Pacific Partnerships for Health -- Copyright -- Preface -- Acknowledgments -- Contents -- Summary -- THE INSTITUTE OF MEDICINE STUDY -- CURRENT STATUS OF THE HEALTH CARE DELIVERY SYSTEMS -- CHARTING A COURSE FOR THE 21ST CENTURY -- Adopt and Support a Viable System of Community-Based Primary Care and Preventive Services -- Improve the Island's Physical Infrastructure -- Invest in Preventive and Primary Care and Public Health -- Maintain or Establish Basic Health Care Standards -- Develop a Regional Health Information System -- Reform Health Care Facility Management -- Promote Prudent Privatization -- Rethink and Restrict Off-Island Tertiary Care Referrals -- Improve Coordination Within and Among the Jurisdictions and the United States -- Role of the United States -- Roles of the Island Jurisdictions -- Interface Between the United States and the Island Jurisdictions -- Increase Community Involvement and Investment in Health Care -- Establish Jurisdictional Health Authorities -- Develop Health Improvement Benchmarking Process -- Use Nongovernmental Community Organizations to Provide Health Care Services -- Increase Community Involvement with Primary Care Sites -- Promote Education and Training of the Health Care Workforce -- Improve and Support Basic Education -- Utilize Distance-Based Learning, Telemedicine, and Electronic Data Libraries -- Provide Postgraduate and Continuing Medical Education Programs -- Sponsor Training for Dentists -- Sponsor Training for Nurses -- Provide Health Administration and Systems Management Training to the Chief Health Administrator -- 1 Introduction -- ORIGINS OF THIS REPORT -- STUDY APPROACH -- ORGANIZATION OF THIS REPORT -- U.S. INVOLVEMENT WITH THE REGION -- Historical Overview -- Current Political Status of the U.S.-Associated Pacific Basin Jurisdictions -- The Flag Territories -- The Freely Associated States.

U.S. Military Interests in the Region -- U.S. Economic Interests in the Region -- U.S. Interests in the Region's Health Care Systems -- 2 Regional Health and Health Care Services Overview -- REGIONAL HEALTH OVERVIEW -- Demographic Characteristics of the Region -- Population -- Ethnicity -- Economy -- Epidemiological Characteristics of the Region -- Mortality -- Disease Prevalence -- Disease Prevention and Health Promotion -- REGIONAL HEALTH CARE SERVICES OVERVIEW -- Structure of the Health Care Delivery System -- Administration -- Coordination -- Data Management -- Health Care Facilities -- Community Involvement with Health Care Delivery -- Off-Island Care -- Financial Resources -- Workforce -- Physicians -- Dental Professionals -- Mid-Level Practitioners -- Nurses -- Health Assistants -- Health Care Workforce Education and Training -- Technology and Equipment -- APPENDIX -- Pacific Basin Medical Officers Training Program -- Overview of PBMOTP -- Student Recruitment and Retention -- Curriculum -- Career Ladder Program -- Results -- Continuing Education and Training for PBMOTP Medical Officers -- Replication of PBMOTP -- 3 Charting a Course for the 21st Century: A Strategic Plan for Future Health Initiatives in the U.S.-Associated Pacific Basin -- ADOPT A VIABLE SYSTEM OF COMMUNITY-BASED PRIMARY CARE AND PREVENTIVE SERVICES -- Improve the Island's Physical Infrastructure -- Invest in Preventive and Primary Care and Public Health -- Maintain or Establish Basic Health Care Standards -- Develop a Regional Health Information System -- Reform Health Care Facility Management -- Promote Prudent Privatization -- Rethink and Restrict Off-Island Tertiary Care Referrals -- IMPROVE COORDINATION WITHIN AND BETWEEN THE JURISDICTIONS AND THE UNITED STATES -- ROLE OF THE UNITED STATES -- Use of Block Grants That Require Meaningful Measures of Accountability.

Consideration of Multiple Uses of Military Facilities -- Continuation of Funding of Research Projects in the Region -- Establishment of an Interagency Governmental Committee on Pacific Health -- IGCOPH Composition -- IGCOHP Tasks -- ROLE OF THE ISLAND JURISDICTIONS -- INTERFACE BETWEEN THE UNITED STATES AND THE ISLAND JURISDICTIONS -- Establishment of a Pacific Basin Health Coordinating Council -- PBHCC Composition -- PBHCC Tasks -- PBHCC Funding -- INCREASE COMMUNITY INVOLVEMENT AND INVESTMENT IN HEALTH CARE -- Establish Jurisdictional Health Authorities -- Develop Health Improvement Benchmarking Process -- Use Nongovernmental Community Organizations to Provide Health Services -- Increase Community Involvement with Primary Care Sites -- PROMOTE THE EDUCATION AND TRAINING OF THE HEALTH CARE WORKFORCE -- Improve and Support Basic Education -- Use Distance-Based Learning, Telemedicine, and Electronic Data Libraries -- Provide Postgraduate and Continuing Medical Education Programs -- Sponsor Training for Dentists -- Sponsor Training for Nurses -- Provide Health Administration and Systems Management Training to the Chief Health Administrator -- Bibliography -- Appendix A Committee Bioraphies -- Appendix B Saipan Workshop Agenda -- Saipan Workshop Attendees -- Appendix C Organization of Institute of Medicine Site Visits to the Pacific Basin, 1997 -- D Assessments of Individual Jurisdictions' Health Care Services -- AMERICAN SAMOA -- Overview -- Government -- Economy -- Population -- Infrastructure -- Health Care Delivery System Organization -- Administration -- Health Care Facilities -- Health-Related Community Organizations -- Off-Island Care -- Health Care Resources -- Financial Resources -- Workforce -- Physicians -- Nurses -- Other Health Care Personnel -- Workforce Quality Assurance -- Technology, Supplies, and Equipment -- Future Health Care Issues.

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS -- Overview -- Government -- Economy -- Population -- Infrastructure -- Health Care Delivery System Organization -- Administration -- Health Care Facilities -- Health-Related Community Organizations -- Off-Island Care -- Health Care Resources -- Financial Resources -- Compact Impact -- Workforce -- Physicians -- Nurses -- Workforce Quality Assurance -- Technology, Supplies, and Equipment -- Future Health Care Issues -- FEDERATED STATES OF MICRONESIA -- Overview -- Government -- Economy -- Population -- Infrastructure -- Health Care Delivery System Organization -- Administration -- Health Care Facilities -- Health-Related Community Organizations -- Off-Island Care -- Health Care Resources -- Financial -- Workforce -- Quality Assurance -- Technology, Supplies, and Equipment -- Future Health Care Issues -- Chuuk -- Infrastructure -- Health Care Facilities -- Workforce -- Physicians -- Dentists -- Mid-Level Practitioners -- Nurses -- Kosrae -- Infrastructure -- Health Care Facilities -- Workforce -- Physicians -- Dentists -- Mid-Level Practitioners -- Nurses -- Pohnpei -- Infrastructure -- Health Care Facilities -- Workforce -- Physicians -- Dentists -- Mid-Level Practitioners -- Nurses -- Yap -- Infrastructure -- Health Care Facilities -- Workforce -- Physicians -- Dentists -- Nurses -- Health Assistants -- GUAM (GUAHAN) -- Overview -- Government -- Economy -- Employment -- Federal Expenditures -- Federal Grant Assistance -- Military Spending -- Tourism -- Population -- Infrastructure -- Health Care Delivery System Organization -- Administration -- Health Care Facilities -- Hospitals -- Public Clinics -- Private Clinics -- Health-Related Community Organizations -- Health Care Resources -- Financial -- Compact Impact -- Public Health Insurance -- Private Health Insurance -- Workforce -- Physicians -- Nurses.

Other Health Care Personnel -- Traditional Health Practitioners -- Workforce Quality Assurance -- Technology, Supplies, and Equipment -- Future Health Care Issues -- REPUBLIC OF THE MARSHALL ISLANDS -- Overview -- Government -- Economy -- Population -- Infrastructure -- Health Care Delivery System Organization -- Administration -- Marshall Islands Medical Care Program -- Section 177 Health Care Program -- Health-Care-Related Community Organizations -- Off-Island Care -- Health Care Facilities -- Health Care Resources -- Financial -- Workforce -- Physicians -- Dentists -- Mid-Level Practitioners -- Nurses -- Traditional Health Care Practitioners -- Technology, Supplies, and Equipment -- Future Health Care Issues -- PALAU (BELAU) -- Overview -- Government -- Population -- Economy -- Infrastructure -- Health Care Delivery System Organization -- Administration -- Off-Island Care -- Health Care Facilities -- Health-Related Community Organizations -- Health Care Resources -- Financial -- Workforce -- Physicians -- Dentists -- Nurses -- Other Health Care Personnel -- Traditional Health Practices -- Quality Assurance -- Future Health Care Issues.