Government of the Federated States of Micronesia

Health Sector Progress Report - 1999-2008

Palikir, Pohnpei (FSM Information Service): December 29, 2008 - The Department of Health and Social Affairs has released its 2008 Annual Report which provides an analysis on the progress made in the health sector from 1999 to 2008 and identifies some challenges and recommendations on ways to improve programs and future reporting.

Below is the Executive Summary for the report. If you would like further information on this report please contact or for an electronic copy of the entire Annual Report, please email with your request.


This report provides the progress (or lack of) of the health sector from 1999-2008. Since much of this report is on the fourteen (14) health indicators already endorsed by the Joint Economic Management Committee (JEMCO) early in the beginning of the Amended Compact years, an explanation was necessary on the historical development of those measures including the integration of the fourteen performance measures into the FSM Strategic Development Plan.

In the FSM Strategic Development Plan, a matrix of operational plan for the health sector as a whole was presented with specific objectives, activities and expected outputs. All of these (objectives, activities, and expected outputs) should assist in informing the evaluation of what changes or improvement have been achieved in the overall health of the FSM population.

Fourteen (14) Performance Measures:

1. Dispensary services - Only Chuuk and Pohnpei reached the 20% target increase. No significant renovation took place to improve the physical structures of the dispensaries.

2. Hospital services - There was a slight increase of patient encounters in the bigger states.

3. Immunization coverage for 2 years old - Despite high fluctuation in rates, the trend suggests that there is an actual increase over the years.

4. Essential drugs and supplies - No state met the target that all essential drugs must be available 80% of the days.

5. Biomedical equipment is functional - FSM met the target for his indicator in 2005 and 2007.

6. Average length of stay - FSM met this target. In fact, the average length of stay seems to be declining, despite fluctuations in few of the states.

7. Infant mortality rate - Infant mortality rate is reduced to less than 16/1,000 per live birth - Despite high fluctuations in rates; the trend suggests that there is an actual decline in infant death rates in the FSM.

8. Mental illness - Trend for completed suicide rate shows a gradual increase up to around 2003 and a sharp reduction onward.

9. Health insurance coverage - Health insurance coverage has been stagnant over the years with about 20% of the entire FSM population with health insurance coverage (MiCare). Presence of ad-hoc insurance scheme is insignificant.

10. Off-island medical referral cost - The target is that the FSM states should not spend more than 10% of its health budget on medical referral outside the country. All FSM states met this target, except Chuuk.

11. Dental sealants - The target is that 70% of all third grade children must receive dental sealants. >From 1999 to 2003, FSM met this target. However, from 2003 onward, there was a decline.

12. Reduce the incidence of diarrhea disease by 10% - There was a sharp increase in diarrhea diseases in 2007. It is not clear if this is due to actual environmental conditions or other factors such as better reporting.

13. Reduction in incidence of diabetes related admission - Only Yap met the target in 2007. The other states remained about the same as in 2006.

14. Quality assurance - Quality assurance did not exist in Chuuk until 2005. In the other states quality assurance was semi-functional.

Other Key Indicators:

The data available on other key indicators such as access to adequate prenatal care, pregnancy outcome, and behavior risk factors, suggest there is a general concern that pregnant women are not receiving proper prenatal care throughout the FSM, despite increase in health care expenditure over the years.

Overall Health Trends:

The common communicable diseases such as TB and HIV/AIDS that had been in existence for a long time are coupled with an increase in lifestyle diseases such as diabetes and cancer. In addition, new diseases are re-emerging as Multiple Drug Resistance (MDR) to TB. Fortunately, there is treatment for MDR and if patients comply with their treatment, they can be cured.

Overall, there have been some achievements in the health sector such as decrease in infant mortality, increase in immunization coverage. Likewise, other areas have not been performing well as they should. These include improving the renovation of the dispensaries, improving prenatal care for pregnant women, improving the physical systems that directly contribute to environment health and sanitation.

Conclusion and Recommendation:

This report provides descriptive analysis on the overall population health, with a special focus on trends, by looking at the fourteen performance measures and other relevant health indicators. To improve future analysis of the FSM population dynamics, it is highly recommended that institutional capacity in statistical and epidemiologic analysis, including ability to conduct and analyze data on population prevalence studies, be given high priority.

For further information on this release, please contact:

FSM Office of the President
Public Information: Press, Radio, Video
P.O Box 34
Palikir Station, Pohnpei, FM 96941
Tel.: (691) 320-2548/2092
Fax.: (691) 320-4356