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)