Staffing Structure

The RMI MCH Program has 14 full time staff with 4 staff funded through the Title V MCH funds. The five Title V funded staff are 3 registered nurses, 1 certified midwife and 1 certified dental assistant.  Nine staff of the MCH Program are funded by CHC, General Funds and other federal grants.

The MCH Program addresses the needs of the RMI MCH population complies with the varying program requirements of the MCH Title V Block Grant and links all services with other programs under the Ministry of Health and Human Services. While most of the staff is funded by sources other than Title V, they all contribute to the Title V mission and MCH priorities. For example, CDC funded immunization nurses implements the activities related to increase of complete immunization rates for 19-35 months.

Although the MCH Program is working closely with the Ministry’s Human Resources and Public Service Commission to improve current workforce capacity, there is still challenges in providing specialized programs due to limited specialists and funding issues.

Recruitment & Retention

Recruitment of Ministry of Health and Human Services (MOHHS) staff including MCH program is handled through the coordination of MOHHS’ Human Resources Office and Public Service Commission policies and procedures. In the last two years, there are a lot of MOHHS’ staff that resigned to look for high-paying job opportunities from other government agencies, private companies or move to USA.  Although the MCH funded staff are long time employees of the Ministry, our MCH activities and priorities are affected because most of our activities are collaborations with other public health and hospital-based programs.

Challenges in recruitment are, but not limited to, low salary grade, PSC’s long process of recruitment and hiring, funding and availability of RMI workforce that fits at least the minimum requirements of the job description.

Every 2 years, more than 10 local nurses graduate from the nursing school at the College of the Marshall Islands. Currently, there’s been a challenge with funding to hire new graduate nurses causing some nurses to apply for other fields, like local other ministries, banks and private offices. Aside from the nurses who graduate from the Nursing School, RMI, like other jurisdictions and territories, recruits a large majority of its nursing workforce from the Philippines and Fiji for specialties in midwifery, ER and ICU. 

Continuing Education/Medical Education

RMI in collaboration with Taiwan established a medical program in 2016 where RMI students attend medical school in Taiwan. As of 2022, there are thirteen (13) Marshallese Doctors graduated from this program. Seven (7) had passed the Internship program and assign to the different hospital and public health programs like NCD, Reproductive Health, Pediatric Ward, Labor, and Delivery Ward, ER and etc. In 2022, 5 of the intern doctors were able to return to Majuro to start their internship program. Two of the doctors have returned to Taiwan to pursue specialty in Surgery. Our first master’s degree in nursing came back and return to work in the Ministry as the Director of Nursing Bureau. There is another nurse taking master’s degree.

Workforce Capacity Training

The RMI MCH program in collaboration with other public health programs is to provide comprehensive and holistic community health services, including medical, dental, mental health and substance abuse screening, perinatal, nutrition, and family planning, all supplemented by enabling services including outreach, providing transportation.

In 2022, RMI MCH staff members took part in the following trainings:

• Minimal Initial Service package (MISP)

The aim of the MISP framework is to contribute to reducing preventable maternal and newborn deaths, reduce the unmet needs for family planning, reduce STI/HIV transmission and reduce gender-based violence during humanitarian crisis. It was a 5-day training provided virtually by United National Population Fund (UNFPA). Participants are from Ministry of Health and Human Services staff from Majuro and Ebeye

• COVID-19 related training

There were several trainings and presentation related to COVID-19 that were provided to the program. COVID 19 presentations, COVID-19 vaccinations, COVID-19 swabbing, IPC training, surveillance, contact tracing refresher course to staff on COVID-19.

• Spot-check Training

Training using tablets to access a database to capture assessment of Family planning commodities at the service sites on Majuro, Ebeye and neighboring islands.   UNFPA Virtual training was provided for 2 days.

• Family Planning Training

10 days of Family Planning training provided virtually by UNFPA. Counselling techniques and commodities were the main topics, hands on training on how to insert implants, IUDs and other methods. Staff from the service sites in Majuro and Ebeye attended.

The need to build and improve the workforce for sustainability of the public health programs is imperative to improving delivery of services to the community. The shortage of local manpower impacts health service delivery in that there is a need to recruit manpower from the other countries, with a lengthy process and a high-cost package compared to local hire, since housing is provided.   The program will work closely with leadership to develop competent, committed, and compassionate MCH professionals.

Workforce Enhancement Activities for Support by ECD for 2022:

• MOHHS Workforce Development Package

Endorsed April 2022. Includes, Nurse Midwifery Program (PG Diploma in partnership with Fiji National University - FNU); Nurse Internship program (for new College of the Marshall Islands - CMI ASN nurses- continue 8 month internship that has been going for past 2 years); BSN Bridging Program (in partnership with University of Fiji), Community Health Outreach Worker program (in partnership with CMI, mainly for Majuro); Reproductive Health Worker program (to train women on Neighboring Islands which have only male health assistants to provide basic safe childbearing, basic family planning, basic antenatal and post-partum care: using United Nations Population Funds’ (UNFPA) Minimum Initial Services Package training program.

Due to community transmission of COVID-19, workforce enhancement plan implementation was delayed.