III.E.2.b. Supportive Administrative Systems and Processes

III.E.2.b.i. MCH Workforce Development
 

There was no recruitment for MCH program personnel in 2018.  There are48 full time equivalent (FTE) staff working in the Family Health Services Unit at the national and state level which MCH program is part of. There are 34 staff that are getting paid by the MCH Program, 4 are getting paid by the SSDI grant, 18 are getting paid by the Title X Family Planning Program, and 2 are getting paid by the HRSA EHDI Program. These 52 employees working under the umbrella of the Family Health Services Unit that are counted under the workforce development for the Family Health Services Unit in the FSM of which the MCH Program is the overall head program for such programs.

Distribution of unit staff by State is as follow: See Table:

Family Health Unit-Key Staff

The MCH programs at the state level are working within their scope with limited funding to hire more staff to assist in other areas pertaining to the MCH program. The staff are getting trainings in personnel management, data management, clinical management, clinical care and services, community relations and outreach, and are properly supported.

The FSM MCH program lack specialized skilled experts and specialty services to assist the targeted MCH population domain in the four FSM States.

The FSM has been contracting Cardiologists from the Orange County Children’s Hospital in California for over a decade now to provide Pediatric Cardiology Services for Children in the four states.

Several overseas contracts were made to hire experts who could do the work of an Evaluator, Audiologist and Speech Pathologist.   Currently, FSM has two contracts executed for Arielle Buyum, Evaluator for the EHDI and Family Planning programs and Dr. Clare Camacho, a Speech Therapist from the University of Guam to provide Speech and Language Support to Children up to 3 years old who are deaf or hard of hearing and their parents. Dr. Camacho is also working with parents in each FSM State to identify parent leaders and help set up and implement learning communities in all States.

FSM Health department also have contracts with Shriner Children, Canvasback, and other visiting medical teams to provide specialized services in all FSM States. Other services were also provided by the US Military including audiology, dentistry and general clinics in selected FSM States .

E-Pathology Services in Pohnpei State enables Pap Smears, Sure path, and Biopsy to be read on-line and results provided to clients in a matter of few hours or a day, at the most. FSM entered into a MOU with a Pathology Lab in Hokkaido, Japan to read and confirm suspected Pap Smears for the FSM. All the FSM States have been utilizing this e-pathology service provided in Pohnpei state.  

Despite the fact that recruitment is underway to recruit one or two lab technician and train them properly, the E-Pathology Project is operational and have cut back tremendous cost on overseas Pap smear reading contract fees and shipping of specimen overseas.

Since 2017, Training and education of the FSM MCH Workforce are still carried out at three levels:  Onsite consultation, technical assistance and training; Regional and National Conferences; Local Workshops & Conferences.

The National MCH Coordinator travels to FSM States once or twice a year doing management training for the family health services unit staff MCH Program Coordinators, CSHCN Program Coordinators, Family Planning Program Coordinators and other public health program coordinators on how to effectively and efficiently implement the five-year action plan and engage stakeholders. The National System and Data Manager travels to FSM States once or twice a year doing training for the MCH Data Clerks, Family Planning Program Data Clerks and other public health programs’ data clerks. The System and Data Manager also provided education and training on developing policy and procedures for data management, including data collection and cleaning, data analysis and interpretation, Quality assurance and Quality improvement and overall improving data capacity.

The National Financial Management Specialist travels to FSM States once or twice a year doing training in Miscellaneous Request Payments processing, Purchase Requisitions, Price comparisons, Reimbursements and Journal Vouchers, Preparing Personnel Action Forms, Account Reconciliation, and expenditure reporting.

Special trainings such as in-country and onsite training/retraining of public health nurses on Cervical Cancer using Pap smear and VIA; training of OB nurses in Early and Essential Newborn Care; and on-line continuing education courses from the Fiji School of Medicine and other institutions.

Organizational Structure – Although the FSM National Constitution holds the four FSM states together, each of the four states has its own state Constitution. Each of them replicates that of the national government with three branches of separate powers. Each of the FSM states has considerable autonomy and each one of them is equally unique in its own organizational structure from the overall state composition down to the local municipality offices.

Staffing Structure – Different coordinators normally have different sets of values and therefore their priorities are not the same despite the fact that program guidelines and service protocols are in place. Re-organizing the public health programs into Units will strengthen collaboration, efficiency and effectiveness of programs services and wiser use of manpower and other resource. This concept also supports sustainability of specialized services and specialty care for families in the FSM.