Training competent and effective Primary Health Care Workers to fill a void in the outer islands health service delivery of the Marshall Islands of Micronesia

A physician instructor with experience and expertise in primary health care in these regions conducted the program. The curriculum included training in basic health science, essentials of endemic disorders and their clinical management appropriate to the outer islands. Emphasis was given to prevention and health promotion as well as to the curative aspects. For clinical observation, the candidates were assigned to clinical departments of the Majuro hospital for 1 year during their training, as assistants to the nursing staff. This paper discusses the details of the training, the modalities used to groom the candidates, and an assessment of the ultimate effectiveness of the program.Out of 16 boys who began training, 14 candidates were successful in completing the program. In 1998 a similar program was conducted exclusively for women under the auspices of Asian Development Bank funding, hence women were not part of this program.For developing countries of the Pacific, appropriately trained human resources are an essential component of economic progress, and the health workforce is an important part of human resources for sustainable progress and development.The Outer Islands Health Care System (OIHCS) is an integral component of the Bureau of Primary Health Care (PHC), in the Republic of Marshall Island's (RMI) Ministry of Health (MOH). The OIHCS is responsible for the operations of the primary health care services to approximately 17 000 people dwelling on 19 atolls in an area of 1 812 992 sq. km. of Pacific Ocean. Outer island health care needs are met through a referral network of 52-health centers each of which is operated by a "Health Assistant". The Health Assistants are mid level practitioners, who single-handedly run the health center. Physician assistance is available to provide guidance as needed by 2-way radio [1]. During the fiscal year 2002 (Oct 2001-Sep 2002), the primary health care network registered 30 481 visits in the various health centers in the o