Author: Einstein Roby

Advancing Digital Health Technology to Transform Health Outcome

Yap, FSM – In its effort to improve access to and better health outcome, the FSM Department of Health and Social Affairs held its 4^th Annual digital health conference in the State of Yap from September 1-5, 2025.  This is a significant milestone in its journey toward a digital health environment.  The weeklong event brought together key national and state stakeholders, global partners, and technical experts to align efforts, share challenges, and build actionable strategies around FSM’s digital health transformation.

Building on the themes of strategic alignment, infrastructure development, cybersecurity, capacity building, and action planning, this conference emphasized intergovernmental collaboration, capacity development, and the responsible advancement of digital health tools and policies.

Day 1: Opening & Strategic Alignment

The conference opened with a prayer by Fr. Rich McAuliff, SJ, followed by welcoming remarks from Director Theo Thinnifel, setting an optimistic tone grounded in Yapese hospitality and FSM’s vision for a modern and equitable health system.  Secretary Marcus Samo delivered the keynote address, articulating the FSM Department of Health and Social Affairs vision on digital health, which boils down to making the health work environment digitally user-friendly, modern, secure, and robust that advances access to health and better health outcome for all.  This vision is premised on an interoperable and resilient health system. This was complemented by a presentation from WHO Consultant Mr. Mugagga Malimbo, who introduced the WHO Digital Health Strategic Plan, showcasing its alignment with FSM’s national goals. Health Planner Joey Wichep outlined FSM’s health KPIs within the broader Sustainable Development Goals (SDGs) framework, stressing the importance of data-driven planning. Les De Wit, from the BES program, presented an overview of the Tamanu Electronic Medical Records System, detailing its phased implementation across FSM.  The afternoon featured state-level presentations from Kosrae, Chuuk, Yap, and Pohnpei, where IT and data teams candidly shared their unique challenges and opportunities, from workforce shortages to infrastructure gaps and data governance issues.

Day 2: Infrastructure & Network Upgrades

With a focus on building a digital health foundation, Day 2 began with a virtual session led by Nathan Bonnice from National ICT & Caedeus, mapping out the current network capacity across FSM. Assistant Secretary Edward Albert (TC&I) discussed the FSM Digital Project, addressing infrastructure goals to support evolving health services. A critical panel facilitated by SPC’s Dr. Rumanusina Maua and Dr Jeff Montgomery explored the intersection of Health Information Systems (HIS), Civil Registration and Vital Statistics (CRVS), climate change, and public health. The day closed with WHO Consultant Dr. Mugagga Malimbo leading a forward-looking discussion on vision alignment and goal setting, culminating in a multi-stakeholder panel with representatives from all FSM states reaffirming their commitment to a unified digital health future.

Day 3: Cybersecurity in Health Systems

As digital tools scale, FSM recognizes that trust and data security are foundational. Alex Wheatley (ASTHO) opened the day with a session on Data Quality and Modernization, covering policy standards and federal alignment.

Assistant Secretary Minoru Stephen and Security Specialist David Loyola from the Division of Cyber Security introduced cybersecurity essentials, highlighting threat mitigation and protection strategies tailored to FSM’s context.

In the afternoon, state IT managers presented real-life cybersecurity incidents, walked participants through risk assessments, and shared recovery frameworks—underscoring the urgent need for robust, localized security protocols.

Day 4: Consensus Building & Capacity Development

Dedicated to workforce development and collaboration, the fourth day opened with a virtual session led by Ms. Ursula Phoenix Weir (PHIG Branch Chief), who shared PHIG’s commitment to advance implementation and accomplishments in capacity building across FSM’s four states and the Pacific Region. Augustus Elias, FSM Health ICT Administrator, led a Skills Gap Analysis Workshop, identifying critical talent shortages, training needs, and potential partnerships to support FSM’s digital health workforce. The afternoon session, led by Mae Balderrama, focused on the FSM Health Lab’s HCLAB system, detailing SOPs, implementation updates, and the essential role of quality assurance in laboratory systems.

To provide first-hand experience of the challenges and success the health assistants are facing, a site visit to Ulithi and Fais was arranged for the FSM Secretary of Health & Social Affairs, Mr. Marcus Samo; the Yap Director Health Services, Mr. Theo Thinnifel; Consultant and former Director of Health Service in Chuuk, Dr. Bosco Buliche; and Chief Financial Officer of the FSM Department of Health and Social Affairs, Mr. Scott Mori. It was evident that the dispensaries on these islands need  renovation, water catchment system, reliable power supply, and communication system. With reliable Internet, medical consultation with doctors at Yap hospital will be possible, let alone regular training and access to online resources for continuing medical education.

Day 5: Action Planning & Closing

The final day brought the week’s work together in an engaging review of key themes and takeaways. Participants engaged in drafting state-level action plans with short-term goals and realistic timelines. Each state presented their tailored roadmap, reflecting local realities while aligned with the national framework.

The conference closed with remarks from the Secretary of the FSM Department of Health and Social Affairs, Mr. Marcus Samo, reminding participants that “Everyone in this room has a role in the digital health technology space; we are all stewards of applying health systems technology to improve health of the FSM people”.  Mr. Secretary highlighted a simple use of technology for telepathology to improve diagnostics in real-time between FSM and Japan.  Mr. Augustus Elias expressed gratitude to all participants for their continued collaboration and announced preparations for next year’s gathering.

Signifying the importance of Internet connectivity for health, the FSM Department of Health had the opportunity to handover 5 Starlink units to the Yap Director of Health of Services to be used for the dispensaries that have power (electricity or solar).  The other states will also receive some Starlink units.

The conference celebrations culminated in a cultural reception hosted at Pine Bar, featuring an opening prayer by Fr. Rich McAuliff, SJ, and farewell remarks by Theo Thinnifel. FSM Secretary Marcus Samo offered special remarks, applauding the week’s progress and reaffirming national support for digital transformation. The evening featured traditional dances from Gagil (Ladies) and Rumung (Men), gift presentations, and an open remarks session where consultants and state delegations reflected on the week’s achievements over dinner.

FSM Department of Health – July 18, 2025 – Public Health workers including health assistants in Pohnpei and Chuuk States are gaining new skills to better connect with families and improve immunization coverage, thanks to a series of Interpersonal Communication (IPC) Skills workshops organized by the FSM National Department of Health and Social Affairs in collaboration with the Pohnpei and Chuuk State Departments of Health, with technical support from UNICEF and the FSM National Immunization Program Manager, Mr. Carter Apaisam.

The most recent workshop, held in Chuuk State from July 8 – 9, brought together nurses, immunization officers and health assistants for two days of hands-on and interactive training. The sessions were facilitated by Pius Attandoh, UNICEF Social Behavior Change Specialist, and focused on active listening, empathetic engagement, and respectful communication to help address vaccine hesitancy and improve caregiver trust.

Earlier this year, a similar IPC workshop was conducted in Pohnpei State for 15 health and public health workers. Both workshops were graced by the presence of the Chiefs of Public Health, Mr. Semenson Ehpel (Pohnpei State) and Dr. Dorina Fred (Chuuk State)-  who emphasized the importance of strong communication in delivering quality health services and increasing vaccine uptake.

The workshops highlighted that the main goal of IPC in immunization is to ensure children receive their vaccinations on schedule by fostering respectful, trust-based relationships between frontline health workers (FLWs) and caregivers. Participants learned how to tailor their communication to caregivers’ beliefs, knowledge levels, and concerns—especially in communities where cultural, religious, or political influences may affect vaccine acceptance.

“This training gave me the confidence to talk to caregivers in a more respectful and effective way,” said one participant. “I now understand how empathy can change conversations.”

The sessions also emphasized the importance of adapting communication strategies depending on whether a caregiver is bringing a child for the first dose or for follow-up vaccinations. While vaccine hesitancy and access issues often affect the former, the quality of service and communication plays a greater role in ensuring return visits.

“I used to struggle with how to respond to vaccine-hesitant parents,” shared another attendee. “After this training, I feel prepared and ready to engage them with facts and compassion.”

Interactive role-plays, videos, and group discussions helped participants reflect on how tone, body language, and cultural sensitivity can influence caregiver decisions.

“The role-plays and videos really opened my eyes. I now realize how much my tone and body language affect communication with caregivers,” said one health worker.

“I am so excited about the new IPC techniques we learned, especially how to build trust and listen better,” added another. “I can’t wait to apply them in my outreach work.”

With strengthened IPC skills, Pohnpei and Chuuk frontline health workers are now better equipped to reduce vaccine hesitancy, improve caregiver experiences, and ensure more children complete their vaccination schedules, contributing to healthier communities across the nation. The next stop is Yap and Kosrae States.

YAP, FSM – The Federated States of Micronesia (FSM) Department of Health & Social Affairs proudly inaugurated its new Field Office in Yap on July 18, 2025. The event coincided with the presence of national health leadership in Yap, following the conclusion of the 2025 Health Directors’ Meeting.

The establishment of the Field Office marks a significant milestone in strengthening collaboration and coordination between the National Government and the State of Yap. This new office underscores the Department’s commitment to bringing services closer to the people and ensuring a more responsive and connected health system across all FSM states.

The Department extends its sincere appreciation to Mr. Theo Thinnifel, Director of the Yap Department of Health Services, and Ms. Maria Law, President of the Yap Women’s Association, for their partnership and support. The new office is located in the Yap Women’s Association Complex, whose provision of space has been instrumental in realizing this initiative.

Moving forward, the FSM Department of Health & Social Affairs will continue working closely with the Yap Department of Health Services and the Yap Women’s Association through the Field Office to enhance access to health resources, improve service delivery, and implement key health programs for the benefit of the Yapese community.

YAP, FSM – Health leaders from across the Federated States of Micronesia (FSM) gathered in Yap for a three-day national health convening, joined by FSM MiCare and development partners including the Asian Development Bank (ADB), United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), and the World Health Organization (WHO). While a range of pressing health issues were addressed, the summit underscored a sobering reality: FSM is in the midst of a full-scale Non-Communicable Disease (NCD) crisis requiring urgent and coordinated action.

NCDs—including diabetes, cardiovascular disease, cancer, and chronic respiratory conditions—are now the leading cause of premature death in FSM, accounting for over 80% of such deaths. Diabetes alone contributes to nearly one in five deaths among adults aged 30–69. The economic impact is equally severe, with the nation spending approximately $6 million annually on overseas medical referrals, the majority linked to NCD complications.

Despite past efforts—including state-level emergency declarations and the adoption of national and regional frameworks—NCD risk factors remain widespread. Increasing rates of obesity, persistent tobacco and betelnut use, unhealthy dietary habits, and declining physical activity continue to accelerate the crisis. FSM health leaders emphasized that this is not a distant challenge but a current and intensifying emergency.

A virtual presentation by Dr. Peter Brett, an oncologist based in the Commonwealth of the Northern Mariana Islands (CNMI), highlighted the strong correlation between betelnut chewing and oral cancer. The presentation noted striking similarities in cancer cases between the CNMI and FSM. Dr. Brett expressed interest in collaborating with FSM to investigate trends and offer clinical services. FSM officials acknowledged the potential of this regional partnership, particularly given shared risks and geographic proximity.

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Other Key Issues Addressed at the Convening of the FSM Health Directors’ Meeting

Health Dispensary Assessment
The National Assessment Team confirmed the completion of a nationwide assessment of health dispensaries. However, the publication of the report has been delayed due to missing and incomplete data from several states. The Team has been tasked to finalize the report within the next three months. Once completed, the findings will provide a critical evidence base for health leaders to advocate for greater investments from state and national governments, as well as development partners, to improve frontline service delivery across the country.

Health Workforce Development
To address urgent gaps in the primary healthcare workforce, especially in remote and outer island communities, FSM is currently exploring ways to strengthen local health education. Negotiations are underway with the College of Micronesia-FSM (COM-FSM) to revise the Health Assistant curriculum, ensuring graduates are equipped with the skills, tools, and competencies necessary to meet today’s healthcare demands. The Public Health Infrastructure Grant (PHIG) Team also presented updates on the number of healthcare staff onboarded since the program’s inception and engaged in dialogue with the states on future workforce support.  The health leadership also discussed opportunities for training of new and existing doctors, nurses, and other health workers that are in the pipeline with other partners and institutions.  It was clear that more needs to be done to attract students into medical and other health fields after high school.

Universal Health Coverage and Primary Health Care
Achieving Universal Health Coverage (UHC) remains a core commitment of FSM’s health sector. The health leadership reaffirmed that strengthening Primary Health Care (PHC) systems—particularly at the community and dispensary level—is key to achieving UHC and reducing reliance on costly off-island care. Discussions centered on expanding access to essential services, improving health literacy, and integrating care delivery across all levels of the system.

Climate Resilience & Health – Green Climate Fund (GCF) Project
On July 01, 2025, the Green Climate Fund (GCF) approved FSM’s project proposal “Increasing Resilience to the Health Risks of Climate Change”.  The project aims to address the increasing impacts of climate change from vector-, water-, and food-borne diseases.  The project will address policy, capacity and collaboration for effective management of climate-sensitive health risks, harmonize climate and health information systems, and adaptation intervention in vulnerable communities across FSM.  Funding in the amount of $17.9M is made available from GCF to support this project over the next 5 years.

FSM Competent Authority- World Bank PROPER Project
The PROPER project has three broad components and several sub-projects to be implemented collaboratively by various National and States departments/agencies/programs in support of overall fisheries and economic development in FSM.  The total budget for PROPER is $56M and DHSA’s share is $2.5M to support further development of our Competent Authority (CA) to enable FSM to access the lucrative European Union (EU) Fish Market.  The key DHSA activities to be supported by the PROPER project include: (1) strengthening of our CA through additional trainings for CA Officers, securing additional CA assets, maintenance of health and sanitary conditions of fishing vessels and processing facilities through audits, monitoring of safety of fish products through sampling and analysis for microbiological and chemical contaminants, and through other means as may be prescribed by EU Regulations; (2) establishment of a national reference laboratory to strengthen FSM’s capability to carry out required tests in-country instead of sending samples off-island for testing, and (3) improving the fish landing site structure and provisioning of safer and cleaner water to the Kosrae seaport.  All these activities will support strengthening of FSM’s CA to fishing industry and eventually gaining access to the EU market.

Vaccine Security and Management – UNICEF
UNICEF reported that FSM currently funds only the Pneumococcal Conjugate Vaccine (PCV) through Congressional appropriations, with all other vaccines provided through support from the U.S. Centers for Disease Control and Prevention (CDC). Recent U.S. funding cuts, following the enactment of the so-called “Beautiful Bill,” place FSM’s vaccine supply chain at risk. To address this, UNICEF is collaborating with GAVI, The Vaccine Alliance, to explore alternative vaccine support mechanisms and maintain uninterrupted immunization coverage.

Sexual and Reproductive Health and Rights (SRHR) – UNFPA
UNFPA highlighted the critical importance of advancing sexual and reproductive health and rights in FSM. Strengthening SRHR services is seen as vital for reducing maternal and adolescent health risks, achieving equitable health outcomes, and accelerating progress toward the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC).

Health Financing and Infrastructure – ADB
The Asian Development Bank confirmed the allocation of $4 million in health sector funding for FSM, pending national decisions on how the resources will be used. Proposed priorities include revitalizing rural health dispensaries and enhancing air and sea transport to outer islands. FSM’s recent reclassification from “low” to “moderate” debt distress also opens the possibility of accessing concessional loans alongside traditional grants, offering greater flexibility in health financing options.

Antimicrobial Resistance (AMR) and Stewardship (AMS) – FSM Pharmaceutical Unit
The FSM Pharmaceutical Unit highlighted the escalating threat of antimicrobial resistance, which is driven by inappropriate antibiotic use and poses serious public health risks. The unit called for Health Leadership commitment to strengthening of AMR and AMS committees in all states and encouraged health providers to take a more active role in promoting the responsible use of antibiotics. Recommendations also included forming national medical associations and establishing systems for clinical governance, with the National Government expressing readiness to support and fund these initiatives.

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A Roadmap for the Future
At the conclusion of the convening, FSM’s health leadership endorsed the FSM Health Strategic Development Plan (HSDP) 2024–2034, a ten-year roadmap focused on advancing health equity, resilience, and sustainability. The plan outlines a unified path forward and reinforces the nation’s collective commitment to improving health outcomes for all communities.

The convening concluded with a clear message: the health of the FSM population is in crisis, and the moment to act is now.

The FSM Department of Health Services & Social Affairs is excited to announce the release of the key findings from the recent Digital Literacy & Access Survey conducted among high school students and staff in Pohnpei, as part of the FSM Digital Gender Project. Funded by the World Bank and led by the FSM Department of Health & Social Affairs, this survey provides critical insights into the digital landscape facing youth today. The results reveal a high level of enthusiasm for technology, with 93% of respondents eager to use digital tools, yet highlight significant challenges such as concerns over online safety, data security, and unequal access, especially in rural areas where 66.7% of participants live. Notably, nearly 19% lack consistent internet connectivity or digital devices, underscoring the urgent need for infrastructure improvements. These insights will inform tailored digital literacy programs, online safety initiatives, and infrastructure development strategies to bridge disparities and promote inclusive digital participation. The findings mark an important step forward in shaping project priorities, ensuring that all youth in FSM can safely and confidently thrive in the digital age.

A 14-member medical team consisting of medical doctors, specializing in obstetrics and gynecology, anesthesiology, pediatrics, surgery, public health; specialized nurses; biomedical technologists, specializing in biomedical engineering, and medical imaging visited Chuuk from May 5-18, 2025 to support Chuuk Hospital medical staff.  The team saw 235 patients and performed life-saving procedures and surgeries on 17 patients. They also fixed 29 medical equipment that had been idle; conducted basic emergency training in obstetrics and newborn care; provided prenatal care screening; and conducted continuing medical education to the local staff.

The medical team is a result of a Memorandum of Understanding (MOU) signed by the FSM Secretary of Health and Social Affairs, Mr. Marcus Samo, and the Philippines Secretary of Health, Dr. Teodoro J. Herbosa.

The Philippines Obstetrics and Gynecology visiting medical team comprised of skilled obstetricians, gynecologists, internist, anesthesiologist, pediatricians, nurses, and support staff who committed their time and expertise to support Chuuk. During their visit, the medical team conducted health assessments, provided prenatal and postnatal care, carried out surgeries, provided gynecological examinations, and even assisted in the ER. These services are necessary as they help reduce complications related to women’s reproductive health, pregnancy and childbirth.  

The team also provided continuing medical education and training to the local staff.  The experience gained by the visiting medical team and the local healthcare providers will guide how the next team from the Philippines is structured and mobilized to the FSM.  The FSM Department of Health and Social Affairs plans to bring more specialized medical team to all FSM States.