese who live the “kumit” lifestyle, which shows supporting one another in every effort to improve health, education, lifestyles for Marshallese people for now and in the years to come. Improving lives, health and education is a shared responsibility and a healthy kumiti lifestyle for all. There are still challenges in lifestyles that the Ministry encountered during the fiscal year. One of the highlighted challenges was the Zika outbreak that occurred towards the end of the fiscal year, which imposed the Ministry to shift resources to focus on the outbreak. The Ministry was able to respond quickly to combat the outbreak with support from the RMI Government, local and regional partners and international partners and agencies. We are indebted for supports received during the outbreak. We extend our sincere appreciation to our local partners and stake holders in the RMI, our regional and international partners and to the RMI Government for your continued support to the Ministry of Health. Komol Tata! RMI Ministry of Health FY2016 Annual Report 3 | Page Table of Contents I. MESSAGE FROM THE MINISTER AND SECRETARY OF HEALTH ................................................ 2 II. MINISTRY OF HEALTH’S FY2016 HIGHLIGHTS ............................................................................ 5 III. MINISTRY OF HEALTH’S PROFILE ............................................................................................ 17 KEY OUTCOME AREA 1: BUREAU OF PRIMARY HEALTH CARE SERVICES .................................... 19 KEY OUTCOME AREA 2: MAJURO HOSPITAL SERVICES .................................................................... 19 KEY OUTCOME AREA 3: BUREAU OF KWAJALEIN HEALTH CARE SERVICES ................................ 19 KEY OUTCOME AREA 4: BUREAU OF ADMINISTRATION ................................................................. 20 KEY OUTCOME AREA 5: OFFICE OF HEALTH PLANNING, POLICY & STATISTICS ........................ 20 IV. HEALTH INDICATORS REPORT FY2016 .................................................................................. 32 V. FINANCIAL INFORMATION ............................................................................................................ 59 RMI Ministry of Health FY2016 Annual Report 4 | Page II. MINISTRY OF HEALTH’S FY2016 HIGHLIGHTS Bureau of Majuro Hospital Services The Assistant Secretary for Majuro Hospital Services is responsible for management and overall operation of Majuro Hospital Leroij Atama Zedkeia Medical Center commonly known as Majuro Hospital serving inpatient, outpatient, public health clinics and ancillary services. In addition to this core role there are other areas that fall under the Hospital Services jurisdiction, • Pharmaceutical Services • Biomedical Services • Laboratory Services • Radiology Services • Dental Services • Medical Records • Clinical Services Network • Nursing Services • Medical Services • Blood and Ambulance Services • Specialist Visiting Teams Achievements 1. Policy and Planning: a. Revised Hospital Service Hour Policy. 2. System Development a. Picture Archiving & Communication System (PACS) installed at Radiology Department and workstations of Outpatient clinics, Public Health clinics, and Inpatient wards. b. Tracking system implemented for Morgue’s Embalming cases and payment c. Installed new oxygen generator for the hospital which is capable of 50 tanks a day. d. Installation of all non‐working fluorescent lamp with new LED light. Repair all clogged drainage P‐Trap in all wards and X‐Ray Department e. Established Kitchen inventory control f. Establishment of the dental school program within the Public School System working closely with grades K‐4th g. Bidding and Awarding of New CT Scan 3. Workforce Development: a. Training and Maintenance of Hyperbaric Chamber b. IAEA upgrading skills with the Laboratory and Radiology staff. c. 6 additional staff attending medical school in Shuang Ho Medical School d. 10 staffs attending Nurse Practitioner (NP) training in Majuro e. Completion of Midwifery Refresher Course in Fiji National University RMI Ministry of Health FY2016 Annual Report 5 | Page f. Kitchen staff given basic training for food handling g. Completed TB Laboratory Molecular Quality Assurance Program in molecular diagnosis (2016 GeneXpert Panel), established by the PATLAB and provided through DLS and PIHOA h. Completed ICD‐10 Training through WHO Support 4. Infrastructure Development: a. Renovated ER Doctors' and Telemedicine room b. Renovated Maternity Ward, Pediatric Ward, Medical Ward c. Converted a bathroom for screening room d. Constructed Radiology room to house the new CT‐Scan e. Upgraded New kitchen f. Implementation of Hospital Redevelopment Project. 5. Medical Missions: a. Canvasback Missions b. Taiwan Medical Missions c. First Humanitarian Mission d. Starky Hearing Mission 6. Donations: a. Donation of Local Food from Protestant Church b. Donation of Cleaning Supplies Assembly of God c. Donation of Cleaning Supplies and help with hospital monthly cleaning event Latter Day Saint Church (LDS) d. Donation of hygiene kits from the Chinese community Water Drill Emergency Response Bureau of Primary Health Care Services RMI Ministry of Health FY2016 Annual Report 6 | Page The Assistant Secretary of Primary Health Care & Public Health Medical Director are responsible for formulation of strategic public, primary health policies and oversees the implementation of public health programs as legislated under the Marshall Islands Public Health Welfare Act 1966. There are 56 Health Centers in RMI. Aside from the 177 Health Centers, Health Assistants are the health care provider in the health centers. Medical and public health staff conduct outreach to the health centers in the outer islands and within the community as well. The 177 Health Care Program Clinics are providing primary health care services to the four atolls affected by the nuclear testing. A primary health care Physician with the Health Assistant manages the 177 Clinics. DOE Clinic is providing medical services to the nuclear patients under the Department of Energy. Kumiti Wellness Center which is managed by Canvasback Mission, in collaboration with MOH, shows right diet and exercise could reduce or replace the need for diabetic medications and provide a higher quality of life for the participants. Taiwan Health Center concentrates on developing health
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