世界银行-马绍尔群岛共和国初级卫生保健系统：初级卫生保健绩效倡议评估（英）-2023-90页._2mb

The Primary Health Care System of the Republic of the Marshall Islands

A Primary Health Care Performance Initiative Assessment

Executive Summary

Marwa Ramadan, Valeria Cruz-Villalba, Cameron Scott Feil, Awa Diallo, Latifat Okara, and Manuela Villar Uribe conducted an assessment of the Republic of the Marshall Islands' (RMI) primary health care (PHC) system using the Primary Health Care Performance Initiative (PHCPI) framework. The evaluation revealed significant challenges in PHC access, coverage, quality, equity, and capacity, but also identified areas for improvement.

Key Findings

Popularhealthcare services in RMI face several issues:

• Access: Only 51% of households seek care when needed, and 32% experience travel time exceeding 30 minutes to reach facilities.
• Coverage: Immunization rates dropped from 85% in 2015 to 82% in 2021, and coverage for HIV treatment stands at 55%. Tuberculosis treatment success rates are only 50-51%.
• Quality: PHC facilities lack essential medicines and electricity, with 37% failing to meet infection control standards.
• Equity: Wealth quintiles show significant disparities, with poorer households (48%) less likely to access care or spend on health.
• Capacity: Governance policies are fragmented, workforce shortages persist, and digital infrastructure is underdeveloped.

Recommendations

1. Integrate PHC into Health Governance: Develop a unified PHC strategy and establish a dedicated focal point.
2. Enhance Quality Management: Invest in facility infrastructure and implement patient safety protocols.
3. Strengthen Workforce Capacity: Evaluate workforce distribution and enforce licensing requirements.
4. Improve Facility Management: Implement a formal empanelment system and enhance data monitoring.

The RMI government is urged to address these challenges through strategic reforms and stakeholder collaboration to improve PHC service delivery and health outcomes.