1. COUNTRY PRESENTATION Commonwealth of the Northern Mariana Islands (CNMI)

2. Overview *CNMI: 14 islands; 3 Primary Inhabited Islands -Saipan, Rota and Tinian -Saipan, Rota and Tinian -Population: 53,883 (2010 Census) -Population: 53,883 (2010 Census) *Former DPH now CHCC -Public Law 16-51 effective October 1, 2011 -Public Law 16-51 effective October 1, 2011 - Board of Trustees, CEO, Corporate Officers - Board of Trustees, CEO, Corporate Officers -Semi-autonomous public governmental agency -Semi-autonomous public governmental agency -from a $38M Budget to $5M in FY2012 -from a $38M Budget to $5M in FY2012 -1 public hospital located in Saipan -1 public hospital located in Saipan -Divisions: Hospital, Public Health, THC, RHC -Divisions: Hospital, Public Health, THC, RHC *Top 3 CHCC Priority Issues: 1. Financial instability 2. Declining resources 2. Declining resources 3. NCDs 3. NCDs

3. NCDs and Associated Risk Factors 7 out of every 10 deaths in the CNMI

4. Fig 1. Number of New RD Patients by Year, 2009-2011.

5. According to a CNMI Nutrition Survey, 45% of 7- 10 year olds were obese or overweight. Childhood Obesity Source: CNMI Nutrition Cluster Survey, Paulino, et al.2008

6. Does CNMI have a Health Plan? No. No comprehensive “whole of society” health plan in place nor a CHCC strategic plan. CDC NPHII…

7. 4 Main Health Plans by 2012 1. Community Health Assessment 2. Community Health Improvement Plan 3. Governor’s Healthcare System Assessment 4. CHCC Strategic Plan

8. What plans are in place?

10. *2007 Strategic Plan *2008 CNMI HRH Action Plan *2008 NCD Plan *2012 Six months Division of Public Health Strategic Plan

11. PlanProcessStakeholdersGuide Strategic Direction 2007 Strategic Plan Paid off-island Consultant Doctors and Hospital Mgt NO. DOA. 2008 HRH PlanPIHOAGovernmental Agencies Needs to be updated. 2008 NCD PlanWHOCommunity & Gov’t Agencies Yes. 2012 PH Strategic Plan PIHOAPH Mgt TeamYes.

12. PlanWeaknessesStrengths 2007 Strategic Plan Lack of Awareness by Leadership Hospital-centered Well written report 2008 HRH PlanNo funding No Follow-up Identified Staff Inter-agency involvement Regional Initiative 2008 NCD PlanGovernment Agency controlled Lack of Awareness 3 year SPC Funding Community Involvement Regional Initiative 2012 PH Strategic PlanCompeting Priorities Lack clear objectives PH Mgt Team involvement Relevant

13. Lessons Learned on “the Plans” *Designate staff /champion with decision-making influence to keep the plan “Alive” *Keep Plan “Front & Center” horizontally and vertically (e.g. Active Collaboration & Engagement) *Secure and align funding (e.g. NA Program, NCD Plan) * Regular and consistent reporting of progress at all levels (e.g. Dashboards, targeted communication strategies)

14. Si Yu’us ma’åsi’ yan Ghilisoow!