who/wpro, south pacific
TRANSCRIPT
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REPORT MEETING OF COUNTRY LIAISON OFFICERS (CLOs) AND
INTERCOUNTRY PROJECT (ICP) STAFF
WHO/WPRO, SOUTH PACIFIC
SUVA, FIJI 15 - 19 AUGUST 1985
Prepared
By Off i ce of the n hC Kepresenta t i ve a nd Programme Coordi nator
Suva, Fiji
August lSE5
CONTENTS
PREFACE AND SUMMARY OF THE CLO/ICP MEETING
DR. M. FELSZER, WRC, SU VA. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1
1. INTRODUCTION. • • • • • • • • • • • . • • . • • • • • • • . • • • • • • • • . • . • • • • • • . . • . . . . . 3
2 WELCOME ADDRESS - DR. M. FELSZER, WRC, SUVA.................. 3
3. OPENI~ R»lARKS - DR. H. NAKAJIMA, RmIONAL DIRECTOR......... 4
4. OBJECTI VES OF THE MEETING AND WHO COLLABORATION IN THE
SOUTH PACIFIC - DR. M. FELSZER, WRC, SUVA.................... 5
5. PROJECTED COUNTRY ACTIVITIES AND REQUIRED ICP SUPPORT
IN 1986...................................................... 8
6. FILM ON PRIMARY HEALTH CARE IN KIRIBATI...................... 9
7. IMPLEMENTATION AND MONITORI~ OF PROJECTS IN THE
SOUTH PACIFIC................................................ 9
8. FELLOWSHIPS. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • . • 11
9. FAREWELL TO R~IONAL DIRECTOR................................ 14
10. AIMINISTRATIVE MATTERS....................................... 15
11. PROPOSED TRA VEL PLANS OF ICP STAFF IN 1986................... 18
12. INDIVIDUAL DISCUSSION BETWEEN CLOs AND ICP STAFF ••••• ,....... 22
13. RECOMMENDATIONS. • • • • • • • • • •• • • . • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 13
14. CLOSING CEREM ONY - DR. M. FELSZER, WRC, SU VA.. .. • • .. • .. • .. .. • 25
ANNEX 1
ANNEX 2
ANNEX 3 (A-O)
ANNEX 4
ANNEX 5 (A-O)
FIGURE 1
TABLE 1
TABLE 2
LIST OF PARTICIPANTS •••••••••••••••••••••••
AGENDA OF THE MEETING, 15 - 19 AUGUST 1985 ....................... .
PROPOSED COUNTRY ACTIVITIES AND REQUIRED I CP SUPPORT IN 1986 ....................... .
IMPLEMENTATION AND MONITORI~ OF PROJECTS IN SOUTH PACIFIC COUNTRIES -
27
28
31
DR. C.T. PALMER............................ 79
PROPOSED TRAVEL PLANS OF ICP STAFF •••••••••
FLOW CHART - WHO/WPRO SUPPLY SERVICES •••..•
PROCEDURES IN IMPLEMENTING FELLOWSHIP AWARDS AND GROUP STUDY TOURS •••••••••••.•.•
SUMMARY OF PROPOSED ICP TT: VEL PLANS IN 1986 ................... , ................ .
82
108
109
III
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PREFACE AND SUMMARY OF THE CLO/ICP STAFF MEETING -
DR. M. FELSZER, WRC, SUVA
"THIS MEETING IS A CONTINUATION OF PREVIOUS MEETINGS HELD MORE
RECENTLY IN 1981, 1982 AND 1984 AND EVEN BEFORE THIS I FEEL THAT THE
MEETING AS SUCH IS AN EXCELLENT IDEA AND I HOPE THAT WE ARE ABLE TO
CONTINUE SIMILAR MEETINGS IN THE FUTURE. I FEEL THAT WE HAVE ALL
BENEFITTED SUBSTANTIALLY FRCII OUR DISCUSSIONS AND MORE ESPECIALLY FR<Jo1:
THE WISE CCllMENTS OF OUR RIDIONAL DIRECTOR.
YOU WILL RECALL THAT THE RIDIONAL DIRECTOR IN HIS OPENING C(JIIMENTS
SAID THAT PROORESS IN THE SOUTH PACIFIC IS S<Jo1:ETIMES IMPEDED BY THE LACK
OF COORDINATION. THIS MEETING WAS HELD TO 0 VERCCME THIS PROBLEM. THE
AIMS OF THE MEETING AS I PRESENTED THEJI IN MY OPENING REMARKS WERE:
(A) COORDINATE AND PLAN 1986 ACTIVITIES.
(B) DISCUSS INDIVIDUAL COUNTRY REQUIREMENTS.
(C) DISCUSS PROBLEMS IN PROORAMME IMPLEMENTATION.
IN CARRYING OUT THESE AIMS AT THE MEETING WE HA VE HAD TO HA VE
RIDARD TO THE COMMENTS OF THE RIDIONAL DIRECTOR, ESPECIALLY HIS
STATEMENTS THAT:
- WE SHOULD BE STARTING TO LOOK BEYOND THE YEAR 2000.
- THE HEALTH MANPOWER NEEDS OF THE COONTRIES ARE CHANGING. FEWER
HIGHLY QUALIFIED SPECIALISTS ARE REQUIRED AND IN THEIR STEAD WE
NEED MORE DOWN-TO-EARTH TECHNICIANS.
- A .NEW BREED OF HEALTH LEADER IS CCMING TO THE FORE WHO HAS
DIFFERENT APPROACHES TO PAST LEADERS.
- NEW TECHNOLOOIES ARE ALL THE TIME BEING DEVELOPED AND THESE
TECHNOLOGIES MUST BE UTILIZED.
THE MEETING HAS BEEN FASHIONED SO AS TO PROVIDE A DETAILED
STATEMENT OF THE NEEDS OF EACH OF THE 18 COUNTRIES FOR WHICH I AM
RESPONSIBLE. WE HAD COUNTRY BY COUNTRY STATEMENTS OF THEIR AIMS AND
NEEDS FOR WHO COLLABORATION IN 1986. WE HAVE DISCUSSED FACTORS WHICH
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COULD AFFECT THIS COLLABORATION IN EACH COUNTRY. WE HAVE FORMULATED AND
DISCUSSED AMONGST OURSEL VES THE PROPOSED TRA VEL PLANS FOR INDI VIDUAL
STAFF Ml!MBERS. I FEEL THAT WE WILL NOW HA VE TO DISCUSS THESE PLANS WITH
THE COUNTRIES CONCERNED BEFORE WE CAN SUBMIT THEM TO THE REGIONAL OFFICE
FOR APPRO VAL.
THE FOliM ULAT I ON OF THE TRAVEL PLANS IS PROBABLY THE MAIN
ACHIEViMENT OF THE MEETING. HOWEVER, IN ADDITION THERE WERE A NUMBER OF
OTHER ACHIEViMENTS. DR. PAllIIER PRESENTED A PAPER ON THE 'MONITORING AND
lMPLl!MENTATION OF WHO ACTIVITIES IN THE COUNTRIES'. TWO POINTS WHICH HE
RAISED AND WHICH SHOUD BE FOLLOWED UP ARE:
(1) THE UNDERTAKING OF JOINT WO/GOVERNMENT PROGRAMME REVIEWS.
THESE WOULD BE OF COURSE WITH THE AGREl!MENT OF OUR REGIONAL
OFFICE.
(2) MORE UTILIZATION OF BU:OOET STATUS REPORTS, FELLOWSHIP REVIEW
LISTS AND THE LIKE, TO ENCOURAGE THE MONITORING OF ACTIVITIES.
THE AIMINISTRATlVE MATTERS WERE CAPABLY PRESENTED BY MRS. WAQAUSA
AND MRS. ZULLAH. IT MIGHT HAVE BEEN OF INTEREST TO YOU TO LEARN THAT 350
FELLOWS HAVE BEEN PLACED BY THIS OFFICE IN THE LAST 12 MONTHS. THIS
OFFICE IS BEC~ING MORE IN VOL VED IN THE AIMINISTRATION OF THE FELLOWSHIP
PROGRAMME. A NUMBER OF USEFUL SUGGESTIONS WERE MADE TO IMPROVE THE
MANAGEMENT OF THE SCHl!ME.
OTHER AIMINISTRATlVE SUBJECTS WHICH WE COVERED INCLUDED:
IMPREST ACCOUNT
TRANSFER OF FUNDS
US DOLLARS ACCOUNT
SUPPLIES AND EQUIPMENT
LOCAL COST
AIMINISTRATION OF STCs
AIMINISTRATION OF CLO OFFICES.
THE RECCMMENDATIONS ARISING FR~ THIS MEETING ARE PRESENTED IN
SECTION 13 OF THE REPORT."
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1. INTRODUCTION
This CLO/ICP Staff Meeting was held in Suva, Fiji from 15 - 19
August 1985. There were 20 participants, including the Regional Director
of WHO Regional Office for the Western Pacific, the WHO Representative
and Programme Coordinator for the South Pacific, 4 Country Liaison
Officers (CLOs) and 1 Acting CLO, 11 Intercountry Project Staff (ICP),
and 2 Administ ra ti ve Assistants (see Annex 1). The Agenda is presented
in Annex 2.
The objectives of the meeting were:
to coordinate and programme 1986 collaborative activities;
to discuss problems in programme implementation;
to consider how best to make use of available WHO and country
resources; and
to share information essential to more effective coordination.
2. WELCOME ADDRESS - DR. M. FELSZER, WRC, SUVA
Dr. Felszer addressed Dr. H. Nakajima, Regional Director, and
participants in the meeting as follows:.
"IT IS MY VERY GREAT PLEASURE TO WELCOME YOU ALL TO THIS STAFF
MEETING IN SUVA. THIS MEETING IS A VERY SPECIAL ONE AS WE ARE HONOURED
AND FORTUNATE IN HAVING HERE AMONG US, OUR REX;IONAL DIRECTOR, DR.
NAKAJIMA. ALLOW ME, DR. NAKAJIMA, IN THE NAME OF MY COLLEAGUES, TO
EXTEND TO YOU A VERY WA~ WELCOME AND THE WISH OF A VERY PLEASABT STAY IN
FIJI, AND TO THANK YOU FOR HAVING TAKEN OFF TIME, ALBEIT A SHORT ONE,
FROM YOUR MANY CCMMI'lMElfTS TO BE WITH US.
AS ALL OF YOU ARE VERY MUCH AWARE OF WHO'S ROLE IN THE ACHIEViXENT
OF HEALTH FOR ALL, YOU WILL AGREE WITH ME, THAT THE BEST WAY TO
SUCCESSFULLY CARRY OUT CUR RESPONSIBILITIES WITHIN THE OIiGANIZATION IS
WITH A TEAM APPROACH CONCEPT. IN FOliMULATING AN AGENDA, THIS CONCEPT WAS
TAKEN INTO CONSIDERATION. EACH OF US WORK WITHIN A SPECIFIC DISCIPLINE,
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HOWEVER ALL THE DISCIPLINES ARE IITERTWIBED .urn NO ONE CAN AFFORD TO WORK
ALONE AND IN ISOLATION IF WE EXPECT TO ACC(I{PLISH THE OBJECTI VES SET
FORTH BY WHO.
I WOULD LllCE TO SEE FRANK AND OPEN DISCUSSION, A VOIDING IRRELEVANT
BUT NOT CONSTRUCTIVE CRITICIIJ(S, THIS CAN BE ACHIEVED WITH GOODWILL
TOWARDS EACH OTHER AND SINCE OUR RIDIONAL DIRECTOR IS .AMONG US I .AM SURE
THAT HE WILL BE A GUIDING FORCE IN THE CONDUCTING OF THIS MEETING.
AS I KNOW THAT EACH OF YOU IS A RESPONSIBLE AND CAPABLE
PROFESSIONAL, I HAVE TRUST THAT YOU WILL NOT SPARE EFFORTS IN MAKING THIS
A YERY FRUITFUL AND SUCCESSFUL MEETING. "
3. OPENING lill'iARKS - DR. H. NAKAJIMA, RIDIONAL DIRECTOR
Dr. Nakajima, Regional Director, talked about several important
points affecting the various levels of the Organization. He referred to
difficulties met in coordinating activities in the South Pacific. These,
he said, were partly due to political inst" bili ty in many of the Island
countries as well as to the absorptive capacity of some· of the
countries. To make maximum use of available national and WHO resources,
he said that it may become necessary to reassign a few of the currently
Suva-based ICP Staff to some countries in the future.
At country level, he saw no need to reduce the staff and individual
country budget allocations. Careful monitoring and supervision of the
management of resources, particularly of funds, would be required as a
part of increasing WHO financial input to national health programmes. At
the global level, there will be more emphasis on audit and control as a
part of the new programme budget policy.
He further stated that we must now look beyond the year 2000. A
complete review of health manpower development is being undertaken to
consider the changing role of the medical practitioner. It is envisaged
that the doctor will become a commL.ity leader as in the past in parts of
Asia and Europe.
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Medical training is being reviewed. In some countries, doctors and
especially specialists, are being over produced. There has also been a
change in emphasis in some countries from the training of foreign
students overseas, to the provision of staff who can assist with
appropriate training in the student's own country or region.
A critical mass of new leaders may need to be produced to apply
Health for All strategies. The medical and nursing professions need to
review training programmes to enable them to adjust, adapt and survive as
leaders after the year 2000.
The transfer of technology is an important area to consider. This
is, in fact, the transfer of individual knowledge, as in the development
of a comprehensive hepatitis control programme in China utilizing
expertise in epidemiology, vaccine production and related areas. A
similar approach may be applied to filariasis control in the South
Pacific.
Dr. Nakajima concluded by informing staff members that he was
pleased to have the opportunity to meet them socially, and indi vi dually
if required.
Dr. Nakajima was thanked by Dr. Felszer for his enlightening
remarks and for noting that intercountry projects will remain an
important part of WHO collaboration in the South Pacific.
WRC/SUVA
4. OBJECTIVES OF THE MEETIlG AND WHO COLLABORATION
IN THE SOUTH PACIFIC - DR. M FELSZER, WRC, SUVA
Dr. Felszer addressed the meeting. His address is as follows:
"I HA VE BEEIi' ASSIGNED TO SPEAK AGAlli TODAY Oli THE OBJECTI ViS OF
THIS MEETIlG AND THE ROLE or WHO IIi 1986-1987 BIEDltII.
Ili ORDER TO MAKE OUR IliDIVIDUAL !liD COMBINED EFFORTS MEANINGFUL AND
ACCCMPLISH THE EXPECTED RESULTS, IT IS IMPORTAliT THAT WE CONTINUOUSLY
IMPROVE, ADAPT AND ADJUST OUR ACTIVIT!ES IN THE INDIVIDUAL COUNTRIES.
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THIS MEETING HAS BEEN CALLED WITH THIS AIM IN MIND. A SPECIAL
HIGHLIGHT OF THIS MEETI~ IS THE OPPORTUlUTY TO RECEIVE GUIDANCE FR(J4. DR.
NAKAJIMA ON THE ISSUES IN VOL YEn.
THE OVERALL OBJECTIVES ARE TO ENHANCE PERFOHMANCE, AVOID
OVERLAPPIlJ;, IRRELEVANT TRAVEL, AND ELIMINATE DUPLICATION.
A NlItBER OF TOPICS HAVE BEEN INCLUDED IN THE AGENDA, WHICH, IT IS
HOPED, YILL BE CONDUCIVE TO THE ACC(J4.PLISHMENT OF THE OVERALL AND
SPECIFIC OBJECTIVES.
THE SPECIFIC OBJECTIVES OF THIS MEETING ARE:
1) TO COORDINATE AND PROORAMME 1986 COLLABORATIVE ACTIVITIES. THIS
EXERCISE WILL PRO VIDE CLOs WITH MATERIAL FOR FURTHER DISCUSSION
iI'ITH GOVERNMENTS, AND THUS PREPARE THE TERRAIN FOR THE ICP STAFF.
IT WILL ALSO HELP TO MAINTAI1 PLANNED SCHEDULES, AS THE GOVERNMENT
OFFICIALS WILL HAVE BEEN MADE AWARE, WELL IN ADVANCE, OF PROPOSED
ICP VISITS AND HOPEFULLY A VOID LAST MINUTE CANCELLATIONS ON THE
PART OF THE GOVERNMENTS, AS IT SO OFTEN HAPPENS.
2) TO DISCUSS COUNTRY REQUIREMENTS WHICH SHOULD REFLECT ORIENTATION OF
WHO'S COLLABORATIVE PROORAMMES TOWARDS INCREASED TECHNICAL
COOPERATION WITH THE COUNTRIES IN SUPPORT OF NATIONAL HEALTH FOR
ALL STRATE)} IES. AS A RESULT, IT IS HOPED, THAT PROJECTED COUNTRY
.ltEQUIREMENT ACTIVITIES AND REQUIRED ICP SUPPORT IN 1986 WILL BEC(]<1E
MORE EFFICIENT AND EFFECTIVE.
3) THIS MEETING WILL PROVIDE THE OPPORTUNITY TO DISCUSS PROBLFlol:S
ENCOUNTERED IN THE IMPLEMENTATION OF PROORAMME POLICIES AND PROPOSE
POSSIBLE ALTERNATIVE ACTION TO CORRECT THE PROBLEMS. ABOVE ALL, IT
IS HOPED THAT THIS MEETING WILL BE THE INSTRUMENT FOR DEVELOPING
BETTER C(]<1MUNICATION AMONG ICP MFlol:BERS AND BETWEEN THE ICP TEAM AND
CLOs.
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4) AS WE ALL KNOW, EFFECTIVE IMPLEMENTATION OF PROGRAMMES REQUIRES
PARTNERSHIP BETWEEN WHO AND THE COUNTRIES. THIS MEETING,THEREFORE,
HAS BEEN DESIGNED TO USE A COUNTRY BY COUNTRY APPROACH TO
CONSIDERING HOW TO MAKE BEST USE OF THE A VAILABLE WHO AND COUNTRY
RESOURCES. A KEY OBJECTI VE WILL BE TO PROPERLY COORDINATE THE
STAFF ACTIVITIES, INTERCOUNTRY AND COUNTRY, TAKING INTO
CONSIDERATON THE NEEDS OF EACH PARTICULAR COUNTRY.
WHERE THERE ARE COUNTRY LIAISON OFFICERS, THESE WILL CONTINUE TO
ASSURE EFFECT I VE COORDINATION. FOR THE OTHER COUNTRIES, ICP STAFF
WILL PAY SPECIAL ATTENTION TO THE OVERALL WHO COUNTRY PROGRAMMES
COMBINED WITH THEIR OWN PROJECTS.
5) ADDITIONAL BENEFITS OF THIS MEETING ARE EXPECTED IN THE SHARING OF
INFORMATION INTENDED TO LEAD TO EFFECTIVE COORDINATION.
I WOULD LIKE TO TAKE THIS OPPORTUNITY TO BRIEFLY OUTLINE THE ROLE
OF WHO COLLABORATION TO SOUTH PACIFIC COUNTRIES FOR 1986-1987.
IT WILL BE OUR RESPONSIBILITY TO CAREFULLY MANAGE OUR PLAN OF WORK
SO AS TO ENSURE THAT IT CONTRIBUTES TO PROGRESS TOWARDS HEALTH FOR ALL.
THIS REQUIRES, AS I SAID BEFORE, A PARTNERSHIP BETWEEN WHO AND THE
NATIONAL HEALTH AUTHORITIES, SO THAT WHO'S ACTIVITIES WILL BE IN THE
MAINSTREAM OF HEALTH DEVELOPMENT RATHER THAN IN AD HOC REQUESTS AND
PERIPHERAL ACTI VITIES. THIS MEANS THAT PROGRAMMES OF COOPERATION WILL BE
STRESSED RATHER THAN ISOLATED PROJECTS.
IN THE SOUTH PACIFIC WHO COUNTRY AND INTERCOUNTRY STAFF WILL
CONTINUE TO BE THE BACKBONE OF PROGRAMME COOPERATION. HOWEVER, THESE
ACTIVITIES WILL NEED TO BE TARGETED TO KEY ISSUES OF HEALTH
DEVELOPMENTS. ONE OF THESE KEY ISSUES WILL CONTINUE TO BE HEALTH
MANPOWER DEVELOFMENT, THIS REJ'LECTS THE iXPHASIS GIVD BY THE COUNTRIES
AND AREAS OF THE SOUTH PACIFIC TO MEETING THE MANPOWER REQUIREKEITS lOR
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THE DEVELOH!:ENT OF A HEALTH SYSTEM BASED ON PRIMARY HEALTH CARE. HEALTH
MANPOWER TOOETHER WITH PROORAMMES WHICH ARE CONSIDERED OF IMPORTANCE FOR
THE ATTAINMENT OF HEALTH FOR ALL, SUCH AS:
(i) DISEASE PREVENTION AND CONTROL.
(ii) HEALTH SYSTEM DEVELOH!:ENT.
(iii) ORGANIZATION OF HEALTH SYSTEMS BASED ON PRIMARY HEALTH CARE;
AND
(i v) PRCMOTION OF ENVIRONMENTAL HEALTH WILL BE STRESSED AND THE
IN-COUNTRY TRAINING WILL ALSO RECEIVE SPECIAL ATTENTION.
IT WOULD HAVE BEEN OF GREAT BENEFIT TO ALL OF US IF A FEW
MANAGEMENT SESSIONS COULD HAVE BEEN CONDUCTED ON THIS OPPORTUNITY, SO AS
TO GIVE US A BETTER GRASPS ON THE FUTURE ROLE OF WHO COLLABORATION TO THE
SOUTH PACIFIC COUNTRIES BEYOND 1986-1987, AS WELL AS OF PROJECT
IMPLEMENTATION AND PROJECT MONITORING AND ON BUrGET STATUS REPORTING.
UNFORTUNATELY, WPRO PERSONNEL, WHO COULD HAVE CONDUCTED THESE SESSIONS
ARE HEAVILY CCMMITTED WITH OTHER RESPONSIBILITIES AND THEREFORE COULD NOT
TAKE PLACE. I AM, CONFIDENT THAT THERE WILL BE OTHER OCCASIONS WHEREBY
WE SHALL PARTAKE AT SUCH SESSIONS.
I SINCERELY HOPE, THAT THIS MEETING WILL PROVIDE US WITH MORE
EFFECTIVE MEANS OF PROVIDING COOPERATION."
5. PROJECTED COUNTRY ACTIVITIES AND
REQUIRED ICP SUPPORT IN 1986
The chairmanship of the sessions on this item and other items of
the Agenda from this point onward were distributed between the WHC, the
Terur; Leader of rCP/PHG/002 (Dr. C.T. Palmer), and the CLOs.
The statements on this projected needs of ICP support by indi vid;;a1
South Pacif: c countries during 1986 were presented by those who were
assigned to prepare them for this Meeting (see Annex 2, pages 2 and 3).
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The presentation and discussions during these sessions were, as
follows:
5.1 AMERICAN SAMOA ANNEX 3 A
5.2 COOK ISLANDS ANNEX 3 B
5.3 FIJI ANNEX 3 C
5.4 KIRIBATI ANNEX 3 D
5.5 NIUE ANNEX 3 E
5.6 SAMOA ANNEX 3 F
5.7 SOL(]t10N ISLANDS ANNEX 3 G
5.8 TOKELAU ANNEX 3 H
5.9 TONGA ANNEX 3 I
5.10 TRUST TERRITORY OF THE PACIFIC ISLANDS ANNEX 3 J
5.11 TUVALU ANNEX 3 K
5.12 VANUATU - ANNEX 3 L
5.13 FRENCH POLYNESIA ANNEX 3 M
5.14 NEW CALEDONIA ANNEX 3 N
5.15 WALLIS AND FUTUNA ANNEX 3 0
6. FILM ON PRIMARY HEALTH CARE IN KIRIBATI
A 1-1/2 hour film on the development and status of promoting health
and preventing diseases in Kiribati through the PHC approach waB shown to
the participants.
7. IMPLEMENTATION AND MONITORING OF PROJECTS
IN THE SOUTH PACIFIC
Dr. Palmer presented a paper on this subject (Annex 4). The main
points covered by Dr. Palmer were:
1) WPRO is tending to the concept of managing "Programmes and
Acti vi ties" rather than "Projects". This is leading to a broader total
country view of work.
2) In order to achieve more effective programmes of cooperation
wi th countries, there should be a greater emphasis on joint WHO programme
reviewB.
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3) In addition to assessing overall programme development, the
programme reviews should facilitate specific implementation and
moni to ring steps. The WHO staff could supply pertinent data to enable
the reviews to be undertaken efficiently.
4) In order to monitor programmes and activities, use has to be
made of the Budget status Reports and other auxilliary documents issued
by the Regional Office. For the reports to be fully effective, CLOs
should endeavour to keep them up-to-date with details of requests for
implementation and reprogramming.
The paper generated a great deal of discussion. The WRC explained
that while agreeing that the notion of a joint WHO/Government programme
review could be good, participation in the review should always be
cleared through the responsible Regional Adviser and Director in WPRO.
The need was expressed to have a clear view in our own minds of the
differences between:
Programmes
Projects
Activities.
The general need to review components of a programme and assist
acti vities in the light of U,.'l aims of the programmes was accepted.
However, the concept of a project comprising a number of inter-related
activities in a country cannot be entirely disregarded especially as this
is the way some countries and even other UN agencies such as UNDP and
UNFPA like to operate.
On the question of Budget Status Reports, Dr. Palmer elaborated on
the reservations of the Regional Office in releasing the reports to the
countries. The Reports often have detailed comments and remarks which
are confidential to the Organization. Despite this, some CLOs felt that
it was not realistic to expect countries to be involved in detailed
planning, but then not permit them to have the la+3st data relating to
implementation. Mr. Chandra, during his recel visit to Suva, had
promised to see whether a modified version of the B".iget Status Report
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could be prepared omitting these confidential details. This modified
version could be issued to the countries and would meet their needs. The
CLOs expressed great interest in this idea, but if such a document is
introduced, every effort should be made to keep it up-to-date as far as
possible.
A question was raised on reprogramming. Dr. Palmer mentioned that
much of the reprogramming which occurs could be eliminated if more
realistic planning had occurred in the first instance. He went on to say
that request for reprogramming should be submitted with the Government's
approval to the request. It is not sufficient for the Government to
enquire whether WHO would in principle agree to the change.
definite statement from the Government is needed.
A more
Before ending the discussion the WIlC said that relevant BSRs and
fellowship monitoring details should be included in the briefing
documents for senior officials passing through Suva on their way to
review country programmes.
8. FELLOWSHIPS
Mrs. Zullah summarized the present position in regard to
fellowships. Of the 18 areas of responsibility of the 'liRC, 16 have
Active fellowships programmes. During the biennium 1984-1985, 35C
fellows were placed. This is a big burden on the Suva Office especially
as the office has become more involved than in the past in the management
of fellowship prgrammes for the Pacific Island countries.
Mrs. Zullah covered many aspects of the fellowship scheme.
Particular points which she brought up and the conclusions reached during
the meeting are summarized below:
FUs - CLOs were reminded that processing is made easier if the
medical clearances and the necessary photographs are included with the
application forms. FAFs for 1987 should be submitted by the 30th of June
1986. Procedures in implementing fellowship awards and group study tours
were presented (Table 1).
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Review Lists - The Revisw List is important in the administration
of fellowships. It provides a summary of the outstanding man-months
involved and the CLO is able to see which slot should be used for funding
the fellowship. This should always be included in the covering letter
with the FAFs as it prevents misunderstanding and delays.
The Review List has been issued every six months or so in the past
but the Regional Office will try to produce it at 2-3 month interval in
the future. CLOs should endeavour to up-date the List manually in U.e
intervening periods.
Regional Office Procedures - Mrs. Zullah distri l.·,;ted a summary of
procedures for processing applications for individu/J.' fellowships and
group/study tours. The Regional Office usually rec,res 3 months tc
complete actions on training activities of this nature.
Placement of Fellows in Fiji - An increasing number of fellows are
now coming to Suva for their training - the number growing from 54 in
1984 to around 80 this year. The Dental and Pharmacy courses conducted
by FSM have been cut back.
Medical fellowships are restricted in that a quota of 9 overseas
students has been set in the MBBS I. This problem is compounded by the
fact that the FSM Academic Board does not make its final selection of
candidates until two weeks before the start of the course. A major
difficul ty is being encountered with the Foundation cou r'ses. Unsui table
stUdents are selected with a resulting high drop-out rate. There is a
need to improve the entire selection process.
Short Courses/Study Tours - Mrs. Zullah mentionEd that complaints
are often received that the course of training which hac been arranged is
not appropriate to the needs of the fellow. To reduce the possi tiL ty of
this occuring, a detailed statement by the fellow on her/his expectations
from the course or tour should be prepared before undertaking the
fellowship and on how the newly acquired knowledge and skills will be
used after returning frem the fellowship.
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Stipends - Mrs. Zullah stated that many fellows have misunderstood
the purpose of stipend. The stipend is to cover room, board and
essential incidentals.
family. Having said
It was not designed to cater for the needs of a
this, she confirmed that the stipend in certain
countries is not sufficient to meet the needs of fellows. The review of
stipend rates is not easy. In some countries it is dependent on the
UNDP, in others it is dependent on the fellow completing a
questionnaire. The meeting felt that it would be easier if WHO itself
obtained rates for a number of hotels, boarding houses, etc. in the
country of training. Even with this approach, there is a problem in
achieving a standard acceptable to all applicable fellows. Some fellows
hold senior posts in their own countries and it is not appropriate to
treat them as under-graduates. Another factor which has to be taken into
account is whether or not the fellow is continuing to receive a salary.
The other problem is that the needs of different fellows vary
substantially. An example was given of a PolyneSian requiring a larger
bed and a greater volume of food than is normally provided in Japan. The
meeting felt that present arrangements for determining stipends are not
satisfactory •
There are many complex problems involved and there is a serious
need for the Regional Office to undertake a thorough investigation of the
problem.
Curtailment of Fellowships - The problem of fellows who return home
before completion of their fellowship was discussed. The option of
providing only a one way ticket was discussed but could not be adopted in
those countries where a return ticket was required for a visa. However,
even in those cases, the ticket should be retained b,y WHO if possible or,
if not, by the bursar of the institution providing the training.
Reports - Obtaining the final report from fellows upon their return
to their respective countries often present difficulties. Suggestions
made to encourage fellows to be prompt in submitting their final report
included the withholding of the fellows' final stipend and/or the
reimbursement of the Airport Departure Tax until the report vas received.
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Evaluation of Fellowship Programmes Periodic reviews of the
fellowship programme are essential. While the management of the scheme
has improved considerably in recent years, there is nevertheless much
room for further improvement. There are cases where the country does not
have the capacity to absorb a big number of fellowships; of donor
agencies competing with each other in providing fellowships; of trainees
being over-trained for the tasks they have to perform; of fellows
continually and/or repeatedly undergoing training; and of officials
attending courses which are not relevant to their work.
The meeting concluded that these observations are all valid; the
si tuation could improve conSiderably if the selection proce1's in the
countries were sufficiently tightened. WHO shoul d continually endeavour
to encourage countries to make realistic appnisal of their manpower
needs and ability to utilize fellowships judiciot;sly. Likewis p , there is
a need for WHO to seriously consider the possibility of properly matching
allocation of WHO funds to fellowships, with the manpower needs and
ability of countries to making fUU use of fellowl,hip provisions.
9. FAREWELL TO RIDIONAL DIRECTOR
In his farewell remarks, Dr. M. Felszer thanked the Regional
Director for coming to Suva as well as for his guidance and participation
during the Meeting. Dr. Felszer said:
"WE HA VE BEEN MOST FORTUNATE THAT OUR MEETING WAS HIGHLIGHTED BY
THE PRESENCE OF THE RID:ONAL DIRECTOR.
DR. NAKAJIMA WILL BE LEAVING TODAY, BUT, HIS GUIDANCE REMAINS AND
IS A PART FOR THE REST OF THE MEETING.
I AM SURE, DR. NAKAJIMA, THAT THIS GATHERING HAS AFFORDED EACH OF
US THE OPPORTUNITY OF CLARIFTING MATTERS, AND A GENERAL BACKGROUND TO
BETTER COORDINATE Allf ,IRRY-ON OUF RESPONSIBILITIES.
-
-15-
I WOULD LIKE TO THANK YOU ALL FOR YOUR SHARE IN MAKING THIS MEETING
SUCCESSFUL AND ON BEHALF OF ALL OF US, PLEASE KINDLY ACCEPT, DR.
NAKAJlMA, OUR APPRECIATION FOR HAVING ACCEEDED TO CCME TO SUVA. WE WISH
YOU A VERY PLEASANT TRIP."
Dr. H. Nakajima, Regional Director, in his parting comments,
emphasized once again the need for better coordination as well as the
need for the WHO staff to individually and collectively assume the role
of a manager and leader to achieve HFA/2000. He mentioned several entry
points which vary from country to country, in effectively promoting HFA
as a goal, e.g. PHC, CDD, CilS, HMD. He made the observation that
poli tics and health are inevitably inter-related. He stressed the need
to be as much aware as possible of the political environment which
changes as needs change. He likewise referred to the need for gathering
as much information as possible on the changing community needs.
In closing, Dr. H. Nakajima stated that South Pacific is
important; that, -I;here is a need to keep it peaceful; and, that, this
peace could drive world leaders to the Pacific way.
10. AIMINISTRATIVE MATTERS
This agenda item was presented by Dr. Felszer with the aSSistance
of Mrs. Waqausa and Mrs. Zullah. Several topics were covered. A brief
summary of the presentations and discussions is given below:
Imprest Account:- The WHC' s Imprest Account now has a ceiling of
F$30, 000. The account is used for:
a) the running expenses of the wac's office as well as projects;
b) the provision of fellowship stipends for WHO-sponsored students
at FSM, USP and FSN as well as fellows visiting Fiji for short
courses; and
c) Ad-Hoc fUnds for project supplies and eqUipment.
-16-
The WEC has authority to pay for the local purchase of project
supplies and equipment from the Imprest Account provided, a copy of the
Purchase Authorization for the Internal Commitment is sent to the WEC by
liPRO.
Transfer of Funds:- The number of national workshop", trai ning
courses etc. funded by WHO has considerably increased. Funds for local
costs of these acti vi ties are processed by the WRe, Suva after authority
is receieved from the Regional Office.
Travel Advances:- The WEC has now a US$ account with a ceiling of
US$20,OOO at the Westpac Banking Corporation. US Travellers Cheques will
no lOIl€er be kept in the WEC's Office. The US$ account will meet all
advances being issued in US$ Travellers Cheques as well as reimbursements
of Travel Claims.
Mrs. Waqausa mentioned that, in future, she will arrange .ith the
Westpac for all Travellers Cheques to l,e paid in this office rai cr than
having the staff member to visit the Bank.
Supplies and Equipment:- A Flow Chart (Figure 1) showing the steps
involved in the Supplies Services in this region was distributed by Mrs.
Zullah. At present CLOs may purchase expendable items needed for the
day-to-day run~ing of their offices (e.e. typewriter ribbons, pen,
pencils, paper). However, all project supplies and non-expends ble items
like chairs or filing cabinets etc. still required prior approval of the
Regional Office. The request for this approval should be processed
through the Suva Office. When requesting such items, mention should be
made of whether they are locally available or not. If local purchase is
to be recommended,
attached. If only
quotations from three different suppliers should be
one i"'lpplier is available, this should be clesl,y
stated in the transmittal memQrandum to ",'PRO. Local purchase in all
these C6ses has been int<,rpreted to cover purchase in all the Pacific
Island countries.
- I
-,
-17-
Pro blems associated with photocopying machines were discussed at
length. The CLOs in Apia and Tarawa said that it was not possi 1;le to
obtain proper services in their countries and, as a consequence, their
machines were often inoperative for long periods. The CLO for Honiara
pointed out that, even when service was available, it was extremely
expensive. In his case, it costs $1,000 a year to maintain and operate a
photocopying machine.
The meeting felt that the Regional Office should be more
sympathetic towards the needs of the island countries for new
photocopiers. A photocopier is now an essential item of office equipment
like a typewriter, and it is extremely difficult for the office to
operate without a working photocopier.
The me~ting felt that provision for a supply of a photocopy macbin~
should automatically be included in the Biennium Budget when it is
prepared.
WHO Workshops in South Pacific Countries:-
1) Most problems are related to the time factor - from the moment
the candidate is selected and FAFs or WP/93 submitted. If time permits,
all documents are sent by pouch otherwise tickets are authorized by PTA.
2) Specific problems related to visas for fellows travelling to
American States. For Solomon Islands, at present, this means provision
of a ticket 1 month before departure dates. There is also apparently a
special form available for completion from WHO. This is to be supplied.
3) Travel advances are a problem in Tonga and may require an
emergency supply of travellers cheques being held by CLO.
4) When travel and itinerary have been approved, CLO should advise
WHO/Suva about ETA and movements of fellows. Otherwise, problems
including delays cannot be avoided.
-18-
5) Delays in funding for workshops, etc. are usually related to
lateness of Government requests and processing of exchange of letters.
6) A checklist for all staff involved in processing of fellowships
was recommended.
7) ICP staff should not get involved at the national level in
discussions on per diem for workshops, as this can create confusion.
11. PROPOSED TRAVEL PLANS OF rcp STAFF IN 1986 (ANNEX 5 (A-D))
The functions of each
discussed by each team leader.
rcp team, and the areas covered were
Individual discussions between ICP staff
and CLOs were suggested in order to discuss specific problems, and the
suggested timing of visits to individual countries. CLOs were requested
to clear the proposed travel plans of ICP staff with the governments of
their respective countries. The proposed travel plans, with necessary
amendments will later be submitted to WPRO for final approval.
A summary of proposed travel in 1986 is presented in Table 2.
11.1 Health Surveillance and Trend Assessment - ICP/HST/OOI
Dr. H. Mehta
Dr. G. Cuboni
Mr. F. Reusar
Mr. C. Allen
Annex 5 A
Annex 5 B
Annex 5 C
Annex 5 D
It was explained Hat HST involves more than just health
stab stics; it also covers :he gross epidemiology of disease especially
communicable diseases. These functions must be treated coherently as one
and should not be separated.
CDD and EPI prog'~es are well underway in all countries while ARI
and Hepatitis B projec1 :'e at the situation analysiS stage.
-19-
Vector-borne disease control is now an integral part of the HST
programme. This unit is able to provide maintenance and supply of
equipment and operational support to countries.
Basically, there is a greater concentration by the team on priority
programme areas as distinct from pure hospital morbidi ty and morteli ty
statistics.
11.2 Maternal and Child Health/Family Planning - ICP!MCH/003
Dr. R. Esmundo Annex 5 E
The presentation centered mainly on the monitoring and reporting
requirements of UNFPA in general and the timing of submission of
moni toring reports in particular as well as the suggeated schedule for
project formulation and submission of project request. Problems with
improving implementation rates were discussed and it was felt that WHO
could effectively assist in improving implementation rates.
It was suggested that ICP!MCH be authorized to participate in
semi-annual operations review of each project bipartite reviews to be
held at an appropriate time prior to the preparation of the semi-annual
Project Progress Report (PPR) which is the single most important input
into tripartite project reviews (TPR). It was likewise suggested that an
early TPR (first quarter of the year). properly planned and organized to
the extent that it yields a realistic implementation/utilization plans
for the year, would give governments and WHO more time during which
planned activities can be successfully implemented and corresponding
resources fully utilized.
11.3 Noncommunicable Disease - lep/NCD/OOI
Dr. K. Gee Annex 5 F
Major efforts are at present concentrated on prevention and
management of rheumatic fever, diabetes and cardiovascular disease.
Particular attention is given to the training of peripheral workers,
Increasing attention is being ~aid to cancer control,
-20-
The HST and NCD teams proposed that all requests for travel to any
country be made 6-8 weeks prior to aDY visit to ensure clearance by and
readiness of Government for the visit.
11.4 Nutrition - ICP/NUT/OOI
Nutritionist - to be recruited
(Suggeeted activities were listed (Annex 5 G)
Most nutritional problems are divided into two groups:
(1) Infant: due to inadequate feeding
(2) Adult: due to overfeeding.
There is no Nutritionist at present with the ICP teR!'".
It was strongly recommended that a sui table nutri tionist be made
vailable who would coordinate at all times with MCH and NeD programmes.
In most countries, progress largely depends on policy decisionR
supporti ve of developing a more effective intersectoral structure which
can deal with the country's nutrition and related problems.
11.5 'E'ssential Drugs and Vaccines - ICP/EDV/OOI
Mr. H. Stephenson Annex 5 H
There has been a change in direction of this programme, moving away
from the original idea of setting up a bulk storage facility.
Priorities now lie with prcYiding an essential drug list,
m:magement training and the setting up of a sui table bulk purchasing
agency.
A seminar to review and prepare a list of essential drugs including
dosages and indications was recommended.
Microcomputers are recommended for maintaining
warehousing facilities and supply status.
better drug
II
I I
I' I
-21-
11.5 Community Water and Sanitation - ICP/CWS/OOI
Mr. T. Videnov Annex 5 I
Emphasis in the South Pacific will De on:
(a) Promoting IDWSSD activities;
(b) Developing advisory services to countries on aspects C'''
environmental health; and
(c) Developing, with the occupant of the new position of
training specialist, a series of workshops on appropriate
technology.
In view of the large number of countries requiring assistance, tn"
WRC noted that it is imperative that a second Sanitary Engineer join th~
Suva-based CWS team.
He also made the observation that the Vector Control Specialist of
ICP/HST would more appropriately be with the ICP/CWS team.
11.6 Leprosy - ICP/LEP/OOI
Dr. J.W. Lee Annex 5 J
Generally, the situation in the Pacific is improving. Most cases
are of the tuberculoid type and are quickly responding to multiple drug
therapy.
It was stated that funds were readily available for workshops,
training and supplies and countries have been encouraged to put forward
their proposals.
11.7 Primary Health Care - ICP/PHC/002
Dr. C.T. Palmer
Mr. P. Hedrick
Annex 5 K
Annex 5 L
Nurse to be recruited Annex 5 M
Health EdUcator to be recruited Annex 5 N
-22-
Generally, most countries in the South Pacific have introduced the
concept of primary health care into their health programmes from an early
stage due to the approaches along this line by various colonial
governments prior to independence. In some countries, the approach has
been adopted more slowly than in others.
A whole host of programmes and projects interlock through a common
PHC approach.
Health education is now becoming an integral part of the programme
and a health educator will shortly join the team.
Evaluation of health programmes utilizing concepts of primary
heal th care is essential and it is recommended that such evaluation be
undertaken.
A nurse is most likely to join the PHC team and her duties will be
baSically related to health manpower development.
11.8 Administration
Planned travel from Mrs. F. Zullah, Administrative Assistant was
presented (Annex 5 0).
12. INDIVIDUAL DISCUSSIONS BETWEEN CLOs AND ICP STAFF
Indi vidual discussions between the CLOs and rcp Staff on project
and related matters including proposed duty travel plans for 1986, took
place during the afternoon of 15 and 16 August.
-23-
13. RECOMMENDATIONS
The following recommendations were made:
General
1. Joint CLO/ICP staff meetings should be scheduled each year to
improve coordination.
2. There is a need to develop a procedure for making CLOs and ICP
staff more aware of changing concepts with regard to WHO assistance to
countries.
Country Statements
3. Country statements should be cleared through the governments
concerned.
4. Annual technical meetings should be held by WHO Malaria Project
staff from PNG, Solomon Islands and Vanuatu.
5. A post for an ICP microbiologist based in the Suva Office should be
esta blished.
6. A micro-computer expert is required in the Suva Office for two
months to develop applications which are common to the Pacific Island
countries.
7. For planning and budgeting TTPI should be treated as four separate
entities.
8. The close coordination between WPRO and the Suva Office is needed
to meet the needs of TTPI, Kiribati, Tuvalu and the French-speaking
countries.
9. The establishment of a CLO post to serve the TTPI area should be
studied.
-24-
Monitoring and Implementation
10. Joint WHO/government programme reviews are to be encouraged.
11. More frequent use should be made of updated budget status reports
and auxiliary documents, to improve programme monitoring and
implementation.
12. Development of a modified budget status report which could be
released to governments should be considered.
13. More care needs to be exercised during the original planning
process in order to reduce subsequent requests for re-programming.
14. Updated budget status reports and relevant fellowship monitoring
details should be included in the briefing documents of senior officials
visiting countries.
Fellowships
15. Medical clearances and photos are required with all FAFs submitted
by CLOs.
16. Fellowship review lists need to be issued more frequently by WPRO.
These are to be kept up-dated by CLOs.
17. More care needs to be exercised in the selection of students for
the Foundation Year at the University of the South Pacific.
18. For
required;
short courses and
specifying what the
study tours detailed statements
fellow needs to learn and how
information is to be put into use.
are
the
-25-
19. The Regional Office should carry out an extensive evaluation of the
programme including these aspects:
(a) method of selection of fellows;
(b) arrangements for determining stipend rates;
(c) how to reduce number of drop-outs;
(d) assessment of how well the programme meets the needs of
the countries.
Transfer of Funds
20. CLOs as a matter of routine should include details of the account
to which local costs are to be paid.
Travel Advances
21. The adminis tra ti ve assistant was encouraged to pursue her idea of
obtaining travel cheques from the Bank and paying them in this Office
rather than having the staff member visit the Bank.
Supplies and Equipment
22. A photocopier for each CLO's office should be provided in each
biennial budget as a matter of course.
23. A driver's position should be provided for the CLO's Honiara Office.
14. CLOSING CEREMONY
Dr. M. Felszer, IiRC, Suva, closed the meeting with the following
remarks:
"TODAY WE HA VE REACHED THE LAST STAGE OF THE MEETING. I HOPE IT
HAS BEEN OF BENEFIT TO ALL INVOLVED AND OF HELP TO IRON OUT MATTERS AMONG
CLOs, ICPs AND THE ADMINISTRATIVE STAFF. THIS FOR THE TECHNICAL SIDE OF
'rHE MEETING.
\ ,
-26-
FRCM THE PERSONAL POINT OF VIEW, I TRUST~HAT EACH AND E VERYCNE HAD
THE CHANCE TO HA VE HAD A HEART TO HEART CON VERSATION WITH THE RD. SO
MUCH, FOR THE OVERALL PURPOSE OF THE MEETING, AND AS A BY PRODUCT, I HAD
IN MIND TO OFFER YOU A BREAK FRCM YOUR ISOLATION AT DUTY STATION AND TO
HELP TO SMOOTH OUT MATTERS, WHICH REQUIRE ;·!oRE THAN MlliOS OR TELEPHONF;
CALLS, THE HUMAN APPROACH.
I ALSO WANTED TO AFFORD THE OPPORTUNITY TO THE STAFF BASED IN SUVA
TO RECIPROCATE, THE ASSISTANCE, HOSPITALITY AND KINDNESS, THAT EACH OF
YOU EXTEND WHEN WE VISIT YOUR ISLANDS.
NOW, I WOULD LIKE TO KINDLY ASK YOU, FOR YOUR CrnMENTS OF THE
USEFULNESS OF HOLDING THESE MEETINGS ON A MORE OR LESS RffiULAR BASIS, IF
YOU HA VE BENEFITTED FRCM THIS ONE AND IF THESE MEETINGS WILL CONTINUE TO
BE HELD IN THE FUTURE HOW BEST TO CONDUCT THEM, TO ACHIEVE THE MOST OF
THEJi! • PLEASE FEEL FREE TO WRITE YOUR CCMMENTS ONCE YOU HA VE REACHED YOUR
DUTY STATION.
THANK YOU VERY MUCH FOR YOUR COLLABORATION AND ON BEHALF OF THE
SU VA STAFF, WE WISH YOU A VERY PLEASANT TRIP BACK."
-27-
LIST OF PARTICIPANTS
Dr. Hiroshi Nakajima, Regional Director, WPRO
Dr. Mario Felszer, WHC, Suva
Dr. M. Gonzalez, CLO/ Vila
Dr. N.U. Rao, Acting CLO, Nuku'alofa
Dr. A.D. Parkinson, CLO/Honiara
Dr. Tin Maung Maung, CLO/Apia
Dr. I. Soetjahja, CLO/Tarawa
Mr. H. Stephenson, ICP/EDV/OOI Project
Dr. C.T. Palmer, ICP/PHC/002 Project
Mr. P. Hedrick, ICP/PHC/002 Project
Dr. R.W.K. Gee, ICP/CVD/OOI Project
Dr. J.W. Lee, ICP/LEP/OOI Project
Dr. R. Esmundo, ICP /MCH/OOI Project
Mr. T. Videnov, ICP/CWS/OOI Project
Dr. H. Mehta, ICP/HST/OOI Project
Mr. F. Rousar, ICP/HST/OOI Project
Mr. C. Allen, ICP/HST/OOI Project
Dr. G. Cuboni, ICP/HST/OOI Project
Mr. L. Belz, TON/CWS/OO6 Project
Mr. Chester Lao, STC, TON/CWS/002 Project
Mrs. F. Zullah, AA
Mr. L. Waqausa, AA
ANNEX 1
, I
-28-
ANNEX 2
AGENDA
STAFF MEETING OF CLOs AND ICP STAFF,
15 - 19 AUGUST 1985
Thursday, 15 August
1.
2.
Welcoming Address - Dr. M. Felszer
Opening by Regional Director
3. Objectives of Meeting and WHO Collaboration
in the South Pacific - Dr. M. FelsZfr
4. Regional Issues - Dr. H. Nakajima
* * * B REA K * * *
5. Projected Country Activities and Required rcp Support in 1986.
(Half the allotted time should be devoted to
the statement and half to discussion).
WESTERN SAMOA
VANUATU
TONGA
Dr. Tin Maung Maung
Dr. M. Gonzalez
Dr. N. U. Rao
8.30 a.m.
8.35 a.m.
8.40 a.m.
9.00 - 10.00 a.m.
10.30 - 11.00 a.m.
11.00 - 11.30 a.m.
11.30 - 12.00 noon
* * * L U N C H B REA K * * *
6. Individual Discussions between CLOs and
rep Project Staff
***
2.00 - 5.00 p.m.
***
Friday, 16 August
5 Cont. Country Requirements
5.
5
6.
7.
Cont.
Cont.
SOLCMON ISLANDS
KIRIBATI
COOK ISLANDS
Dr. D. Parkinson
Dr. I. Soetjahja
Dr. R. Esmundo
* * * B REA K * * *
Country Requirements
FIJI Mr. p. Hedrick
T.T.P.I. Dr. C. Palmer
AMERICAN SAMOA Dr. J.W. Lee
TOKELAU Mr. H. Stephenson
NIUE Dr. H. Mehta
* * * L U N C H B REA K * * *
Country Requirements
TUVALU Mr. C. Allen
FRENCH POLYNESIA Mr. T. Videnov
WALLIS AND FUTUNA Mr. F. Rausar
FILM ON PRC IN KIRIBATI
Cant. Individual Discussions.
*** *** *** -* *** ***
8.30 9.00 a.m.
9.00 - 9.30 a.m.
9.30 10.00 a.m.
10.30 - 10.55 a.m.
10.55 - 11.20 a.m.
11.20 - 11.35 a.m.
11.35 - 11.50 a.m.
11.50 - 12 Noon.
1.30 - 1.45 p.m.
1.45 - 2.00 p.m.
2.15 - 2.30 p.m.
2.30 - 4.00 p.m.
-30-
Saturday, 17 August
8. Implementation and Monitoring of Projects in
Countries of South Pacific
9. Fellowships
10. Parting Ccmments
Dr. C.T. P'l.lmer
Mrs. F. Zullah
Dr. H. Nak',.jima
* * * B REA K * * *
11. Administrative Matters
Monday, n August
Dr. M. Felszer
Mrs. L. Waqausa
Mrs. F. Zullah
12. Travel Plans of ICP Staff in 1986
(i) WHO Workshops in Pacific Countries
(ii) HST Project
(iii) MCH Project
(v) Nutrition
Mrs. L. Waqausa
Dr. H. Mehta
Dr. R. Esmundo
Dr. C. T. Palmer
* * * B REA K * * *
( vi) E.D. V. Project Mr. H. Stephenson
( vii) C.W.S. Project Mr. T. Videnov
(viii) Leprosy Project Dr. J. W. Lee
(ix) PHC Project Dr. C.T. Palmer
(x) Administration Mrs. F. Zullah
* * * L U N C H B REA K * * *
13. Summary and Recommendations - I'r. M .. Felazer
14. Closing Ceremony Dr. Itt. Felszer
8.,0 - g.30 'l.m.
9.30 - 9.50 a.m.
9.50 - 10.00 a.m.
10.30 - 12.00 Noon
8.30 - 8.50 '. fi.
8.50 - 9.30 a.m.
9.30 - 9.40 a.fi.
9.50 - 10.00 a.m.
10.30 - 10.40 a.m.
10.40 - 11.00 a.m.
11.00 - 11.10 a.m.
11.10 - 11.40 a.m.
11.40 - 12.00 noon
1.30 - 2.30 p.m.
2.30 p.m.
..J.
ANNEX 3 A
s. PROPOSED COUNTRY ACTIVITIES AND REQUIRED rcp SUPPORT IN 1986
5.1 AMERICAN SAMOA - Summary of WHO collaboration required in 1986
With the annual health budget per person of more tt.an $230 (Fiji,
$40), the Government of American Samoa has one of the largest health
budget per person in the South Pacific. However, about 12%, or more than
one million dollars are spent on the referral treatment outside the
territory, mainly in Hawaii. Also specialized health services are
largely provided by the short and long term recruits from overseas.
The needs to train and retain sufficient number of the indigenous
people to replace the overseas recruits, and contain the referral cost
has been an important goal for the health policymakers in American Samoa.
HMD
The development of a self-reliant health system is the one area in
which WHO will mainly be collaborating in 1986-1987. For the purpose,
the total amount of $115,000 will be spent on providing fellowships.
MCH/Family Planning
The health authorities expressed interest in the field of health
education in the context of MCH/Family Planning. The MCH team in Suva
will address the needs on the basis of individual request.
ICP/LEP/OOl
The Leprosy Advisory Service received an urgent request for leprosy
drugs on two occasions in 1985. The result of the drug shortage was most
probably due to less than perfect management rather than the dire
financial difficulty. In 1986, a participant will be invited for the
planned Leprosy Workshop in Suva in October.
Also, the Iep team could visit American Samoa to follow-up their
leprosy programme.
I
-32-
NCD
The health authorities have expressed on several occasions their
interest in estatlishing collaboration with w'HO' s Non-Communicable
Disease (NCD) activities. In view of the fact, that the coronary heart
disease (CHD), and cancer are the numbers one and the third causes of
death and the hypertension and diabetes mellitus are the important cause
of morbidity, the close collaboration in this field in 1986 is deemed
necessary •
General Comments
Leadership of the health programme in American Samoa has
traditionally been a political issue. With the recent election of a new
Governor, a new Director of Health who seems very receptive to WHO
cooperation has been appointed.
CLO/ Apia will visit American Samoa to discuss WHO cooperation.
It was noted that the US Public Health Service and Centres for
Disease Control are active in American Samoa resulting in little demand
for WHO cooperation in communicable disease programmes.
Specific Comments
Ess~ntial drugs and vaccines
ICP/EDV/OOI will visit to discuss drug procurement.
-33-
ANNEX 3 B
5.2 COOK ISLANDS Summary of WHO Collaboration required in 1986
Programme Areas
Primary Health Care
Community Water Supply and Sanitation
Leprosy
Non-communicable Diseases
Health Situation and Trend Assessment
Maternal and Child Health/Family Planning
Aims Needs
Assess PHC activities One visit by Dr. C. Palmer
Develop health informa- Three visits - 2 by tion system; microcomputer Mr. P. Hedrick and 1 by a processing of health data regional staff member
Assess integration of MCH/FP/PHC in the basic nursing training programme.
Assess health education programme
Biparti te review of COK/CWS/OOI
Continue ground water studies in Rarotonga; monitor and support community water supply and sanitation programme development in Southern (particularly Mangaia) and Northern Groups.
Implement workshop in MDT and assess drug supply requirements.
Review of NCD activities; evaluate COK/NCD/OOI
Assess situation and trend of ARI, HBV infections and STD.
Assess EPI/CDD programmes particularly the logistical aspects of cold chain and ORS.
Review organization and operations of vector control programme.
Bipartite review of COK/MCH/001; prepare Project Progress Report (PPR)
Tripartite review (TPR) of COK/MCH/OOl; prepare implementation/utilization plans for 1986.
One visit by Nurse Educator or STC/Nursing Education in collaboration with ICP/MCH/ 001, Suva
One visit by Health Educator
One visit by Mr. T. Videnov
Fulltime sevices of Mr. M. Ramos (STC/Sanitary Engineer up to Feb 86
One visit by Dr. J.W. Lee (10 days, November 1986)
One visit by Dr. K.Gee (1 week, late 1986)
One visit by Dr. G. Cuboni (11 days, January 1986)
One visit by Mr. F. Rousar (12 days, Feb/March 1986)
One visit by Mr. C. Allen (11 days, April 1986)
Two visits by Dr. R.Esmundo (1 week, last week July 86; 1 week, thrid week Dec 86)
One visit by Dr. R. ~smundo
(1 week, last week Apr 86)
I
-34-
General Comments
Although there is no WHO office in Cook Islands, the Government is
very responsive to WHO cooperation and there should be no problem in
ensuring that visits take place as planned.
Specific Comments
MCH/Family Planning
1. Possibly, two to three-week visit(s) [timing and frequency to
be determined by project's work plan for 1986] to monitor ope rations and
provide technical and management suport to training activities of
COK/MCH/OOI and related projects.
Essential Drugs and Vaccines (EDV)
One visit of 2 weeks in April is required to participate in a
workshop on management of the drug supply support system and advise on
the drug distribution system.
-35-ANNEX 3 C
5.3 FIJI - Summary of WHO Collaboration required in 1986
The following projects are likely to be funded by WHO under the
Regular Budget during 1986-1987:
FIJ/MPN/002 -
FIJ/PHC/OOI -
FIJ/HMD/OOI -
FIJ/HMD/002 -
FIJ/HMD/099 -
FIJ/CWS/OOI -
FIJ/NCD/
Managerial process for national health
development
Primary health care
Fiji School of Medicine
Fiji School of Nursing
Fellowships
Rural sanitation facility programme
Dia betes cont rol
Balance
TOTAL
$ 10,000
$ 70,000
$520,000
$ 50,000
$296,000
$ 25,000
$ 25,000
$ 4,000
-$1,000,000
Three long-term staff are being provided for the F311 and it is
possi ble that a Nursing Advisor will spend some time at least at the
School of Nursing. Consultants are being provided for the PHC project,
the F3II, the FSN and the Diabetes Centre.
ICP staff are likely to be involved in a number of Government
projects. Activities envisaged at this stage are set out below. These
activities have still to be cleared by the Government.
PHC
Aims (1) Development of training programmes for health education and
communication aspects of PHC.
(2) Training of trainers and supervisors of community health
Needs (a)
workers.
3 to 4 months of rcp health educator services in close
coordination with family health project.
(b) About 4-6 weeks services of public health administration and
ICP nurse.
(c) Involvement of rCP/PHC/OO2 associate expert if assigned.
/
-36-
Health Information
Aims (1)
(2)
Needs (a)
Implement an information system appropriate for moni toring
PHC activities.
Colla bo rate in thE) processing of health info rma tion on the
F::M compute r.
WHO Statistician is likely to spend 4 weeks on these duties.
Epidemiological Surveillance
Aims (1)
(2)
(3)
Improve the reporting and recording of selected diseases.
Develop a plan of intervention for ARI.
Collaborate in introducing a control programme for
Hepatitis B.
(4) Prepare a plan for providing support for control measures
Needs (a)
for STD.
Divisional training for reporting and recording selected
diseases.
(b) Visi ts by WHO Epidemiologists totalling 3-4 weeks.
(c) Intercountry Training Course for Case Investigation Repr. rt.
(d) \\'PRO to provide assistance in areas of Filariasis, TB and
Mental Health.
EFI
Aims (1) Review vaccine and ORS supplies.
Needs (a) Divisional visits by EFI Field Officer for 3 weeks.
Vector Control
Aims (1) Improve operational aspects of vector control.
Needs (a) Visits by Vector Control expert for 3-4 weeks.
-37-
N on-Communica ble Disease::
Aims (1)
(2)
Needs (a)
( b)
Leprosy
Aims ( 1)
Development of National Diabetes Centre.
Study overall problem of cm in Fiji.
Reg~lar consultation with NCD expert.
Work with Ministry in studying nature and extent of CVD.
Develop Leprosy control programme in Fiji.
(2) International TB/Leprosy seminar in October 1985.
Needs (a) WHO Leprologist to be involved in one Leprosy Workshop in
MCH
Aims
Suva and two workshops outside Suva
weeks.
time involved 3-4
(b) Tripartite review of programme with Government and Leprosy
Trust Board - 1 week.
(c) Assi s t in 0 rgani zing and part i c ipa te in In terna tional
~eminur - 4 weeks.
( L)
(2)
(3)
(4)
(5)
Urldertake joint operational reviews
T riparti te review of MCH/FP programme
M oni toring of Family Health programme being conducted with
the Fiji School of Nursing.
Participate in training activities of FP Association of Fiji
(Western Division).
Review the role of Soqosoqo Vakamarama in health work.
Needs (a) MCH expert to participate as required by the Fiji
Government. A total time of 4-6 weeks could be involved.
I
CWS
Aims (1)
Needs (a)
EDV
Aims (1)
(2)
Need (a)
-38-
Implement Rural Santitation Facility programme.
'';HO Sanitary Engineer ';0 t'e involved with the Environmental
Health Division of the Ministry in the implementation and
follow-up of the project throughout the year.
To review the village pharmacy scheme.
To discuss progress in the drug supply scheme.
Visit of 2 weeks by ICP/En/OOL
General Comments
In the past, activities in Fiji of rcp staff have been ad-hoc
rather than planned in advance. The activities suggested have not yet
been approved by the government.
Specific Comments
Health Information
Difficulties in deciding which type of computer to procure
has delayed implementation.
Noncommunicable Diseases
Cancer control should also be included.
ANNEX 3 JJ
-39-
5.4 KIRIBATI
General Comments
All health acti vi ties are directed towards primary health care.
There are no individual programmes in the Kiribati Ministry of Health and
Family Planning.
rep staff have met difficulties in ascertaining specific needs of
government for their services. It was agreed that tentative plans for
visi ts would be included in the schedules of the various ICP staff.
These plans would be baaed on the perceived needs as outlined in the
Kiribati statement. These proposed visits would be confirmed after
discussion with CLO, Tarawa.
I
-40-
5.5 NIUE
Niv.e is a self-governing country in free association with New
Zealand.
The bulk of the economic assistaLc:e for development and recurrent
expenditure is provided by New Zealand.
The medical services are provided free.
WHO has provided collaboration in the development of the health
manpower through fellowship and training and ancillary services for
Health, MCH, Water and Sanitation and Vector Control.
The 1984-85 budget of US$58,OOO was utilized for manpower
development and purchase of a Toyota Hiace for the MCH project.
Cooperation expected in 1986-1987 will be in the field of manpower
development, provision of vaccines, oral rehydration salts and
insecticide and equifment for vector control, supplies and advC. jOry
services for MCH & FP, water supplies and sanitation.
The Government has already approached WHO for support in
development of plan of operation for the control and prevention of
Hepati tis B.
WHO epidemiologist from ICP/HST/OOI will visit Niue in 1986 to
review, EPI/CDD programmes and other communicable disease problems,
particularly ARI and Hepatitis B, with a view to strengthen control
activities.
Budget: specific allocation is not made in the 1986-87 Regular
Budget. However Government requests will be met on their merits from
Regional and rcp budget allocations.
-41-
5. 6 SAMOA - Summary of WHO Collaboration required in 1986
Primary Health Care
Aims (1) To conduct National Workshops at the National and District
level.
(2) To involve the community in primary health care project such
as water supply and sanitation.
(3) To evaluate primary health care awareness and activities.
Needs (a) Intercountry staff on primary health care to assist in
conducting a national workshop at the national level
espeCially to promote intersectoral coordination (2 day
workshop)
(b) To conduct primary health care seminar at the district
level, especially to promote community participation (2 x 2
day workshop). This district level seminar to be assisted
by Primary Health Care and ICP Staff.
MCH/Family Planning
Aims (1)
(2)
Needs (a)
To conduct the tripartite review.
To conduct a situation analysis of the project on needs.
Doctor Eamundo to visit for one week to participate in the
tripartite review.
(b) Doctor Esmundo to visit for one week to assist in the
situation analysis of the project.
Health Situation and Trend Assessment (Statistics)
Aims (1)
(2)
(3)
Needs (a)
( b)
To conduct a national health information system workshop,
with EPI as the entry point. ICP/HST Team.
Improve the health situation reporting and recording system.
The use of micro-computer for processing health information.
Three visits by micro-computer experts.
Visit by Kr. Hedrick to participate in the national workshop
on health information.
, I
-42-
Managerial Process for Health Development
Aims (1)
Needs (a)
To advise Governn:ent to improve on managerial process on
health development.
A visit by rcp Staff on Management for one week.
Health Legislation
Aims (1)
Needs (a)
To advise the Government to review and revise present health
legislation in the country.
An STC to visit for one month.
Health Manpower Development
Aims ( 1)
Needs (a)
Oral Health
Aims (1)
Needs (a)
To conduct a comprehensive health manpower development in
the country.
An rcp Staff to visit Samoa for two weeks to conduct a
health manpower needs of the country.
To continue the support to the ~ental nursing training
school.
An rep Staff to visi t Samoa for one week to help in WO' s
further assistant.
Clinical, laboratory and radiological technology for health primary
health care
Aims (1)
(2)
Needs (a)
To continue a support
radiological technology.
on clinical laboratory
To assist in setting up a public health labor" tory.
and
An rcp Staff to assist in the setting up of a public health
laboratory.
Ii ! , I-i
'-
-43-
Essential drugs and vaccines
Aims (1) To assist in management and distribution of essential drugs
supplies.
(2) To assist in bulk purchasing of drugs
Immunization
Aims (1)
(2)
To provide assistance for better coverage of EPI.
To assist in improving the cold chain.
Needs (a) An ICP/HST team to assit in EPI and cold chain activities.
Parasitic Diseases
Aims (1) To conduct helminthic surveys in the country.
Needs (a) An Iep team on parasitic diseases to assist in survey.
Tuberculosis and Leprosy
Aims ( 1)
(2)
Needs (a)
( b)
To assist in MDT in leprosy control.
To assist in situation analysis of TB control.
An Iep Staff to assist in MDT programme.
An Iep Staff to assist in TB control.
Other non-communicable disease prevention and control activities
Aims (1) To assist in disease prevention and control
noncommunicable diseases.
of
Needs (a) An rep Staff to visit Samoa for two weeks to assist in the
Cardiovascular diseases and metabolic diseases.
-44-
General Co=en'-~
Recent major ':anges in the senior staff of the Department of
Health should improve cooperation with WPRO.
The Regional Director noted that a major problem in Samoa has been
frequent staff changes in the Health Department and a limited
understanding of Primary Health Care at senior level. He hopes that the
new leadership would lead to comprehensive health plannj_ng in Samoa.
The Regional Director also expressed concern at the unsatisfactory
results from fellowships in Samoa. It was felt that selection of
candidates for fellowship in the past had been been roor. However, it
was pointed out that selection procedures have now improved.
Specific Co=ents
Primary Health Care
A good co=uni ty participation infrastructure is present in
Samoa. The need is for increased intersectoral coordination. The role
of women is very important.
Two-day workshops are planned as it is difficult to obtain
release of local staff for longer periods.
MCH/FP
The present agreement expires at the end of 1985. Extension
for a further four year period is being negotiated.
HST (Statistics)
Money for a computer haa been available for some years. The
initial need was for improvement in data collection end registration.
Improvement has been slow but it is now of an adequate Jality tv ju~tify
a computer.
-,I
,
-45-
The Regional Director stated that IEM or IEM-compatible
systems are being considered for use.
Health Legislation
Much of the present health legislation is outdated.
Essential Drugs and Vaccines
If a bulk purchasing scheme is established in Samoa, other
country may wish to participate.
Noncommunicable Diseases
The new leadership is eager to develop acti vi ties in thts
programme. Tte Regional Director noted that the cost of drugs must be an
important consideration in the development of NeD programmes.
, ,
ANNEX3 G -46-
5.7 SOL(MON ISLANDS - Summary of WHO Collaboration required in 1986
Health Situation and Trend Assessment
Aims (1) To continue development of a health infrrmation system:
( i) By improving collection of data from the periphery.
(ii) By improving provincial data collection and
processing.
(iii) By improving central data collection, processing and
retrieval
(2) To develop a computerized system for evaluation of data in:
( i) Epidemiological components
(ii) Health managerial aspects.
(3 To assess the impact of the expanded programme of
immunization.
Needs (a) ( i) Provision of an STC for 2 months to assist Government
at the provincial level to initiate and implement the
use of newly designed forms through workshops and
individual rural clinic contact.
(ii) Two visits by Mr. Hedrick or Dr. Cuboni to assist
wi th central data processing and any necessary
adjustments to format.
(b) Provision of a computer programme or instructor for 1 month
when computer is installed if the UNV statistician has not
yet arrived.
(c) A visit from Dr. Mehta to closely look at the EPI system and
assess effectiveness of operations and data collection.
A visit from Mr. Rousal' to look at aspects of cold chain
~anagement at the periprery would also be useful
\ •
-47-
Primary Health Care
Aims (1) To continue development of awareness of the concepts of PRe
at the periphery through
i) area workshops and village seminars
ii) distribution
periphery.
(iii) development
of
of
appropriate li terature to
model village situation
the
for
demonstration of appropriate technology related to
water supplies and sanitation, village hygiene,
vector control, community organization and
communicable disease control.
( i v) assistance with workshops and seminars for the
training of village volunteers for malaria case
management and mass drug administration, T.E. and
leprosy case detection and management and village
health worker training.
(2) Continue network workshops for middle level management.
(3) Continue development of central Hospital Plan.
Needs (a) A visit from Dr. Palmer in May 1986 to assess progress.
Provision of basic texts for village health workers and
volunteers.
Provision of funding for workshops not covered by regular
budget.
(b) Provision of funding for a middle level management workshops
for 20 health workers ••
(c) Provision of funding to develop appropriate technology
demonstration in certain villages and train individuals
particulary women's groups in maintenance of certain aspects
e.g. water supplies.
I
-48-
(d) Provide STC for 2 months to complete Central Hospital Plan
now that a new site has been chosen (Mr. Entwistle).
Health Manpower Development
Aims (1)
Needs (a)
Establish a training system in the College of Higher
Education for Assistant Health Inspectors with the view that
this would include candidates from other South West Pacific
countries.
Provide STC over at least two years to set up and implement
the course and establish base line needs for South Pacific
countries.
(b; Train a trainer to succeed the STC.
MeH/Family Planning
Aims , ~)
Needs (a)
Nutri tion
Aims (1)
Needs (a)
To promote the development of maternal
services at all levels in conjunction
assisted projects.
and child
with the
health
UNFPA
Dr. Esmundo and Mr. Bavelaar to visit for 1 week to assist
with preparation for annual tripartite review.
Undertake national
other government
organizations.
nutrition survey in
ministries and
conjunction with
non-governaental
Dr. Alvarez or Dr. Swaainathan to assist in training
workshops at the national level for staff and to direct
survey.
(b) Additional assistance to that from regular budget for
provinci.al workshops and implementation of the survey.
-49-
Oral Health
Aim (1) Conduct school dental health survey.
Needs (a) Yet to be determined and dependent upon time available to
Chief Dental Officer.
Accident Prevention
Aim ( 1) To conduct a survey of accidents and causes of accidents in
Honiara and in provinces.
Needs (a) Funding for a medical stUdent for a 3 month elective period.
Water Supply and Sanitation:
Aims (1) To conduct a fast finding survey on the impact of wate!"
supplies and sanitation in the community.
(2) To develop appropriate technology for maintenance of wate,'
supply and sanitation projects and link with PHC.
(3) Provide advice on management and development of urban wate,
supply and sanitation needs and development in Honiara, Giza
and Nora townships.
Needs (a) Two visi ts of 2 weeks from Mr. Videnov (1) and (2).
(b) Fellowships for visits to Fiji and Tonga at appropriate
times for 2 Health Inspectors followed Qy visit from
Mr. Bell: or appropriate STC for 2-4 weeks to assist with
development of rural sanitation project in low lying
mangrove areas.
I
-')0-
Essential Drugs and Vaccines
Aim (1) To review and develop appropriate list of essential drugs
for South West Pacific countries.
Need (a) One week seminar involving participants from each country.
Rehabilitation
Aim (1) To develop an appropriate centre for disabled and
handicapped.
Need (a) STC for 1 month to advise on and plan the centre in
collaboration with Ministry of Health and Medical Services.
Vector Control
Aim ( 1) Conduct a seminar on airport vector control in Honiara in
May 1986.
Need (a) Provision of funding and consultants for seminar.
Malaria Control
Aims (1) Review malaria control project.
(2) Assist in training of health staff.
(3) Conduct a workshop for medical officers in malaria control
in Honiara for 2 weeks.
(4) Conduct a training course for malaria microscopists in
Honiara for 6 weeks.
(5) Conduct a workshop for entomology technicians in Honiara for
6 weeks.
-51-
(6) Conduct a trial of mosquito nets impregnated with Permethrim
and a trial of use of anti-mosquito soap.
(7) Conduct drug sensitivity surveys.
(8) Tenth South West Pacific Malaria Conference, May 1986.
Needs (a) Visit from Dr. Matsushima for one week in June.
(b) Provide fellowships for training of 5 health workers in
Madang.
(c) Provide funding for doctors workshop, and assistance from
Mr. storey or another parasitology from Kuala Lumpur for 7
weeks (3) and (7).
(d) Provide funding of courses (4) and (5).
(e) Provide funding for trials as developed in the project
protocol.
(f) Provide support for South West Pacific Malaria Conference to
follow consecutively on VBe.
Tuberculosis and Leprosy
Aims (1) To improve the detection and management of tuberculosis and
leprosy cases.
(i) By conducting national and provincial workshops for
health workers.
(ii) By training volunteers from villages in management of
these diseases utilising concepts of PHC.
Needs (a)
( b)
(c)
-52-
Provision of STC as in project document.
Visit by Dr. Lee in July.
Funding of workshops and provision of materials and logistic
support.
AIDS and Hepatitis B Project
Aims (1)
(2)
Neel}s (a)
( b)
To determine the incidence of AIDS in the community.
To screen bloods from specific groups of foreigners entering
the country.
PrOVision of fellowships for a doctor to visit Australian
laboratories to study AIDS ar.d Hepatitis B detection methods.
Provision of fundiIl8 for and STC to work aloIl8side nation"l
doctor to conduct an epid.~miological survey for s duration
of 6 weeks.
(c) Provision of fundiIl8 for laboratory screening of blood
collected includiIl8 sero-epidemiological survey from
specified areas of Solomon Islands.
Cancer and Noncommunicable Diseases
Aims (1) To establish a cancer registry.
(2) To assess incidence of oral cancer and specific
noncommunicable diseases in specific ethnic groups.
Needs (8) Visit b.Y Dr. Kingsley Gee for 2-3 weeks in August.
(b) STC fro. Lyons for setting up registry.
-53-
General Comments
The statement of requirements was prepared in consultation with the
government.
The WEC expressed concern over cancellation of visits which are
part of approved travel plans. It was noted that some changes are
unavoidable.
Specific Comments
Oral Health
A visit from the RA/ORH may be requested.
Accident Prevention
Guidance from ICP/HST/OOI or ICP/CVD/OOI may be requested.
Water Supply and Sanitation
The Country needs the services of an STC for 11 months to
evaluate urban water supplies.
Cancer and Noncommunicable Disease
SPC has worked in the field of cancer in the Solomon
Islands, but the Government wishes further cooperation to come from WHO,
not SPC.
-54- ANNEX 3 H
5.8 TOKELAU - Summary of WHO Collaboration required in 1986
Projected Activities
Health Situation and Trend Assessment
A national workshop on Health Systems Assessment - to assess new
PHC approach.
Continuation of system of monthly reports and information exchange
on incidence of communicable diseases.
Managerial Process of National Health Development
Training health staff - a national workshop for training tE-'ll th
personnel in new skills required for new PHC approach.
Organization of Health Systems Based on Primary Health Care
A national PHC seminar.
Heal th Manpower
Fellowship (5 months) for training in Fiji in Public Health Nur~ing.
Public Information and Education for Health
A Health Education seminar. (The government may request the
services of a resources person from the Western Samoa Health Department).
Maternal and Child Health
One fellowship (five months) for training in Samoa in midwifery.
Vector and BiOlogy Control
The government lIay request reprogramming of portion of the 1986
budget to provide for the purchase of insecticies for vector control.
This has been funded b,y WHO in the past years.
-55-
Immunization
Provision of EPI vaccines by UNICEF, assisted by WHO.
Required ICP Support
None, other than advice if necessary on controlling epidemics of
communicable diseases, if there is an epidemic.
General Comments
Major problems in communications exist. Managerial capacity is
limited.
Tokelau has expressed interest in participating in appropriate
workshops and training activities held in Samoa.
Specific Comments
Immunization and EPr
An informal request has been made for a visit to review EPr
and Cold Chain activities.
-56- ANNEX 3 I
5.9 TONGA - Summary of WHO Collaboration required in 1986
Primary Health Care
Ai.ms (1) Planning and management of health se~vices
(2) Improvement in the health care delivery to peripheral areas.
(3) Involvement of the Community, in selected areas such as
water supply, diarrhoeal diseases control etc.
(4) Intersectoral collaboration in nutrition, school health
education etc.
(5) Expanded programme of immunization.
(6) Reduction, if not elimination, of the target diseases of EPT
programme.
(7) Training of community health workers.
Needs (a) Assistance from rcp staff for conductng 6 co~!:::'mi ty
participation workshops.
(b) Till the new post of nursing adviser is filled up, rcp staff/STC in nurisng education should spend some time for
strengthening the nursing services.
(c) Support is necessary to strengthen Tonga Health Training
Centre as a national centre for continuing education of
health workers.
(d) Short-term consultants:-
(1) 2 months for continuing education of health officers.
(11) 2 months for curriculum design for dispensary
assistant training.
(iii) 1 month for Dental Health Education.
,-
-57-
Health Situation and Trend Assessment (Statistics)
Aims (1)
(2)
(3)
Needs (a)
( b)
Development of health information system.
Use of microcomputer for processing health information.
Lay reporting of PHC activities.
Two visits of microcomputer expert after it arrives Tonga.
Three visits by the statistician of ICP/PHC/002.
Cardiovascular Diseases and Diabetes Control
Aims (1) Development of NCD programme.
(2) Prevention of rheumatic heart disease (RF/RHD) in Tonga.
(3) Assessment of the need and preparation of a list of supplies
and equipment for the survey and diagnosis of NCD.
Needs (a) Three visits by the medical officer (epidemiologist) of
ICP/CVD/OOl.
(b) Training of PH nurses in NCD case detection.
Pr'omotion of Environmental Health
Aims ( 1)
(2)
(3)
Provide drinking water.
Provision of sanitary facilities.
Monitoring of water quality.
(4) Study the impact of these measures.
:ieeds (a) Need a sanitary engineer as a regular staff or an STC to
cooperate with th government to carry out the above
activities.
( b) rep assistance is needed on vater tanks and solar pumping
installations, depending on funding. Water tanks are
required for lfiuatoputapu, Niuafo' ou and the outer islands
of Vava' u. Solar pumping installations were requested for
15 locations, mainly on Tongatapu.
,
-58-
(c) Assistance from ICP team for vector control programme in
Tonga.
(d) Require an STC to review the curriculum of the health
inspector, Grade II training course. The STC should be
different from the one who wrote the original curriculum.
(e) Two visits by the epidemiologist of the ICP/HST/OOl team:
one to study the impact of improved water supply and
sanitation; second visit to conduct WHO/National Wo rkshop
on epidemiology.
Health Laboratory Technology
Aims (1)
(2)
(3)
Improvement of the diagnostic laboratory service.
Laboratory support for the public health activities.
To cut down on the clinical specimens sent overseas.
Improvement in self reliance.
(4) Strengthen the ac ti vi ties in STD diagnostic service and in
contact tracing.
(5) Improvement in the fUnctioning of T.B. laboratory.
Needs (a) A biochemist (clinical Chemist), preferably an experienced
medical technologist is needed to strengthen this area.
(b) ICP team in tuberculosis is requested to visit for the
assessment of the bactriological work at CPHL.
(c) Funds are needed for eqUipment and supplies and short
fellowship for the laboratory staff.
General Comments
Tonga has received strol18 support from rcp staff. Concern was
expressed that some national staff received more than one WHO fellowship
and sometimes became overspecialized. Whilst countries select fellows,
WHO should encourage middle level trainil18 rather than over
specialization.
'\
-59-
It was also felt that, in some countries, fellowship allocations
had been excessive leading to difficulties in implementation.
Specific Comments
HST (Statistics)
use.
National staff are undergoing
Visits by the statistician will
training for microcomputer
not be required until the
microcomputer is installed.
Noncommunicable Disease
It is not clear who is presently responsible for day-to-day
management of this programme in Tonga.
Environmental Health
Difficulties have arisen in implementing the Health
Inspector Grade II curriculum prepared by an STC several years ago.
Health Laboratory Technology
Several technicians have undergone year-long courses in
Japan but feel unable to implement what they have learnt without
assistance from an expert from Japan.
Pharmacy and MCH/FP support is also required.
-60- ANNEX 3 J
5.:i.O l'RUSl' TERRITORY OF THE PACIFIC ISLANDS Summary of 'mo
Collaboration required in 1986
Health Information and Trend Assessment
Aims (1)
(2)
(3)
Needs (a)
( b)
Develop health information systems to assume
responsibilities devolved from High Commission to Marshalls,
F3'! and Palau.
Train local staff.
Improve communicable disease surveillance.
Two months STC as budget ted for Marshalls.
Suva or Manila ICP statisticians to follow up in Marshalls
and initiate service to FSM and Palau.
(c) ICP epidemiologist to Marshalls and F3'!.
Managerial Process for National Health Development
Aims (1) Follow-up managerial staff and procedures development in F3'!
and Palau.
(2) Develop nursing administration and activities in F3'! and
Marshalls.
(3) Improve programme budgetting all TTPI entities.
Needs (a)
( b)
STCs 2 months each to Marshalls and FSM for nursing
administration workshops, as budgetted.
Preparatory folIc\;- '!) visits
including Palau ir. ,~onnection
workshop.
by ICP nursing adviser,
wi th local costs for MPH
-
-61-
(c) Follow-up visits by MRO probably required (to be decided
following November/December 1985 visits).
(d) Visit by rCP/PHC/002 medical officer tc 511 TTPr entities.
Primary Health Care
Aims (1) FSM: Inservice training to reorient staff to PHC
(2) F5M: further development of PHC community-level projects.
(3) Marshalls: upgrading/PHC reorientation of outer islands
health assistants and their S & E.
(4) Further staff training and programme development for medical
and dental eqUipment maintenance and repair.
Needs (a) Part of FSM's local cost PHC provisions to be used in 1986;
national staff to provide most of technical input but visits
by ICP/PHC/OO2 staff including health education would be
desirable.
(b) Visit to Marshall Islands by rCP/PHC/002 Medical Officer
required in connection with planning optimal use of Local
Cost and S & E provisions.
(c) STC 2 months FSM and/or Mr. Reeves.
Health Manpower Development
Aims (1)
Needs (a)
(b)
(c)
Balanced manpower development utilizing local and overseas
training and requiring health manpower planning.
RA/HiD viSit if possible.
Poll ow-up u"MOR and/or ICP/PHC/002 team.
Pellowship provision to be used consistent with planning.
Nutrition
Aims (1)
-102-
Palau - strengthen nutrition surveillance and intersectoral
collaboration.
(2) FSM - develop infant growth monitoring system.
Needs (a)
MCH/FP
Aims (1)
(2)
Needs (a)
( b)
ICP/NUT/OOl Medical Officer visits and coordination with
expected UNICEF support.
strengthening of proj ec t implementation - Marshalls. FSM.
Palau.
Develo~ing health education aspects.
Visits by Dr. Deodato.
Visits by MCH or PHC health educator.
Alcohol and Drug Abuse
Aime (1)
(2)
Needs (a)
Followup programme development and monitoring in Palau.
Situation assessment in Marshalls and Northern Marianas.
STCs 1 month each Palau. Marshalls and Northern Marianas as
budgetted.
Community Water Supply and Sanitation
Aims (1)
(2)
Planni!l8. training and implementation activities for
community water supply and sanitation in FSM.
Planni!l8 of a submarine outfall for the community in
Marshall Islands.
Needs (a)
( b)
-63-
Regular budget consultancies plus UNDP funding.
Planning and monitoring assistance from ICP/CWS/OOI sanitary
engineer.
Clinical, Laboratory and Radiological Support
Aims (1) Upgrade laboratories in FSM.
(2) Upgrade water quality testing and radiological procedures in
Palau.
Needs (a) Consultancies as budgeted.
(b) Mr. Reeves to follow-up consultant month concerning
radiological procedures.
Essential Drugs and Vaccines
Aim (1)
Needs (a)
( b)
Upgrading of purchasing, management and distribution in F::Jt
and Marshalls.
STC as budgeted for FSM.
Mr. Stephenson to follow-up in Marshalls.
Sexually Transmitted Diseases
Aim (1) Situation analysis and programme recommendations in FSM.
Need (a) One STC month with follow-up by ICP/HST/OOI Team.
Cardiovascular and Noncommunicable Diseases
Aim (1)
Need (a)
Assessment and strengthening of existing programmes all
parts of TTPI.
Visit(s) by Dr. Gee.
Leprosy
Aims (1)
(2)
Needs (a)
( b)
-64-
Continued development and assessment of programme in FSM.
Review of situation in Marshall Islands.
Continued extrabudgetary project support to FSM with visits
by Dr. Lee.
One visit by Dr. Lee to Marshalls.
General Comments
A major problem has been lack of communication between the various
states of TTPI and the Trust Territory headquarters.
Some governments are crisis orientated with little long-term health
planning and WHO cooperation may not be requested without some
stimulation by WHO.
The extent of Suva Office invo 1 v',ment in TTPI in general and
communication problems in particular snould be raised with the Regional
Office.
Specific Comments
Primary Health Care
Palau has not been included as its PHC system is well
advanced and staffed by experienced nationals.
Clinical, Laboratory and Radiological Support
Follow-up by an ICP Microbiologist is needed.
Essential Drugs and Vaccines
The status of request for cooperation is uncertain.
-
-65-
EPI
It was noted that there is increasing involvement with
UNICEF particularly in ORS supply.
Noncommunicable Diseases
A meeting of hypertension coordinators was planned for 1986
and WHO participation may be requested.
Leprosy
A meeting with US Public Health and TTPI Government
authorities will be held in November 1985. The general problem of
communication may be raised during the meeting.
-66- ANNEX 3 K
5.11 TUVALU - Summary of WHO Collaboration required in 1986
WHO has provided collaboration in the development of the Health
Manpower through fellowships an" trRining and ancillary services for
Health, Manternal Chiid Health, Community Water Supply and Sanitation and
Disease Prevention and Control.
The 1984-85 budget of US$75,OOO was utilized for development of
PHC, manpower development, community water supply and sanitation and
disease prevention and control (filariasis and intestinal parasitic
survey) .
Cooperation expected in 1986-87 will be in the field of:
(1) organization of health systems based on primary health care;
(2) health manpower;
(3) maternal and child health including family planning and
(4) community water supply and sanitation.
The WHO Sanitary Engineer from ICP/CWS/OOI plans to visit Tuvalu in
1986 to review the community water supply and sanitation programme.
The WHO Technical Officer for lJector Control ICP/HST/OOI plans to
visit Tuvalu in 1986 to coordinate with the Government on the operational
aspects of vector control.
Budget: The 1986-1987 Regular Budget allocates a total of
US$35,OOO for Tuvalu; with the follwing breakdown:
( 1)
(2)
(3)
Development of PRC
Heal th Manpower
Community Water Supply and Sanitation
1,800
31,400
1,800
35,000
It is noted that no provision has been made from the Country budget
for filariasis control. Therefore, it is envisaged that any request for
support will necessitate use of intercountry fUnds.
-67-
Specific Comments
MCH/FP
Visits by Dr. Deodato (Manila) will be required to prepare Fl
project progress report and to carry out a tripartite review.
Communicable Diseases
One 2-week visit to do a situation analysis of ARl,
hepatitis and diarrhoeal disease.
control.
Prima~ Health Care
One 2-week visit to review vector
A visit of 1-2 weeks may be required for the national PRC
follow-up workshop.
Essential Drugs and Vaccines
A one-week visit to review drug supply and ordering, and to
establish an essential drug list.
-68- ANNEX :l L
5.12 VANUATU - Summary of WH0 Collaboration required in 1986
Technical collaboration between Vanuatu and WHO has increased
steadily in the last years and had covered practically every area of
health or related services.
The 1986-1987 Programme Budget was prepared taking into account
priori ty needs for the rapid development of health services based on
primary health care, the availability of funds and the absorptive
capacity of the country. Sufficient room was left for a more effective
and ample utilization if rcp staff and Regional Advisers and external
staff was proposed when ours was not available or the need was too
lengthy.
Now the time has come to present Vanuatu's needs of rcp and RA
staff for the year 1986.
The summary of WHO collaboration that follows as attached is t·.e
result of a two way dialogue between WHO local staff and Minist' -.If
Heal th officials, that is, decision makers and relevar. ~ department ht· : s.
Some dates were proposed and are reflected whe~:ever it was thought
necessary, flexibility permitted. Others which were not precisely
required at a certain time were left for later discussion.
Whenever B.n STC or Temporary Adviser had funds allocated, this was
reflected as (RB), in other cases the unavailability of funds was also
stated.
Some consul tantships were considered premature for 1986 and were
marked in the Programme Budget for 1987 as an internal reminder.
All areas of possible collaboration were covered and duplication
was avoided to the greatest extent possible. In some cases it was
considered that local staff would suffice and therefore the request was
not considered.
It was agreed that the redults of the dis' ~s9ion at rCP/CLO meeting
would serve as the basis for 1986 intercouLt :'y team collaboration to
Vanuatu, together with approved RB 1986-1987.
-69-
Aims (1) Arrange PHC islands workshops
( 2) Conduct PHC evaluation in on-going projects
(3) Conduct data analysis workshop
(4) Organize and support Intercountry workshop
(5) Resource person for PHC workshop for school teachers,
Needs (a) rep Team Dr. K.S. Lee and Dr. C.T. Palmer in March 1985 for
Regional workshop
(b) Dr. C.T. Palmer, PHC workshop for School Teachers in
January, Pentecost and Malekula workshop in March and Tanna
Evaluation third quarter 1986.
(c) Dr. K.S. Lee, February for Data Analysis workshop, in March
for East Ambae. In May for follow-up on North Efafe
development project.
MCH/Family Planning
Aims (1) Undertake Tripartite Review
(2) Review supply needs and assess work of UNVs
(3) Review MCH standards of care at nurse level.
Needs (a) Dr. Esmundo and Mr. Bavelaar to visit for three days
November 1986.
(b) Dr. Esmundo visits January and July 1986,
(c) Nurse from SUVa Office or STC to make one visit 3rd quarter
1986.
Health Situation and Trend Assessment (Statistics)
Aims (1) Use of microcomputer for health information and
pharmaceutical serVices
(2) Review reporting system at peripheral level.
,
-70-
(3) Refresher training of local staff.
(4) Follow-up lay reporting activities.
Needs (a) At least three visits by ll[r. Hedrick required.
according to possibilities.
Timing
Nursing Advisory Services
Aims (1)
Needs (a)
Review and restructure nursing curriculum and
Practitioners Programme.
nurse
Temporary Adviser, Ms. J. Bentley for 3 months early 1986
(RE) •
Communicable Disease Control
Aims (1) Evaluation of EPI activities
(2) Assessment of Hepatitis B programme and counterchecking of
tests. Propose appropriate technology.
Needs (a) One visit ty Mr. F. Rousar preferably by third quarter 1986.
( b) One visit by Dr. H.S. Mehta. Date according to
possi bili ties.
Laboratory Technology for Health Systems Based on PHC
Aims (1) Develop standards for clinical, diagnostic methods in
laboratory technologies.
(2) In service training for laboratory technicians.
Needs (a) Combined visit STe for development of standards and
in-service training by second quarter 1986 (RB).
-71-
Health Education
Aims (1)
Needs (a)
Training of local staff, eleven nurses in health education
techniques, ~ourse of six months duration, 1 month of
initial preparation, 3 ms theoretical and 2 ms practical.
STC Mrs. L. Zamora funded by UNFPA, VAN/MCH/OOl, early 1985.
Health Legislation
Aims (1) Propose definite National Health Act to be adopted.
Needs (a) One STC for 1-1/2 months mid 1986.
Malaria Control
Aims (1)
(2)
Needs (a)
( b)
Nurition
Aims (1)
Needs (a)
Food Safety
Aims (1)
Needs (a)
Mapping of chloroquine resistant baseline data and training
of in-vitro drug sensitivity.
Overall programme evaluation.
Visit of Mr. J. Storey or Dr. K.L. Palmer Jan-Mar 1986.
Visit of Dr. T. Matsushima not later than mid 1986.
Evaluate programme and advise Government on measures for
improvement.
One visit by Dr. Swaminathan by third quarter 1986.
Increase national capability in food control.
One STC to conduct local trainiDB (no local coste funds
available) •
. ,
Leprosy
Aims (1)
Needs (a)
Oral Health
Aims (1)
Needs (a)
-72-
Case detection at Northern District (Santo).
Visi t by Dr. J. W. Lee at least once a year for a period of
two weeks.
Training of supervisory functions for dental therapists.
One STC, two months 1986 (RB).
General Comments
It WIotS stressed that the health service in Vanuatu, and in many
other island countries, depends on nurses who are the entry point to
health care for most of the population. It was emphasized that a nurse
is required to present WHO views effectively to the nursing profession.
Vanuatu is training nurse practitioners to replace expatriate
doctors working as health administrators.
Specific Comments
Communicable Disease Control
Mr. Rousar's visit will now be required before the third
quarters of 1986. The Regional Director noted that the terms of the EPI
review may be broadened to review the general health situation and
infrastructure of the country.
Laboratory Technology
The need for an Iep Microbiologist was expressed. Inservice
training and supervision of laboratory standards is lacking in many South
Pacific countries.
-73-
Health Education
Attempts will be made to unify the health education aspects
of MCH, PHC and other programmes. Follow-up of STC ac ti vi ties may be
undertaken by the ICP health educator planned for the Suva Office.
Health Legislation
The last STC visit was untimely.
Malaria
There has been no overall evaluation of the programme.
Interchange of experience between staff in Vanuatu, PNG and
Solomons would be valuable.
Nutri tion
In 1986, the pot of Medical Officer for Nutrition is likely
to be based in Manila.
-74- ANNEX 3 M
5.13 FRENCH POLYNESIA - Summary of WHO Collaboration required in 1986
WHO has p:-ivided collaboration in the development of health
manpower through fellowships and trai ning as we 11 as consul tancies for
the other sectors of the h"ealth services. Total WHO contribution for
1984-85 is $86,000.00.
Earlier this year a visit was made by tr.e WHO Epidemiologist to
cooperate with the Government in the preparation of the 1986-1987 WHO
Budget Estimate and Evaluation on the strategies for Health for All by
the Year 2000.
WHC, Suva visited Papeete in July this year and carried out
comprehensive discussions with the Government on the current WHO
collaboration.
The problem of amoebic dysentry and hepatic abscesses in the
archipelago of Tuamotu has been discussed. The possi bi li ty h.s been
considered for prOVision of a team Sant tary Engineer and Epidemiologist
to cooperate with local staff for carrying out studies on the water
sources contamination.
The possibility has also been considered for provision of a
computer terminal and software for leprosy control programme work.
The cooperation expected in 1986-1987 will be in the field of
manpower development and prOVision of STC for the other sectors in
particular, nutrition, oral health, MCH, community water supply, food
safety as well as development of the National Health Information System
and expanding of the immunization programme. The total amount of $70,000
is envisaged for 1986-1987.
General Comments
Language is a problem for maDY ICP staff but the Government is keen
to increase WHO cooperation.
-75-
Specific Comments
Health Surveillance and Trend Assessment
One 2-week visit jointly with the sanitary engineer to
investigate amoebiasis. This may be undertaken by an ICP staff or an STC.
One 2-week visit to discuss vector control.
Community Water Supply
One 3-week visit to investigate environmental aspects of
amoebiasis.
MCH/FP
A possible visit to discuss childhood mortality.
Leprosy
A visit has been requested for 2 weeks. This may be
undertaken by an STC or ICP/LEP/OOI depending on language needs.
Noncommunicable Diseases
Follow-up visits by an STC or rcp staff for rheumatic heart
disease and cancer control may be required.
Health Information
One consultant may be required for the three French-speaking
Pacific territories.
I'
-76- ANNEX 3 N
5.14 NEW CALEDONIA - Summary of WHO Collaboration required in 1986
Control of Communicable Diseases
Sexually Transmitted Diseases
Aims (1) Investigate disease determinants for gonorrhoea, syphilis,
chlamydia, and others as feasible.
(2) Appraise drug-resistance patterns of selected infectious
agents.
(3) review current disease control procedures.
Needs (a) Visit(s) by ICP/HST/OOl Epidemiologist, to follow-up STCs
assignment (1986) and cooperate in design/cunduct of S~D
survey.
Leprosy Control
Aims (1)
Needs (a)
Make protective footware readily available to leprosy patients
Visit by ICP/LEP/OOl Leprologist, to review control
activi ties, and, among others, utilization of shoeshop
supplies from WHO.
Epidemiological Surveillance/He~lth Information System
A.R.I.
Aims (1)
(2)
(3)
Needs (a)
Review ARI pattern in the territory.
Review ARI control procedures in the territory
formulate recommendations towards a comprehensive ARI control
programme.
A visit by ICP/HST/OOl Epidemiologsit.
-77-
CD Surveillance/Health Information System
Aims 1) Overhaul the health information system,
notifications
particularly CD
(2) Integrate said system in the existing computer services
available to Public Health.
Needs (a) Simultaneous visit by ICP/HST/OOI Epidemiologist and
ICP/PHC/002 Statistician.
General Comments
A changing attitude towards WHO collaboration has been noted.
Previously, WHO collaboration was mainly confined to occasional STC
visits. Some follow-up visits may be required. Political instability
may affect cooperation in 1986.
Specific Comments
Communicable Disease Control
A visit of 2 weeks to review vector control is required.
-dl- ANNEX :3 0
5.15 WALLIS AND FUTUNA - Summary of WHO Collaboration required in 1986
This overseas territory of France has a population of 11,300
people. The main sources of personal income are government work and
funds remitted by relatives working in New Caledonia.
Revenue for the territorial budget is derived from import taxes,
licensing of fishing rights to Japan and South Korea, and French
Government subsidies.
There are virtually no exports other than a small amount of Trochus
shell. The trade deficit each year is usually equal to the imports.
Medical services are provided free by the French Government. Good
quality tap water is available everywhere in Wallis Island.
Budget: No WHO budgetary support is provided at present. A CPF
similar to that provided to Tokelau is supported.
Intercountry project resources are available from WHO Suva Office.
Health Information
A visit by a French-speaking STC in statistics is planned.
-79-
Implementation and Monitoring of Projects
In South Pacific Countries
The following comments were made by Dr. C.T. Palmer:
MmEX 4
"I wish to make some introductory remarks concerning implementation
and monitoring, allowing for discussions as we proceed. Please feel free to
interrupt at any time.
We are still using the term "project" because it remains the official
structure for WHO action in countries. It should, however, be kept in mind
that WHO hopes to abandon the "project" approach and concentrate instead on
programmes and activities. Thus we should be redirecting our thinking in
terms of total country programmes of WHO cooperation.
Although WHO will continue to need proper handling of procedures
and financial accountahllity, the more important aspect will be to have effective
overall programmes of cooperation with countries for health development. WHO
is recommending that this be approached through joint WHO-Government programme
reviews. The WHO Representative and Programme Coordinator is the key individual
in conducting these programme reviews. At times he may delegate this to
Country Liaison Officers or perhaps to other staff.
How often should the reviews be held? I would be interested in your
Views on this. I suspect it should be done more often than has been the case
su far in most countries.
Will the countries be receptive to such reviews? While I anticipate
they will be, provided we take a creative and sensitive approach to it, this
is also a matter on which it might help to exchange our views.
Another question is which individuals or units in Government to conduct
joint reviews with. Sometimes it has been convenient to deal mainly with one
or two counterparts. This allows efficiency but perhaps misses the chance of
getting a greater number of Government personnel involved in the programme of
cooperation with WHO. Some of our Governments have weaknesses in internal
communication about programmes, so perhaps we should be stimulating stronger
communication. There are also sometimes changes in personnel, so it may help
to have others well briefed in addition to the present main decision-makers.
-80-
In as much as these reviews are considered to be a significant
activity, it LS strongly recommended that they be documented.
These programme reviews could be useful for specific implementation
and monitoring steps as well as for the broad rev i.ew of overall programme
development. Although documents such as the budget details and budget status
reports are internal WHO documents, the WHO staff involved could prepare pertinent
extracted information from the Government to review. WHO staff should be
prepared to explain implementation and monitoring procedures with emphasis on
the actions required from the Government. Examples would be properly prepared
and timely government submission requesting implementation, whether of STe's,
local costs, supplies and equipment. Reprogramming may also need to be explained,
bearing in mind that WHO can be flexible in entertaining reprogramming proposals
provided they are based on significant needs consistent with the main lines of
health development. Reprogramming of course should not be endorsed too casually;
it is preferable to do good initial programming :lild follow it up faithfully unleso>
circumstances have changed so as to justify reprogramming. It appears in particu:
that ad hoc requests for supplies and equipment may be screened more strictly in
the future.
When reprogramming LS to be considered, it is often necessary to
explain to the Government that they have to specifically request reprogramming,
and indicate the source of reprogramming. If the source is unclear, one
technique which sometimes works is to give alternatives in the Government
request and let the Regional Office choose its preference.
It is worth while keeping track of the details of \';PRO responses to
implementation and reprogramming requests, since their decision on amounts and
source of funds may differ from the details envisaged at the time of the request.
These responses are usually found first in programme committee minutes or poll
requests and later reflected in the budget status reports.
BFO LS now attempting to put out budget status report every two months,
but by the time we get them there have often been subsequent changes. WRC, Suva,
is working on monitoring systems to keep track of these subsequent actions,
but he does not currently have adequate staffing to keep it as current as
might be desired. Thus it is suggested that eLO's do their own monitoring as
double check.
I I
-81-
To conclude my introduction, I believe that most of us have
recently been heavily involved in promoting implementation and monitoring
of thc 1984-1985 programmes in the fact of deadlines for making use of tht
available provisions. I want to suggest that the time has arrived to begin
working on advance steps for the 1986/87 programmes."
-82-I I
ANNEX:> A ------
PLA[',NEO ACTIV).TlES
··'~E : DR, H. :-fUIlA 1'J{OJCCT: Iep HST 001 [,EReOLJ: JA:-il.:ARY 198b TO ['I·:C [:~fBEJ{ 198b -:-f,\ J l\ ACT I V I /1' SHUK'! OESCRII'IIOl\ 1.0CA r 1 ul\ !JAIl':
Advisory Servic(' Ass(;ssment of the implementation of Tonga 18- J 1 J.L t t c.,." r y ;'fogramme planning EPl/ClJD programme evaluation recommend f-
a t ion made in March 19~k Deve 1 op iurtb.ar work ulan LorI
Advisory service/programme Preparation of protocol for EPl!CDD Kiribati 15-23 February planning and operations programme evaluation
Programme evaluation comprehensive review of EPr ~rogramme Vanuatu 10-28 ~Iar('h
with some components of COD, Xlso coverage survey
EPI/CDD/HBV Operations EPI Post review implementation Western SamOd lb-~~ APl'j:
of recommendations assessment
- I
Advisory service Post review implementation of Solomon Islands 7-18 May (,,'ogramme planning and EPl target diseases surveillance (),)erations. and operations assessment
H,)me Leave Homt' Leave Un it "d Ki ngdom 2') JcJ:lc' t " 02 St.'j)t "Il\bl'r
- -
I
EPI!CDD/HBV EPI/COD post review meeting Vanuatu 15 S"I' t "tnber tll operations Uev~jop HHV plan of opt'fation 2fl S"I,~·'mber
l .- - - --- ---- --
I- Ix : .. p; l2
PLA~~ED ACTIVITIES
NAHE UR. H. 'IEHL\ pKOJECT: Iep HST 001 PERlOD: .JA~U'\RY 1 'ibh Ttl 1J!:n::,tIlER 1986 --. -.-. ---.-. -----.---- r --- -. --'- ,.---.--.. --------1 MA.rN ACTIVITY SHORT D£SCRIPTIO:-l : LOCATION I DATE
---:-Pl ~c~[)-:~uati:l~'-'- :-:~l ~review. m~eting. _ ..• - ~ribal i ---- ----.--. ---~ -1~'-L~--(-)(-.t-·o-t-)e-'r-- ,
trawwg I tPI/CDD tralning I
-1-. ----.+---. l
i Tonga training workers ESD/EPI/CDD Refresher training for peripheral
-------.----t--- ---------- -J-. Annual Leave i
I
Annual Leave I Fij i I
I . ---. .------- --1 ----·-r--r--- -------- -----~.- 1
I I
t\--1 Y Nuvember
r"· '" '''"cmbc, .
._------------ ._._--
-----; .. -----.. -- ------- ---- ----' - -1--' -+--- --- .. -
'1
I I
- _._--- - ----. ---- ~
/'
NAME. OR G. CUBONI
MAIN ACTIVI'IY
Situation and Trend Assessment
Situation and Trend Assessment
STD Control
Home leave
I
, Situation and Trend Assessment
Situation and Trend Assessment -Epidemological Surveillance
J-'+
PLANNED ACTIVITIES
PROJECT: ICP/HST/001
SHORT DESCRIPTION
Review of current control procedures for ARI. HBV, STO with a view towards formulation of a comprehensive control program
• Review of current control procedures for ARl with a view towards formulatiol of a comprehensive control program.
- For STD, the rev i ew wi 11 i ncl ude Follow-up of the recomm~ndations of a 1985 STC.
Review of control procedures including follow up of recommendations of the 1985 consultant from HQ.
Home I eave
Review of current control procedures fo ARI with a view towards formulation of a comprehensive control program
-Review of current control procedures for ARJ with a view towards formulation of a comprehensive control program.
- Progress review following the 1985 consultancy on surveillance.
'-ANNEX 5 B "
PERltlh 1986
tocATtOlf DATE
COOK ISLANDS 20-31 January
FRENCH POLYNESIA 17-28 February
VANUATU 6-14 March
31 March t() ! ITALY ,
30 May I
--- --
SAMOA 16-28 ,June I
i I
NEW CALEDONIA 14-25 July
--
I- ; J< 5 p~ J "', " PLANNED ACTIVITIES
IWIE I DR G. CUB ON I PROJECT: ICP/HST/OOI PDICI" 1986
MAl" ACTM1Y SHORT DESCRIPTION LOCATIOI' DATE
Situation and Trend Review of current control procedures Assessment for ARI with a view towards formulation
of a comprehensive control program. SOlor«>N ISLANDS 11-29 August
I
Situation and Trend Review of current control procp.dures I
Assessment for A~I, HBV, STD with a view towards I I I
formulation of a comprehensive control WAlLI S/FUTUNA 15-27 September program
Situation and Trend Review of current control procedures ) PONAPE Assessment for ARI,HBV. STD with a view towards F .S.M. ) YAP 13-31 October KOSRAE formulation of a comprehensive control ) TRUK nraaram ~ - -.
I
Review of current control procedures Situation and Trend for ARI. HBV. STD with a view towards TONGA 17 -28 NovembE't Assessment formulation of a comprehensive control
program
Overa 11 Prograrrme - Prograrrme Management during Team All interVf>nin(] Leader's absence on duty Duty Station periods
Management and Intercountry - Coordination with other ICP Programs fnnl"l'i;n"t;nn - Preparation of Reports/Summaries
------ . -- -, .. - -
I I
I i I
---- --. i I
I
--"-----_ .. --
Date of AbsenCt'
6 DEC4 1')·:;:.)
o JA~. 1986
7-31 JAN,I8f> o S!P. 1 'H',6-
OCT. 19%
0-28 FEB.
10-28 MARCH
I -8 6-
ANNEX" C
m::nU3ffi "rnA VELILEA \'E FOR nn=: YEAR 198 6
WfC/CLO 0 1\,"/ D
Director
10> Team
o o
Staff IiIaOOer: :cuL'SA,,-TFCE:: :C\L OFFlCER-[P 1 ,feuD
No. of $ Dlnyl i ! ~ G----.----------'-'---
Days I C.ast I A:~lUal/: Q,untry ,\n~, i Pu.:"r.()::~\..'
I Bar",' I ' i llinp I :
')6 r--r-,-,-.. -,-.-, ~}'; , \-----L~'-I'l-~-,l" _ I I· .. · .... " '. !,"""., .. ,_,.C
9
18
18
1 l"· ... ' J I .... "'.... I
I i (, .. ". I c< ; ; _( .. " " "", )f) ~ ,:, c J_._. jJ. ...... J.. \......: •• Lt ..... " -.x J._l. • tIP€ldt .... un d
I(H!t:l::in::~ areas
I
Dut'.' I ',1 ~ct.,.... '-""~' )', ! ., t..: -:. t.:.. . ,(. .. ! ( ,
I
I
Duty Va~u,~~tll
assessment, \'isit Ct-;\cr1J
and Peripheral areas [0
assess i::·rylementation ()f
EPl/C[)ll pro,',rRmmes ',,:~ t\l referCl1l>:". t.o r~corrune~lJ-:'lt i()tls from 198] pru!..:r:um:lL' ~·(.,:·'.'i!·h'.
F~)l leUD OP2:-:-;1::i,1:: ;1ssessrr.(~llt. ~\SSe:3S
irupl~mentati0n EPI;CJU pro?,rallunes ·>'Ii.th particular refer~nce to Cold Ch3in and LD2istical Aspects. And Follow-up EPI Revie'.;
EPI progrd~~e revie~ dnd Coveri.ge survey. Conduct n3tiu;'.'.~;ide EFT pro ·.r':_L''-~1~!l= revi!.·w and cOVl~r:l , __ -:: surv.:.:v
Dirt.:"('tol"S Dr"~'.s Rt:nL :-1:"''''
-----l--' &,,,'CIlItl.'l1da t 100 , l~'.: lS lon
----'----- --+--' i t-I
-----~--~I -~,-----.--
No. of' ~ I Dl;ty' Date of AbseJ'l/;(->
16-30 APRIL
19-30 MAY
23 JUNE to 15 AUGUST
1-12 SEP.
Da \' s Ct. ... t i f-~.Ilcti:! . I llYn... I
:R.c.Vf' ,
'> •. Ar.JD·o :::-:-- .'~ rt'.· J.
15 IJllty r :)()jOlIlUIl 1.s
12
54
12
Dllry
I I
! ! I I
I Eorne / I
Leave
Duty
COOk ISldnJ
USA
Tonga
L87 I ,",. 5 IPag
1 t);U;;'.i:l.i TI\o~·.!·':_/1..r"",~\';, FJh 'I:I.L Yt~\.i: j!..k:(,
[_.,
,t"l\'/(J.l) -I D~ rl..('t~)r C] r-----,
L~ IG) 'i t.~ .. l.r" 'L __ I
~'. ~1.:- HdIt.)f- r; • '_ ~. , t' i'_ :-.: ... .1. •
;.
!~:. J ..L /' { : i J D i ll"-. r .1 L .!.. ;Y: 1:;)
a:> 5 t.': ~ " :.-,('~", t . \'~sit l'_"-":c::al
:l[~cJ :_ll:ri ;':',t2ral ~:I"I,:':!_ t,~l
dSS,-~SS i!:l?lt~:::t'!;t_~t·~,.--:·; ~·.~1
~lIh.l CD~) r)L.)·-~r:_;::ls y;:t ; t::'J1ptl~-i
SlS )n Ie ,lsci, .. 's, Cl1lc.: Cl;~i11
3nJ u:-~S.
EPI'CUU Assessment Assess i~plcmentati0n EPI/CDD prograrrrrnes \.;1. t';
particlllar reieren~ ... to enId Ch" i'1wd lo·i.Q1C'.d
Aspects.
Rest and Rccupera~iun
EPl Rt'.vi,,·,,; ~ollo\"-llp
visit. Follow-up visit to .:J.s~ess implerllenL~t ion "f EFI ]{C'vi",,' and l[linin,-
1985 with particular reference to logistical : l r~ t I ,.' I, I j 1: , I ~ :) •
i'L~~ii\-Ll~.\l Co' il~' ~\--~:;' (.LJi.1
~) ~ ',."
}<, \ ... I~m: n I,
- ... ,
'::
I -88-
HO!U:illJ TIlAVllJlliWE FOR THE YEtJt l~·il
\1iK'iQD D h:, 1- 1
Di roc tor 0 ICP Team 0
I I ANNEX 5 C
I -Page 3
Staff WeIDer: ~_~!<_"~~K ~-\L1L:)AR - .i."~CH:;lC~\L CFF [Cfr~--:~~'--' (»1)
D:lte of Absenc.e
No. of Days
$ Coot
------
T-- --. ···-----·-r
Duty/ I,
Anliu:.ll / U)W-,:' r~. :\ ~·t.·~l }'t.:l~ .. ':::~:,(
lkIoe I
u<.ve t
---- ---+----1---+-----+---_ .. . .J..
,-22 OCT. 17 Du t'J
10-28 NOV. 18 Duty
K 1. ilL:1 ~- 1
J'u V ... l: l:
I':.' r: err, r';)l'r. ~i.'~lr: .\.S:::i( ~.;~;Cle:l.[
A;~s~~;:; i:!~!)!C!·le:lt:lt~0[~.
El'I I CUD pro:: r,l:l'; ',' it:: jJ:lt'l icuL, ..
Col d Ch:lLl1
Aspects.
l"e'"eI"cnCe [(~
J!lJ l~ogistic;l:
TTPf 1 ErT/CDD Op":r:ltiuns I
FS~I, ~A1ZSHALL! Assessment. Visit -:2ntr:il
IS. /; PALAU I and peripher,l :'H,3S to 3ssess implementation. EPI/CDD with emphasis on logistic:s, Cold Chain 3nd
OR:;.
--t 11in- ,,'r
fume r-~c !\t", "cm:) -nd UJ ~~!
I ~', ..I: ,i()!l
...-,.... -;::.--
: .
r- r- r'~-'I
. -
NAIll: CLAUDE ALLEN
HAIN ACTIVl1T
Collaborate with vector control unit
Collaborate with vector control unit
Home Leave
Follow-up and collaboration with Vector Control Unit
Attend Seminar
Follow-up and collaboration with Vector Control Unit
Collaborate with Vector Control Unit
L ....... -b~-
PLAIQIID ACTIVIHES
PROJECT: I CP 1IST 00 t
SHORT DESCRIPTION
Overall organization and operations of vector control units Specially vector control operations at air and sea Darts
Overall organization and operations of vector control units, specially vector control operations at air and sea ports.
-
Follow-up on previous visit to review overall organization and operations of Vector Control Units
Attend Seminar on Airport Vector Control
Follow-up on previous visit to reveiwoverall organization and 0pl·r.ltillnS of Vector Control unlts
Overall nr~anization and operations at vectur control unlts specially vector control operations at air and aea J)QLt ___
I I ANNEX .5 D
PERIOD: 1 JANUARY- 31 DECEMBER 1 "86
-,
LOCATION DATE - i Tuvalu and/or 6-17 January I
Kiribati
Fij i 3-14 Febru.iT·.· (Central & Eastern Divisions)
USA 3-28 March
Cook Islands 7-18 Aprii
SololllOn Islands 8-16 May
I Fij i 9-27 Ju ne I
(Western and Northern
I Divisions)
New Caledonia 7-1R July I j
') /
J-. I ' , ... t-.-
HAMI: CLAUDE ALLEN
HUI ACTInn
Collaborate with Vector control unit
Collaborate with Vector Control Unit
Collaborate with Vector Control Unit
Collaborate with Vector Cant ro I Unit
Coordination with countriea/areaa of Pacific by ca.munication
I -90~
PLANNED ACTIVITIES
PIIOJICT: lCP 1I5T 00 1
SHORT DESCIUPTION
Overall organization and operations of vector control units Special~~dvector control operations at air a sea nart.,;:
Overall organization and operations of Vector Control Units sfecially Vector Control operations a aLr and sea ports
Overall organization and operations of Vector Control Units Specially Vector Control operations at. air and aea porta
Overall organization and operations of Vector Control Units ~p@c~ally Vector Control operations at alr and sea porta
-preparations reports -General administrative duties -coordination with countries/areas of the Pacific
..
I I I ~~~EX 5 D - Page 2
page 2
PERIOD: 1 JANUARY - 31 DECEMBER 1986
LOCATION DATE
Tahiti 18-29 August
Niue 8-19 September
TTPI Harshall Islands 6-17 October I ,
Western Samoa 17-28 November
Duty Station All intervening periods
JII.
..
-91-ANNEX 5 E
PROPOSED TRAVEL/LEAVE FOR THE YEAR 1986
DR R; ESHUNDO, ICP/HCH/OOI
Count ries Pur]x?se
SOLalG." ISL-\.'IDS TPR; preparation of draft implementation/utilization plans for 1986.
FIJI
Bipartite rpvieIV of project; preparatio~ of draft PPR for J an-Jun and Jul-Dec 86.
Provide technical support during in-service training course in health education for MCH/FP and related services.
TPR; preparation of draft implementation/utilization plans for 1986.
Bipartite revie.v of project; preparation of draft PPR for Jan-Jun and Jul-Dec 86.
Provide technical and management support during in-service training course in health education for MCHiFP and related seli,'ices .
TPR; preparation of dTaJt implementation/utilization plans for 1986.
Bipartite review of project; preparation of draft PPR for Jan-Jun and Jul-Dec 86.
Monitor FIJ/MCH/OO2-related projects(Fiji School of Nursing's Family Health/PAC project; FP project of Fiji Family Planning Association/Western Branch; WID/Geneva-funded Wanen, Health and Developnent project of Soqosoqo Vakamararna; and FP project of Fiji Red Cross); provide technical and mann.ganent support durinj,! training activitips of alx.lV~> proj,>cts.
Schedule
1 week, last week of Feb 56
1 WPE'k, 2nd WPek of Jun 86; 1 week, 1st week of Nov 86
1-2 weeks during discussion of ~ICH/FP content of training course
1 week, 1st week of \1;.).r 86
1 week, 3rd week of J\ill
86; 1 week, 2nd week ,J f Nov 86
2-3 weeks during disc~sion of ),QI/FP content of training course
1 week, 2nd week of jl;u-
86
1 week, "*th week of Jun 86; 1 week, 3rd week of Nov 86
3-"* weeks, as necessary and when suitable
.,.
-92- Ac'lNEX 5 E - Page 2
Prop:?Sed Travel Plans for 1986/Dr R.A. &mundo ..•••
Countries
TONGA
WFSI'ERN SAMJA
CXXlK ISLANDS
Purp:?se
TPR; preparation of draft imr plernentation/utilization plans for 1986.
Bipartite review of project; preparation of draft PPR for Jan-Jun and Jul-Dec 86.
Provide technical and management support during in-service training course in health education for MCH/FP and related services; m:mitor related projects(FP project of Tonga Family Planning Association; Catholic Church's Ovulation Method project; and JOICFP-assisted integrated parasite contr~l and family planning project).
TPR; preparation of draft imr plernentation/utilization plans for 1986.
Bipartite review of project; preparation of draft PPR for Jan-Jun and Jul-Dec 86.
roonitor and provide technical and managerent support during training activities of Catholic Church's Ovulation Method project.
TPRj preparation of draft imr plementation/utilization plans for 1986.
-Bipartite review of project; ·prepru::ation of draft PPR for Jan-JUD and Jul-Dec 86.
Monitor CXlUMCH/OO1-related projects(Adolescent Health project with Ministries of Education and Internal Affairs! Youth and Women's Affairs Sections and the Child Welfare Association; UNESCD-executed Porulation Education project); provide technical and management sunoort to ~in1nv activities of above. projects.
Schedule
1 week, 2nd week of Apr 86
1 week, 3rd week of Jul 86; 1 week, 1st week of Dec 86
2-3 weeks during discussion of MCH/FP content of training activities
1 week, 3rd week of Apr 86
1 week, 4th week of Jul 86; 1 week, 2nd week of Dec 86
2-3 weeks during training of couple trainers / supervisors, when suitable
1 week, 4th week of Apr 86
1 week, 1st week of Aug 86; 1 week, 3rd week of Dec 86
2-3 weeks during discussion of fLlI/FP and adolescent bealth contents of training activities, when suitable
I f undertaken as planned, above-mentioned proposal. would mean that I shall
be on duty travel for 30-36 weeks during 1986 - 6 to 7 of which will be
spent for FIJ/MCH/OO2.
T I [)att of Nv. of S Dut)! AtJ.:..tlfk. I)-d, ,., la.t I AAIlU.,; -
1bDt-,
U'i!V, ---- , --.. . 1 . j .,--" ,
Januarv I
7 I I
, (Late I ,
I
i I i
! I , I
Febrll.:lry 14 I i I , , , (Mid) ,
I I I
I ,
I I
I I March
I 7 I I
(Early:
Apri) I 7 (MiJi
May 28
June 14
July 14 (Early)
-93-
PtUFU:ifll 1l\AVUJU.AVE RlR 111[ YfAR 198 6
IKICW 0 RAI 0 Sta f f IIIaJiler:
D lI'13C tor 0 10' Team 0
DR. K. GEE
T ~ -~ ~.-~---.- ~ .. ,~---~ , I i
1.....(Iu';it r: :\;'t -;.1 i Purp:...<,'- RA'narL
I .-; _. -. t - -.-- ---- -- ------ - --t--- ~--
, : I U I, ~:" ! l(ev ie, .. I'll';:' 85 \ClJ <lctivi-
I tics (TON/CVD/OO1) I I
I ,
I I SdInO'-\ Prepare programm", of l-IHu I
I Amt:rican Samoa) collaboration on NCD I I I activities I I i
I I , I I I Kiribati Review \CD activities
I I , I ,
10116d Cooperate in Planning NCD I workshop I I I ,
TTl'l Situation analysis of Hyper~ tension Control ProgralWl1e and other NCD activities
I
Fiji Assess Cardiovascular Disease and Diabetes problem at Lautoka and Labasa Hospitals.
Tonga NCD Workshop for Public Health Nurses and Health Officers - Vav'au
17 August 1985 ANNEX 5 F
Director's D~'s
fIec.cmIIilnda t ion I)e(; ision
------
1
I I ,
I _ 9 ~_ I
PHJIUiID 'ffiA va IU.AVE fOO nn. YF.AR 198 6
WfC/a.o D Director D RA I 0 10' T8UIl 0
Ifu'l'N ___ J F 1ge
Sta ff MEatIer: ..IoD~R .... ~K ........ l.<CEl:.fl:.· ________ _
Dat. of AlX>l~),:t .
Au'~us t
S,,?tl'iJbc r
('Ii J )
lOc" of' S rr .. y» Cobt
Duty/ Annual I
Ha!x' I Lt~\I"
.. _;.- l----i----- .. !
18
l.('U1,ll-\ '\~-. : n'a I
----1 I :,Ui0t11Utl hldnJ~ si
KL: i I i l\ .
1--" -1--- -- ---,- - --- - -+-I
I 1.. . . '0:1 kl
LU
~c
--
PUJ'p . ." Rtmtrh.s
---.-- -------t----tuation analysis uf NCO. '
view cancer re~istry I
tivitie:; I
I :i",w rheumatic fever
, ,
1t ro I progralJUlle, Deve lop ~
) control progranune !
- , I
ill: 1.1.:.1 \/t: ,
------T-~---·-T --------- ------~---
I ,
I umb., 2H I' ... , u. Ii.. : ""
,. I. , .. -+--1 -. -., .. -, .. --~---I
Director's flecamlendat ion
DPM's Decision
(Mid) I .• -----+~.r_o_g_r_a_nun_l_' _______ + ______ -+ ________ -+ ____ _
DE:cember
Date of No. of S Dutyl I AbsencE' Days Cost Annual I CoWlt T\ .' An ':\
HaDe LeaVE'
february/ 28 Solomons
'1arch (Tentative
'1ay 14 Kiribati
.luI" 14 TTPI
September 14 Vanuat',
October 14 TTPl
,
I I
November 7 Cooks
,
-tj5 -17 Allgust 1985
PIOru;ru TRAVUJLl:.A\1-_ fUll TIll. YEAR 19k (,
D i roc lor 0 11K/aD 0 RAi 0 10' Team lLJ - ICP INUT /001
Staff IknDer: NUTRITIONIST (to be recTuitccl) .--_. __ ._-----_._- -----_.--_._.--.---~.-.- --..
i{lWOn REMARKS DIRECTORS
RECOt-fMENDATIONS
-.. -
Trainin.; for and dircrti,'n
of national nutrition SUr\·t ':
Advise Technical Task F."")fj-l'
on communit:: organized services con\- ...... rning
nutrition prt,blcms
Dt~ ,./{l I op inf,1nt ~·~ro'.·:t ~I
moni, nri ng '''; '.;'; ~ I'm, F':"
Lval'J;}te nut.rition prq',r,lmmu
and advisE' un '"'!;£..'.Jl..;llrl..\~ for
i mpro'!pm"nt
11d 1 all - ~_..;trt·ih~thcn sl1rv('}-
llan"" .1'ld lilt "r~~f' t C' 1'1 I
( nil ,1i.-L1r ."lt i " f ,.,:
nlltri~;,~n
I .... ~:..;e~ nIt ~ I ~ ", ; f :' i' :'
iUH'U."1x 5 IV
---.. ~-:-~ DPM'S
DECISION
/ DRAFT .....
18 August 1985
Dale of No. of S Dutyl Ab&alce Days C«5t Annual I Country/Area
HaDe Leave
1-8 January 8 AIL AUSTRALIA
.
1 - 15 February 15 DUTY FIJI
7- ~O April 14 DUTY COOK ISLANDS
6 - 8 May 3 DUTY SANDA
11 - 21 June 10 DUTY TONGA
,
I i
!2 - 24 June 3 DUTY FIJI
~
PfOfOiED 11IAVEL/U.AV[ RJl 11iE Yf".A!r.1986
WPC/(1) 0 Director 0 RA/ 0 10> Team 0 Staff .I6adler: Howard W. STLPHENSON
I I ., I' 11 I I I II J I
• PurJx>5e. R£mirk..s
Annual Leave
I
1. Village Pharmacy Review I 2. Admin. Matters
i I •
I
I I
-r
Workshop on Drug Supply · I 1
Discuss Feasibility of I I Village Pharmacies with
"
Village Groups I
· 1. Computer Feasibility I
I Assessment
2. Improvement of Dru~ Distribution
3. Advise on Annual Drug Procurement •
-1. Transit , ! 2. Admin. Hatters
•
I I . I
I
·
Director's Recatmenda t ioo
I ANNEX 5 H
DF\1'" Declslon
r----I I I ~ I
.
I
Oatf' of No. of S Duty I A~er>ce Da}'S Cast Annual I
HaDe Leave
24 - 31) June b DUTY
----1 - I ~ 14 (lUTY July
1 August -26 Sept. 56 H/L
27 October - 2 November 7 lJUTY
J - 9 November 6 Dun
10 - 20 November 20 DUTY
1 - 4 Decesnber 4 DUTY
-
OluntryfArf'3 I
VANl~'\IT
J -~ {- -
PfCJf\EW 'mAVll../LIAVE FOR ilIE YEAR 19!16
m:1a.D 0 RAt 0 Staff IIBdJer:
Purpoo;,..
Director D 10> Taun 0 Howard W. STEPHENSON ICP/EDV/OOI ,
I Rtm:lrf~
,
Assess Pharmacy Computer I J os tallat i on
, '---------
I SOI.()rl0N S'Juth Pacific Essential ISLANDS Drug List Meetinf
!
I AUSTRALIA Home Leave I ,
I I
Tl!VAU' I Essential Drug List I I
l. Essential DTug List I KIRIBATI 2. Improvement of OTug I
Distribution I
, , TIP! I Follow-up 1985 Visit
-_._---+-1. Transit I
FIJI 2. Admin. Matters.
ANNEX 5 H - Page 2
I I -
rHrectOT'~ 01"-\" ~
R£>carmmdat i~ Ol'<. IS Ion
I I I
I ,
I !
-
I ,
! I I I I I I
,
I , , I
I ! I I
Date of No of $ Duty/ Annual
Absence Days Cost Home LeaVE
L2 Feb. 7 Duty
l2 Mar. 11 Duty
-19 Mar. 7 Duty
Mar.- 14 Duty April
April- 14 Duty May
24 May 7 Duty
21 June 19 Duty
23 July 14 Duty
-98-
l'Il)Ii.).~W n;,\\11 !L\\I. frn 110. HAil 1986
\\1(ClClD
HAl
o i....J
DII'L~tor
lep Tc>:1Ill
Cl CIJ
_,::,fl 'ltniA'r: TODOR VlDENOV
lCY/CW:;/OVl
Country Area Purpose
Cook Islands Project review and facilitate finsncial support for IDWSSD activities
Kiribati Follow-up project activities and provision advisory services in problem areas
Tuvalu Promotion of IDWSSD activities
Solomon Is. Advisory services in problem areas and promote IDWSSD activities
Fiji Northern Di v • ) Follow-up implementation project
a~tivity and study problem areas
Vanuatu Follow-up Government approval Report Sewerage System Vila and collaborate preparation of request for funding
Marshall Is. AdviSOry services in rural sanitation and promotion IDWSSD activities
Tonga Prem~ion appropriate technologi s in ~u~al water supply
.
I,X' I rl.l~il( E .J..
-- -- ------Remarks
Director's DPM's Recommendation DecisiOll
L8 8
}-
5-
De
Date of Absence
Aug.~
Sept.
!3 Oct,
~ Nov.
cember
No of $ Duty/ Annual
Days Cost ~ome Leavt
10 Duty
14 Duty
14 Duty
Home Leave
1- 9 Ix 'i Pc ~
;'!JIIU.LlJ .1_\\,1 'J.\\'i 11.~1 l1U. rUH l~ 86
111.1 111J CJ [)ll"t.:\.."t\)r CJ i:'\ I '--'
!IT' T·.l:.m OJ
d I \jlml,,'l": TODOR VIDENOV
T "I> I rue: I nm _. -- -----Director's DPH's
Country Area Purpose Remarks RecOllllendation Decision
Fr. Polynesil! Improvement of environmental health services and promotion of Decade activities
Fiji (Central Div.' Follow-up implmentation
project activities and promote decade activities
Solomon Is. Advisory services in studying problem areas and develop project proposals.
.
.:,
t.irL:l
f-----,- -:1------: So., of S: Put~.' i
I
0;.:" COt;! I Annw]: !ian"
l,..:1\'( ,
,- ----4- ,---t------
'...;. ,j
: ':'JeJ";S
(,j'L;!)' Y", .\ :",
I i l..I 1 J 'j '11' t I
i i I'unai;c: fruki ,
I "j' 1, l I • .
I
I
I -100-
PH IlU-;Jl, l'W1n':LfU.A\'f H~i THI Yl..\J: l~ ~
"H-l(ll) 0 RA 0 ~~~ I. f ~ .... :1Tnc r
i ~ ,
DinlC't,or CJ 1 IT Team GJ
J.\J.Lee HD - .. _-- .,
l{'n· :~;.
+- ,.----. -- -- ---" ----------
Ll:~lrU::>y s Lt'J.lt iun rt...'>\· ie\oo'
~urk&hor, each une in Punape 'lnd lruk.
,; r 1, ~ ~
'10 <.Ia'is J bO Ill) days
dA-J$ '~rJ Ja ::s)
lor.>'" 1 ca'1t' lilL .Jap'-llo/KorcJ.
L'L i 1
':...:nt...
'..:1,
~
\.UgU6 t
~/i!pt_(')er
}clu[,t:r
,ovem:,cr
I __ ,..~~ r
I !
! 10 day~ l~dAr$1 IO~
10 day
10 day
10 day
10 -I
~~I
D/T
I I I ~anlua I Fo tlUIo.'-up
"r'k'hOP io
MDT
Intt'rcduntry
K:~; b .... ~
So) omon 1" landsl
Vanuatu
Nt'''' c..lif,dllniC!
I I
Cook r~(c.-~>
/lJe-v -z.~
Suva (or LFnrusyiT~berculusis.
Review of Leprosy/TS projec~.
Review, Case detection.
Revil'''' Jeposy siluatiun
Gue 2Lv:~IV. ·o:-.It.
WIIO I L TG'VH~t""'.'''''''
. ~--- -- -. 1
I
--~
I I ANNEX 5 J
Ilr .. ·' , [II r!"-" or" RJ,,-/rnn'nd;tlI1>!1
"1-" .---, 1 •. ,,- I'-,Inn
j ,
----~---.--' ... ----....,----' .. -
i l:i: ~ (, f
At)~'-':-J '.
1\i ... ,. of Day~
( I Du1\! (:0., ( AnnU:ll .'
I lien< , l.A:~:a \'~
I .(JllJlt r\
, --. ---_ .. ---+ ----.;.----- ,-,~ I :
.' r·. I
~!. :. l'
"1 r
1. ~ r '
',' .
F 1 r ~: .'-ld' 1~ ., ]'i'I!I!l,',
~ it '- ":.1'.'
early June 1" rIP I
Late June 7 I 1uv:llll
July 7 1 ron~"'j
I Ed r;': ~t':pr 10 I ".!:,,, \ " 'I
\1'1 :t
I -101-
l'ltllUiHI THA\U.,/Ll.AH H)t( TIn HAJl 1981,
v.~', :eH) C~ lh ru .. tor r-]
Ic', [:-:-J la' TP<lI'1 l~J
I ANNE).2Y-
17 Augus t 1')85
~taff ~'m~'r: _C~J_,_I'A.L'!EI~~_D,,-----
~ ...... ;. I
;1'ljl ""urk·,tlull 1,·1' !IUL,l it t'.l' fl.'r
r:-r ·d::lf!I'.~nit· ;),irticir:ltiun '.", I r, ·,,11'
i ; l~. ~ : >- '-,llnlih'
I' .0,1 'j' (,-;-1r.f'~ t"t'n!.~lti\·(')
: 'I: :_ r r:' ,~,:'! in...!
: ,J! ',! ', ... ,lrk'" ''.\..'',l'
I', 11LI..'\_",1 ,I!h.l l)r '.LlLcKULt
I As·;c s s PHC progress i 1
Icountr y health programming and PHC planning (Marshalls)
,
INational follow-up PIlC j"'OrkShop
I Fo 11 ow-up communi t v part j ci-I pat ion w\)rkshop
lL\' .1lut ilJn r .mIla I'll , P roj c L'l
- -- _._-- .--- ... -I
III t'I'\'t (Ir'.'
f~jn .... ', HI ~ 'J nTll: 'fld~I' i (H
lJ!~" .. l,lflo. 1'- 10fl
--l-)~-C': i 1"0. of S Dut)!l, Ab....,en'."· I Days I C.obt Annual! Lounll",
; ! HonK I'
Il [,",\I
---- ; --t-I "-I ,
'. l!. ~ .;,~ 1 i Jr: , 1. I
LJt~ ,j,--l~'~t;r
Nuv~mbt:r
DeceIT",.: " ~:J - '\ 1
7
~ t
I , ,
H I
.. U.
E i r; t •• 1 r i
"
\rt ~I
-lCf - ANNEX 5 K - Page 2
I'fUR'6TI.J 'ffiA\1JJl1.~\'L fDfi nn Yl:Ak 1%
Y"T~/OD C] Ri' 0
ILr •. .:.:wr 0 JO" Team EJ
S1 ,lf1 Mf[mcr::~,~_P\L~I[R....J'1. (I •
. _- - - - - --_. - --- - - -- - -+ ---------.--.
'''''''1 ,
,!
!t Ull! ~_ r, '~\.... 'I 1 t ',1 ;lrl-' r,I!'I~T,i n.~;
'1-1IlJ l'H(' !;-...; :r,.lr.1r.~(· .iso...:essment
I (FS:·!)
!,\S:jl..:'" ,"tit ,h.~tivitie~
,Ev" I'Llll' ;'He prp,!!',lmmes
, Di l"l,(,t,)!,1 ~~
H'fa .. : .. ~_ R('-'.c.rrI'l:Y"~(bt ion
.. I
m'l.·'s Dr-"" .. lsion
I J~ltt --t- -~--1 ---.
of I No, of $ 1\1".,,::,-., iDa"," I Cost
1-:1 Early Jan
Late Jan 14
Feb 14
Early March 7
Late March 14
April 7
Late April 14
May 30
Early June 14
Late June 7
* An STC lin He
Dutyl Annual I HaDe
Leav('
Duty
Duty
Duty
Duty
Duty
Duty
Duty
H/L
Duty
Duty
-1U3 -
Pfl}IU5ID 'IllA VEL /l.J:.A \ 'l. FUR 11IL YEAR 198 6
WPC/Clil 0 Director 0 RAI 0 10' Team rn
ANNEX5 L
Sta ff WE!IDer: MR: PAUL HEDRICK - ICP PHC 002
.--- -~ ... -~~ -'~'r--' ._'. .--------_.-;--_. -------+-----, IIi rE-ctor' !- DT'o~' "
eo •• , ": ~ + __ ... ""~" __ Fij i pevelop PHC Information System
Solomon Is. I Follow-up earlier visits
Vanuatu I('QI11Plet~ consultancy on Lay , Reportl.ng
I National workshop on Health Information
Western Samoa
Cook Islands
Fiji Islands
Tonga
Australia
Vanuatu
Fiji
I
NHIS
~uter at the FSM
Microcomputer Applications (with MicDocomputer expert)
Home Leave
I Microcomputer Applications
i 'compu te r at FSM
f{(m~ :~~.
"
RL ... 'amEf}dat iOIl Ik"" i5ion
I
-~------1---
I I
th Info~mation will be requested for 2 months to intttoduce the new and ~evised records.
....
DaH of No. of S Outy f I Aboenc(> Days Cost Annual I Country iAn-a
HaDe Leave
Ily 14 Duty Tonga
A Igust 14 Duty Solomon Is.
L lte September 14 Duty Cook Islands
:tober 14 Duty Vanuatu
N Dvember 14 Duty Tonga
D ecember 7 Duty Fij i
1
I
I I
-104-
Pl{)rolID 'rnA va./lD.VE JOUR 1lIE YFAR 198 6
'ffC/aD 0 Director 0 RAt 0 ICP Tewn [!J
ANNEX 5 L - page 2
Staff MmDer: MR. PAUL HEDRICK - ICP PHC 002
I I Di rI'<.'t
Purpr...-.,' , IiHrurL ! R .... <xlmel 1
-----r-- .. · or' ~ Dr;\~' ~ cllil1011 1 DL'_I sion
I 1
- ______ ..J-_ -- . ---- .. ------ ----+ ---1 -- -- .. ----1-I
i
NHIS and Microcomputer I
I
i I
NHIS Development , i
NHIS and Microcomputers (with Microcomputer expert)
I
,
Refresher Training and I Microcomputer Applications
I
! i NHIS and Microcomputers i I
I 1
Computer Applications at FSM, 1
I
!
I , 1
I ,
I
I
-'
Dat£' of No. of S Dut~'1 Absence Days Cost Annual I .
tIane Leave
bruarv 14
rch 14
v 14
ly 14
·ptember 14
tober 14
NOTE: Th --L.
-105- -- ANNEX') M
PfORliED '!RAVEL/l.EAVE FOR mE YfAR 100 6
1m:/a..o 0 RAI 0 Staff ~r:
Director 0 ICY Tmm IiJ (Probably ICl'/HMD/OO7)
NURSE (to l?e recruited)
Ccuntr,' I Area T------- ·=:YY~.-t
H'r~'
T'll r! -r,t ('T- I
R, .. (fiT") ':1'1:-' l")f
Tonga Advise on strp nursing sen:ic
TTPI Planning of tr granune for nur administration
I Marshalls Kiribati I Advise Technic
, on nursing Sllr
I field services
Vanuatu Review Met! su care at nur~e
TTPI Hanagerial t r, in collaborat: ICP/MPN/OO2
Cooks , Assess integr.
I ~fCH!fP!PHC In , nursin~ train
i
~ nurse wi II be heavilv cornmitl
nf'.tht?nl n'.: l:'lt
es
alnln,: pr0-Sln~
- FS'I ilnd
al Task Fore" port tc'
nd,Hd~: .)1
Il'''I' J
ining, 1>.11.111, on with
tion of basic nl!
d 1 n F ill ,c it 1.1 1'1" ;': ":! '"
jll .. " , .. ;
--
DatE' of No. of S Duty I Absenc(> Days Cost Annual I Country I An'" Heme
Leave
~bruary 14 Tonga
lrch 14 Samoa
pr i 1 7 Cooks
ay 14 Kiribati
une 7 Tuvalu
'j I Y 14 TIPI
eptember 14 Tonga
ovember 14 Kiribati
I i , I I
Commun t.orksh
PHC na worksh
I Asses~ I educat I
Advi SE
on put staff
:-Jat iot
Advis. i aspcc , , of Mi, I , I Folio'
i patio I
PIIC e
-106-
17 August 1985
PK)IUmJ 'rnA vu.. fLLA \ 'I-- FOP. nil Y1AR 100 6 Dirocwr 0 WP:/a1> 0
RAI 0 10' Team GJ ICP/PHC/002
Sta ff MmDer: HEALTH EDUCATOR (to be recruited) -
P·_P .... I,·
tv Pdrticipati~n op
ional .1n<l district or
and ad .... ise 1.H1 11',1! '- 'j
on pro~r,lf.1nf' ~
Technical Task force ic education ,lnd
education and tt-,ji:lin',~
al follOl,'up 1'Hc' ,cork.itul'
on heal tIl l'd'j( 1 t i '.)11 S of I'IW. red. ','l.ll."· rone~ i.1
up c;ommunit:: p;lrt i ('workshop
a]uatinn
TIl r, 0(
H, !.~. PI' {~'~1'1
ANNEX 5 N
;,; ...... .' .
'-I
Date of No. of S Duty! AbsencE' Days caot Annual! Country/Area
I HaDe
Leave
.
F Lb:,i.'-t'~?.Y '; Duty Sarr.oa
,\PEl L 5 Duty Vanuatu
~lA': 5 Duty Solomons
JL"~~L :, Duty Kiribati
JCLl' u\L'(TST 30 Annual Leave ,
SEPTE~mER 5 Duty Tonga
-I
I
-107 -
PRJJU)ID 'rnA \ 'EL !L£.A\'E FOR nlE YFAR 198
m::!CLO 0 R.~I 0 Sta ff Idanber:
Purpose
Director 0 1 CP TffilI1 0
'VaM.1:z.;.,. 2v..ll~
Ranarks
To provide administl'ative support to CLO Offict:
" " " "
" " " "
" " " "
" " " "
JNEX - b
Di rector' ~, DF\l's Reccmnenda t ion Decision
I I FIGURE 1
-103-
Proj(lcts (j) FLOW .cHART
\VHO/WPRO SUPPLY SERV ICES 00000 \\ll/ ~ ®
Lo,o1- ---'@~ .. G ~~~hase Suppller+ -- u.o • V
- U PA or PO
for Local Pu.rchaae
Initiates~8 procurement SAO action @ "
It G~
@ Confirms Certifies
specification funds
@ fH'O"\_ ':..0.:.,. -+'ltbrld wid(l suppli~rs ~
t , P. A. I I I I I I I
I
, , IPtzgionaJ Suppliers ,
,'P.O.
I(lj' a) DSP sign P.A./P.O.
~ b) WPR Contract Rrlle"vY • ~ Committn
c) R. D.
Project. will provida spacificationl and qUintity of supplies and equipment to be procured through HQ/Ceneva. In c ... of loeal procurement, project. viII submit three local quotations obtained from local suppliers (if only one .upplier a.ailable please state so) to SAO/WPRO. If very mioor items involved, i.e. bolts, nut. or fittings, etc., wbole total value is about USS2500 or lesl and if WTitteo quotatioo is difficult to obtain, the project te~ leader or W&C./CLOa .. morand~ or telea to SAO, indicating items to be procured, quantity and estimated total value, should suffi~ for lagional Office to consider local procurement.
'.
I -109 - TABLE
PROCEDURES IN IKPLEHENTING FELLOWSHIP AWARDS
AND GROUP SnJDY TOURS
For individual fellowships
When PAP received in WPRO. it goe. to HMO/PEL to cbeck and enter n.me of candidate in Fellowship' ieviev List for the respective budget year (bienuiUlU.
BMD/PEL to refer FAP to re.pective adviser (Operational Officer) for comment. , recommendation on tbe place of study, and then to BFO for certification of budget availability and adequacy of provision vi.-a-vis place of .t.acIy.
Referral memo i. returned to HHD/FEL. If field and place of study is mutually approved. plscement is then initiated.
(By placement, it i. the sy.t .. of obtaining agreement of the receivinl countries(institutiona to receive the candidate and arrange the required study prolr ..... )
3.1 Placement proce •• take. a .inu.u. of tbree month. before study arrangement. are confirmed. unle •• followinl problema arise, viz.
a) English te.t or other language requirement (need for interpreter. etc.)
b) Candidate non-acceptable at firlt attempt and therefore need. replacement
c) At laat minute. candidate not available and therefore to re-schedule date.
For group/study tours
1. When FAP. received in WPRO, they are referred to the respective Adviser (Operational Officer) to get his comments and ~ecommendations on the countries to visit, duration and starting date. Also to check ou the budget earmarked if amount is sufficient.
2.
3.
Operational Officer returns FAFs to HMD/FEL with his comments and recommendations as to county(ies) to be visited, duration and proposed starting date.
HMO/FEL to initiate placement arrange~ents with receiving cpuntries/institutions.
(Same note as So. 3 - left side)
3.1 Same notes as 3.1 - left side.
For individual. (Cont'd)
Wheo plac~nt finally cleared, BHD/FEL to i.aue FF! and
i •• u. award to be sent to fellow'. govt. Other adminis
tratvie actio~ will follow, like issuance of air ticket.
and payment of stip~nd •• etc. Instructions for visas will
.imultaneoUi be taken up.
(fellows are required to advi.e WPRO of
their ITA.)
A11o •• o.eti ... we experience delay. in reporting
due to exit and entry permit. not obtained 00
ti.a.
; .00 completion of fellow. hip a final report i. to be
• ubmitted. Theo 6 .aoth. after the utilization report
should a1.0 be .ubmitted to WPRO.
•
-110-I
TABLE - Page 2
For study tours (Cont'd)
4. When tour's V1SLts cleared, HMO/FEL vill inform the
country of origin about programmes arranged and dates
or·reporting. The CTA is issued to allocate the required
funding. Then air tickets are issued and stipends paid
to tour member. before their departure. IN THIS CASE NO
FELLOWSHIPS AWARDS ARE ISSUED.
(Problem of issuance of entry visas sometimes
delay the starting date of the tour.)
5. Same requirement as for fellows (see left side) .
I ' J J -111-
TABLE 2
PROPUSED ,,'Ti !;': ':,' ',; - 198n
, ,; j7?: ELs~where , \:"~;'.'_';7·J '.··.5! '.,', ':.:·'A .. :;;::-.~; .A,
I -+1-__ ,
Jan May Feb ilarch ':lov I June I Oct ~l.:Jn/ J un~ Sept/Oct
It/L 1-15/1 WFRll-Feb /Mar HiL 10-31/12
",F ..... , ...
;.;£),' f cr.:
Apr 14-21 i July I I i I
Sept I_I
; Feb . June
Oct
Jan ! August
• ~ T
Apnl , March I i ~!arch July I I Sept
Nw i '
-:.~--. 16-24/5 31/3-19/4 9-2317 j 1-12/3 1112-19/3. 4-12/2
\ j u_-"" • 5-9/1.1 I
:l£,IT\
C~ ~t~;\ [
I ! 10-28/3 7-18/5 18-11/1 16-25/4 115-23/2 I
15-28/9 8-19/11 ! 15-22/10 I
, 6-14/3 11-29/8 17-28/11 16-28/6 20-]1/1
I I
HIL May Jan Aprll June Dec
K,ji.:::;,\/( 10-28/3 I I -:c
16-30/4 1-12/9 10-28/2 16-22/10 rnci Tuvalu HiL 23/6"1 ')/7 27-31/1
3019-3/10
HIL 3-28/3 ' 3-14;2
I
I , 8-16/5 17-28/11 6-17/1
ALLC; 7-18/4 6-17/10 :I. Caled. 7-18{7 9-27/6
Fr. Pwly 18-29/S ~llle tl-11~/9
c:r', August Jan (20-27~ Feb ~Iarch :-Iovember ilay H/L Uctober June
_ J
---,---------
Seotember AUlI:ust J
I I . , I _ren feb Apr i Apr , I
June June July i July I ES.!l'~::>O I Nov Nov Dee , Dec
llf-ju/6 I-14fT 1121,6 : 6-8/5 , I
! S Tt: rl1L;~Sl1:\ : UTRITlONIST I Sept Feb/March
~
D b I
, I
. ' 27 i 10-2/ Ie
I I
1-\ay I
I ----------_ ....
~ovembc r ''''1. I reo
I Apr Aug I Dec I
H/L \1",cI1~;by , July n l 3 - Dc t . I
I ~.Z. ~ov --,
i
I
.'·1 •. 1 retl
June
.'10 v
7 20/4
I 10-20/! I i fill 1-8/
H/L 1/8-1 ! 1-5/2
26/~ 22-24/6 I
i 1-4/12
Nov July I
I ,
Oct i --------