Table 1

FSM field epidemiology project examples

Project typeExamplesCommentsPublic health action
Performance monitoringNational Key Performance Indicators ProjectDeveloped collaboratively across all four FSM. Supported commitment to reach SDGs and other national priorities.Used as basis for annual strategic planning and budgeting at state and national levels
Disease surveillanceDevelopment of standardised NCD surveillance plans and annual NCD status dashboardsDeveloped collaboratively across all four FSM states.Harmonised approach to use of surveys and vital stats to track NCD epidemic. Used as a basis to annual strategic planning for NCD programmes and advocacy.
Development of standardised communicable disease surveillance plans, action thresholds, and weekly report templatesDeveloped collaboratively across all four FSM states. Lab-based surveillance introduced. Projects supported FSM commitments for improved surveillance and control of communicable disease under IHR.Early detection through weekly state-level surveillance of influenza and hepatitis A outbreaks; this resulted in the early response by state outbreak control teams
Health surveysRapid secondary school risk factor surveyIdentified high and rising prevalence of betel nut use in youth.Results used in successful campaign to regulate sales of betel nut.
Identification of disease ‘hot spots’Geographical distribution of leprosy in Pohnpei State, FSMIdentified that most infections in FSM are limited to a few locations.Intensive leprosy case-finding and treatment activities initiated in three villages.
Chlamydia infections in Yap State, FSMIdentified high and rising incidence of chlamydia infections among youth and in outer islands.Initiated outreach and universal screening of target populations.
Hospital admissions for alcohol-related injuries in PohnpeiHigh frequency of admissions, especially among youth.Results successfully used for advocacy of stricter law regulating alcohol sales.
Analysis of FSM Cancer Registry DataIdentification of cervicacancer as the no 1 cause of cancer death in the FSMProgramme changes to increase the frequency of cervical cancer screening and to increase levels of HPV vaccination in schools from 85% to 95%
Service deliveryLost to follow-up of severely mentally ill patients in Pohnpei StatePatients residing in outlying rural areas lost to follow-up at high rates.Enhanced outreach; purchase of vehicle for use by mental health programme.
Clinical quality improvementPreventive services coverage in Kosrae State, FSMDocumented low levels of coverage. Defined indicators and processes for data collection, monitoring of indicators and improvement of delivery of preventive servicesEstablished baseline measures and initiated ongoing QI programme for primary care in Kosrae.
  • FSM, Federated States of Micronesia; HPV, Human Papilloma virus; IHR, International health regulations; NCD, non-communicable diseases; QI, quality improvement; SDG, sustainable development goals.