ASTHO INSULAR AREA HEALTH
OFFICIALS SUMMIT
AUGUST 11, 2014
HONOLULU, HAWAII
Pacific Island Health Officers Association
Emi Chutaro
Executive Director
PACIFIC ISLAND HEALTH
OFFICERS ASSOCIATION (PIHOA)
• Established in 1986 by Pacific health officials – regional voice for the six USaffiliated Pacific island countries and territories
• Non-profit 501(c)3 – chartered in the CNMI and the State of Hawaii
• 3 offices – Honolulu (HQ), Guam and Palau; 1 staff currently on extended onsite assignment to American Samoa
• 8 staff and 3 contract retainers; hosting 2 regional CDC Immunization staff
(with plans for 2 more from CDC Chronic Disease and Preparedness)
• Funding sources: CDC, CDC ASTHO, HRSA and membership dues
PIHOA BOARD MEMBERSHIP
Executive Members – voting members
1. President - Dr. Vita Skilling, Secretary of Health, FSM
National DHSA
2. Vice-President – Motusa Tuileama Nua, Director of
Health, American Samoa DOH
3. Mr. Jim Gillan, Director of Health and Social Services,
Guam DPHSS
4. Mrs. Esther Muna, Chief Executive Officer, CNMI
CHCC
5. Mr. Gregorio Ngirmang, Minister of Health, Palau MOH
6. Mr. Philip Muller, Minister of Health, Marshall Islands
MOH
PIHOA BOARD ASSOCIATE MEMBERS
1. Dr. Livinson Taulung, Director of Kosrae Health Services, FSM
2. Mr. Paulino Rosario, Director of Pohnpei Health Services, FSM
3. Mr. Julio Marar, Director of Chuuk Health Services, FSM
4. Mr. James Gilmar, Director of Yap Health Services, FSM
5. Mrs. Julia Alfred, Secretary of Health, RMI
6. Mr. Joe Verga, CEO, Guam Memorial Hospital
7. Mr. Joseph Fleming, CEO, American Samoa LBJ Hospital
8. Dr. Debbie Ngemaes, Director of Hospital Services and Administration,
Belau Hospital
9. Ms. Berry-Moon Watson, Director of Public Health, Palau MOH
PIHOA BOARD AFFILIATE MEMBERS
1.
American Pacific Nursing Leaders Council (APNLC)
2.
Cancer Coalition of the Pacific Islands (CCPI)
3.
Secretariat of the Pacific Community (SPC)
4.
Association of USAPI Labs (AUL)
5.
Pacific Resources for Education and Learning (PREL)
6.
Pacific Basin Medical Association (PBMA)
7.
Pacific Basin Dental Association (PBDA)
8.
Pacific Islands Primary Care Association (PIPCA)
9.
Pacific Basin Behavioral Health Collaborating Council (PHBCC)
10. Pacific Post-Secondary Education Council (PPSEC)
CURRENT IMPLEMENTATION PARTNERS
• WHO and SPC
• USAPI health agencies
• UH JABSOM and School of Nursing, UoG and
FNU CMNHS
• Local colleges – CMI, COM, PCC, ASCC and
NMC
• ASTHO
• APHL and DLS (Hawaii and Guam)
BOARD MANDATES
• Promote improved health practices
• Provide a forum for the exchange of information and knowledge
• Be a vital link/network between and among visiting medical and
health professionals
• Promote health-related research beneficial to the welfare of the
people of the Pacific
• Increase the knowledge and practice of public health in the
region by promoting high professional and medical education
standards
• Foster and support other organizations that have similar public
health purposes and objectives
• Research on funding mechanisms to maximize the quality and
quantity of health services available to the Pacific
• Foster regional efforts in providing appropriate means of
improving the accessibility, quality and cost-effective delivery of
healthcare services to the address the needs of Pacific
communities
STRATEGIC PLAN 2013-17 OUTCOMES
• Outcome 1 – Demonstrated political leadership at the highest level
to take responsibility for and address health at national and regional
levels
• Outcome 2 – Have ensured appropriately adapted, contextualized
and relevant multi-sectorial policy environment to mainstream
health responses
• Outcome 3 – Priority cost-effective and evidence-based
interventions with appropriately set performance monitoring
frameworks, including research and surveillance efforts, are
supported and strengthened
• Outcome 4 – Have ensured that priority public health responses
are adequately resourced and sustainable, including appropriate
and relevant human resources, infrastructure, financial resources
and technical assistance
• Outcome 5 – Have ensured accountability of all sectors, including
pertinent non-health sectors, for their respective contributions to
stated health priorities
• Outcome 6 – Strengthened advocacy and community engagement
in health
• Outcome 7 – Strengthened health systems to effectively respond to
health priorities
SCOPE OF WORK 2013-17
 Ancillary and Support Services
 Health Information Management Systems (HIMS)
 Performance Improvement
 Human Resources for Health (HRH)
 Strategic Planning and Engagement
 Policy Development
ANCILLARY AND SUPPORT SERVICES
• TA and consultation on laboratory system improvement
process for Level I and II labs
• Improvement of influenza lab-based surveillance and other
infectious diseases
• Strengthening specimen shipping networks, including
diagnostic referrals and IATA certification (Specimen
Referral Revolving Fund)
• Consultation and TA to strengthen local lab potential and
accreditation, including LQMS
• Communication and networking with regional USAPI lab
networks, including local health agencies and regional
partners (CDC, WHO and SPC)
PERFORMANCE IMPROVEMENT AND HIMS
• Strengthen QA & QI programs in local health agencies –
design and implement QI projects / develop policies and
procedures
• Building Quality & Performance Communities of Practice
through workshops, conference calls, listserv (pacificqualnet@googlegroups.com), and cross-jurisdiction
attachments
• Development, dissemination and mentoring for local college QI certificate curriculum
• Rapid performance and quality program assessments
• Assistance to health officials to identify performance indicators that match agency
priorities, develop data definitions and methods for collection, assemble dashboards,
and integrate use of dashboards into QI program plans and management routines
• Development & delivery of EpiTech curriculum for preparedness,
environmental health, NCD and outbreak-prone disease surveillance
• Development of advanced applied epidemiology fellowship – Field
Epidemiology Training Program
• Health Metrics Network/Pacific Rapid Assessment and Strategic
Planning Process consults
• Cross-jurisdiction mentored peer consultations – SWAT team
approach
• As needed, assistance with preparing systems requirements sets for
proposed EHR projects
• As needed, arranging expert review of IT contracts and arranging
informatics consultations
• Facilitation and review of Planning for Agency Reform/Project
Design
USAPI NCD CORE SURVEILLANCE FRAMEWORK
Tobacco
Deaths
(30-69 years)
Chronic Lung
Diabetes
Cancer
Cardiovascular
All Cause
↑Cholesterol
N
DM
↓
Diseases
(adult)
HTN
↓ N
Adult
CNMI
↑BMI
Youth
N
Adult
↓
Youth
Am Samoa
Alcohol
Chew- Adult
Chew- Youth
Cigs- Adult
Cigs- Youth
USAPI
NCD
Core
Surveillance
Indicators
↓
↑
N
N N N
N
↓
N
↑
↑ ↑ N
↓
Chuuk
15 – Improved
15 – Worsened
33 – No Change
81 – Insufficient Data
FSM
Kosrae
Pohnpei
Yap
Out of 144 Indicators:
N
N
N
N
N
Guam
↓ ↓
↑
N
↓
Palau
↑ N
↓
N
↓
RMI
↑
↓
↑
↓
↓
N
↓
N
N
N
N
N
N
N
N
N
N
N
↑
N ↑ ↑
↑
↑
↑ ↑ N
N
HUMAN RESOURCES FOR HEALTH
• Home Caregiving training to families
for the homebound
• Oral Health Workforce Education Plan
implementation in partnership with
WHO
• Formal undergraduate Public Health
training network
• Environmental Health strategic
planning and workforce training and
education
• HR Management mentoring and
coaching
• Foundations Sciences implementation
• TA to local and regional health licensure boards and professional associations,
including coordination/networking
• Nursing Education - local clinical faculty training, Bachelors in Public Health
Nursing, Nurse Practitioner training, and support to the APNLC - Chief Nurse
Association
• Updating HRSA HPSA designations and improving NHSC recruitment and
retention
• Continuing health professional development – all levels
STRATEGIC ENGAGEMENT AND POLICY
Building consensus and regional response to health issues of regional significance
Declaring a Regional State of Emergency to the NCD Crisis in the USAPIs - PIHOA
Resolution 48-01, May 2010
APIL Resolution No. 31-GA-05, CD1
“Relative to strengthening formal collaborative efforts between the
Association of Pacific Island Legislatures (APIL) and Micronesia
Chief Executives’ Summit (MCES).”
BE IT RESOLVED that APIL fully supports the work and initiative of Pacific Island Health
Officers Association (PIHOA) in "Calling for a Health, Non-Communicable Law and Policy
Summit" to bring together MCES, APIL, Micronesian Traditional Leaders, Chief Health
Executives (PIHOA), and world experts (WHO, CDC, SPC, etc.) to review the large body of
law and policy experience in addressing NCDs with the view that templates of such NCD laws
and policies may assist chief executives and legislators in addressing the NCD crisis in their
respective jurisdictions;
THE COMMITMENT
Fifteen Essential Policies for Reversing the Epidemic of NCDs in the USAPIs
Risk Factor: Tobacco
Commitment 1:
Commitment 2:
acts
Commitment 3:
Commitment 4:
Increase taxes on tobacco products
Pass and enforce model comprehensive smoke-free air
Restrict all forms of tobacco product advertising
Establish and sustain tobacco cessation programs
Risk Factor: Alcohol
Commitment 5:
Restrict all forms of alcohol advertising
Commitment 6:
Restrict access to alcohol
Commitment 7:
Increase taxes on alcohol
Risk Factor: Poor Nutrition
Commitment 8:
Implement policies that reduce salt consumption
Commitment 9:
Implement policies that reduce sugar consumption
Commitment 10:
Implement policies that reduce fat consumption
Commitment 11:
Implement policies that promote breastfeeding
Commitment 12:
Implement policies that promote local foods
Risk Factor: Lack of Physical Activity
Commitment 13:
Develop the built environment to promote physical
activity
Commitment 14:
Promote physical activity in the work place
Commitment 15:
Promote physical activity in the schools
• Endorsed by the PIHOA
Board in 2013
• Currently being
streamlined into new
USAPI NCD Plans (Guam
completed)
• USAPI NCD Law and
Policy Summit
• Online USAPI
NCD Policy
Toolkit aligned
to the USAPI
NCD
Commitment
Package
• Under
development
in partnership
with UH
JABSOM