Federated States of MicronesiaPIHOA

14-18 November 2011Honolulu, Hawaii, USA

COUNTRY DEMOGRAPHIC PROFILE (SNAP SHOT OF FSM) - 2011

Federation of Four Island States KOSRAE/POHNPEI/CHUUK/YAP

Number of Islands 607 Islands (65 Inhabited Islands)

Land Area 710 Sq. Km ( 271 Sq. Miles of Land Mass)

Population (2010 Census) 102,843 (2010 Census)

Life Expectancy 70 years

Crude Birth Rate 19/1000 (FSM DHSA/HIS 2010)

Crude Death Rate 4/1000 (FSM DHSA/HIS 2010)

Infant Mortality Rate 10.2/1000 (FSM HIS 2010- Hospitals’ Reported)

HEALTH SYSTEM FRAMEWORK – FSM SDP -2003-2023National Level (FSM National Government, Department of Health and Social Affairs) Mandates:

Policy Direction (national health and social affairs)Program Management/Coordination (national programs and donors’ projects)Monitoring of programs’ activities and funds utilizationTechnical Assistance Repository of national data (health vital statistics and programs’ data for reporting purposes)Collaboration with regional and international organizations supporting state and community health programs.

State Level (State Department of Health Services – Hospital and Public Health):

Implementation of day-to-day direct medical and preventive health services Patient Referral (OI and Abroad)State policy on healthData Collection/Reporting

Municipal Level (Primary Health Care and Dispensary Services) Community:

Primary Health Care (PH and Dispensary services)Data Collection/ReportingMunicipal charters on community health

PROFILE OF PUBLIC (GOVERNMENT) HEALTH FACILITIES: FSM 2011

Facility Type

FSM Total Chuuk Kosrae Pohnpei Yap

Gov’t Owned 111 66 7 12 26

Hospital 4 1 1 1 1

Licensed Beds 341 130 45 116 50

Operating Beds

294 125 35 92 42

Community Health Centers

5 - - 1 4

Dispensaries 92 64 - 9 19

Dental Clinics 4 1 1 1 1

Aid Posts 6 - 5 - 1

PROFILE OF PRIVATE HEALTH FACILITIES: FSM 2011

Facility Type

FSM Total Chuuk Kosrae Pohnpei Yap

Private Health Facilities

11 3 - 8 -

Hospitals 1 - - 1 -

Licensed Beds

36 - - 36 -

Operating Beds

36 - - 36 -

Private Health Clinics

3 - - 3 -

Private Pharmacies

5 3 - 2 -

Private Dental Clinics

2 - - 2 -

Profile of the Four State DHS: FSM 2011

Description Pohnpei Chuuk Yap Kosrae FSMDepartment or Section

Operation/Surgery; Medicine; Dental; Obstetrics/Gynecology; Pediatrics; Emergency; Hemodialysis; Radiology; Laboratory; Physical Therapy; Medical Supply; Public Health

Operation/Surgery; Medicine; Dental; Obstetrics/Gynecology; Pediatrics; Radiology; Emergency; Laboratory; Medical Supply; Public Health

Operation/Surgery; Medicine; OB/GYN; Pediatric; Radiology; Emergency; Laboratory; Pharmacy; Public Health and Mobile Clinic;

Operation/Surgery; Medicine (OPD/Inpat);OB/Gyn; Radiology; ER; Dental; Pharmacy; Laboratory; PH and Mobile Clinic

Program Management, Coordination,Monitoring andEvaluation;TAPolicy Development

No. of Doctors 20 20 12 11 63

No. of Dentists 3 7 3 2 15

No. of Graduate Nurses

50 69 43 36 198

No. of Pharmacy Technicians

6 3 2 2 13

No. of X-Ray Techs.

5 6 2 2 15

No. Lab. Techs. 8 6 8 6 28

No. of Med. Supply Techs.

4 1 1 1 7

No. of Patients 120/day 210/day 60/day 50/day 110/day

No. of X-Ray 20-33/day 50/day 18/day - 26/day

No. of Lab. Works

250/day 50/day 30/day 35/day 80/day

PROFILE OF HEALTH WORKFORCE (SNAP SHOT OF THE FSM HEALTH WORKFORCE: FSM 2011)

INDICATORS NUMBER RATIO/100,000 POPULATION

DOCTORS 63 1:1,632

DENTISTS 15 1:6,856

NURSES AND MIDWIVES 249 1:413

OTHER NURSING/AUXILIARY STAFF

86 1:1,196

OTHER PARA-MEDICAL STAFF 282 1:365

OTHER HEALTH PERSONNEL 183 1:562

PHARMACY TECHNICIANS 13 1:7,911

X-RAY TECHNICIANS 15 1:,6,856

LAB. TECHNICIANS 28 1:3,673

NCD Conditions As Leading Causes of Morbidity FSM 2010

Other Heart DiseasesDiabetesHypertensionCancerKidney DiseasesStroke Chronic Obstructive Pulmonary Disease (COPD)Gout

Leading NCD Conditions as UCOD – FSM 2010

DiabetesCancerMyocardial InfractionCerebro-vascular AccidentRenal FailureHypertensionChronic Obstructive Pulmonary Disease

FSMNG Response To NCDs

NCD/Chronic Disease Unit (National and State)DiabetesCancerTobacco Prevention and Control Nutrition Action Plan (Advocating for “Go Local”)Physical Activity (schools and work-place)Small scheme through SPC for Local Farming and PA2-1-22 Grant (WHO/SPC)

FSM Endorsement to the Regional Declaration on NCD by FSMNG Leadership (Have not nationally declared); Environment – supportive;

Need to collaborate with the four states for proper declaration (FSM NCD Meeting/Conference in Yap-12/2011)Secure Political Commitment (Funding Support for sustainability)

What Already ImplementedLaw/Legislation (Tobacco and Substance Abuse)

Clean indoor Law in all public places - all statesNo Sale to Minors Law – all statesNo Promotion, Advertisement and Sponsorship Law – all states, except KosraeNo sale of Single Stick Law – Only in KosraeImportation Tax Law on Tobacco Products – at NationalNo Betel Nut Chew by Minors – Kosrae StateCommunity Smoke Free Nahs – only in Enpein Powe, Kitti, PohnpeiSin Tax - All States

BillPackaging and Labelling Bill- at FSM NationalBan Tobacco Importation Bill – Chuuk State

PolicySecond Hand Smoke Policy in all government buildings/office space rentals and government vehiclesNo Soda Drinks/Drinking in Church Activities (receptions/parties)- KKCC Faith Group

MOAHealthy food sections at selected food establishments

Draft PolicyFSM Nutrition and Physical Policy for schoolsGuidelines for food served during government hosted workshops, meetings, summit , etc.

Executive DirectiveTwo-hour Physical Activity /Exercise – Kosrae State

On Going ActvitiesSponsored PA (Fun Wallk/RunLand Grant Agriculture and Nutrition Programs

……What Already In-placed and Needing Review

Chuuk NCD Strategic Plan - 2011-2015Pohnpei NCD Strategic Plan – 2011-2014FSM National NCD Strategy 2011-2015 – Need Review by 12/2011 - YapSalt Reduction Program (New)

Kosrae and Yap need to develop their NCD Strategic Plan

Objectives for the Next Two-YearReview Draft 2011-2015 FSM NCD Strategy National Declaration of PIHOA NCD State of EmergencyEndorsement of FSM National Nutrition and Physical Activity Policy Endorsement of National Guidelines for food served during government hosted workshops, meetings, summit, etc.Review and amend existing NCD policiesFine Tuning the Salt Reduction Program (New Program)Improving Data Management (NCD Data)Hiring of a Pathologist

Practices and Successes – Implementing NCD Policy

Clean Indoor Law – through collaboration between governments (national and state) and private sectors;

Involvement of stakeholders in the process

Lessons Learned - Challenges

Political Commitment and Support (Funding)Conflict of Interest (Policy Makers are business owners)Identifying Champions (devising policies/legislations)Gathering evidenced-based data supporting legislations

Supports Needed for NCD Policy, FSM

Technical AssistancePolicy Review/DevelopmentHIS – SWAT Analysis (Linking of various data registries for an Integrated HIS)HRH – Drafting of HRH Plan - PlanningQA/QI

Training (on-site) for:community change agentsICS System

Funding Opportunities (for Sustainability)

Thank You