The Republic of the Marshall Islands comprise of 29 atolls ( island “rings” ) and five islands spread out over three-quarters of a million square miles on the Pacific Ocean. The distances between atolls and islands, and the country’s relative isolation, have obvious implication on the ability of the government to deliver health care services to its remote areas. In spite of the physically challenging environment, complicated by the distinct cultural values of the Marshallese, the Ministry of Health and Environment has instituted a unique health care system that responds to the needs of their population. Their health care resource includes two hospitals in two major atolls and 60 community health centers in the outer atolls. These centers are staffed by minimally trained health assistants who are supported via radio by a Medex (with more formal training) for complex procedures. The Medex in turn look to the medical staff of the two hospitals for complicated cases and decisions. Meanwhile, amidst the high incidence of both infectious and chronic diseases and with very limited resources, the Ministry opted to focus on preventive services and primary health care. Hence the Ministry adopted the motto: “Our Health, Our Shared Responsibility” which aims to increase the capacity of community, family and individual to care for their own health. Community Health Councils were formed in every atoll, headed by community leaders who are trained to facilitate the development and implementation of health promotion activities using cultural principles of community involvement and community empowerment.
Learning Objectives: At the conclusion of the presentation, the participants will gain understanding of the complex issues of health care accessibility in the Marshall Islands and identify strategies to address remoteness and lack of resources through community empowerment.
Keywords: Access to Health Care, Diabetes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Republic of the Marshall Islands Diabetes Control Program
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.