Observed source
Actors and responsibilities
WHO reports a Pohnpei outreach programme involving health-service, community and traditional-leader actors; it is not a national authority map.
World Health Organization, Pohnpei outreach, 2020.
How the health system is organized
This profile follows the organizational chain from national institutions and subnational authorities to purchasers, provider organizations, referral networks, and people using services.
Formal source
Actors and responsibilities
The cited plans frame health direction as national and state alignment, without resolving every operational decision right.
FSM Strategic Development Plan, 2024; DHSA Framework, 2024.
Formal source
Decision rights and autonomy
The digital strategy proposes national standards and governance for health data, not a complete observed decision-rights matrix.
FSM Digital Health Strategic Plan, 2026.
Reported source
Decision rights and autonomy
The cited plans do not support a categorical autonomy score for hospitals or primary-care providers.
FSM Digital Health Strategic Plan, 2026; FSM Strategic Development Plan, 2024.
Reported source
Delivery and referrals
World Bank sources provide dated national density series and 2013-2014 state facility context, without current ownership or referral-flow denominators.
World Bank WDI, retrieved 2026; World Bank Public Expenditure Review, 2017.
Reported source
Delivery and referrals
Historical sources describe public state facilities and limited private services, but do not yield a current national public-private share denominator.
FSM DHESA Primary Care Assessment, 2005; WHO Country Cooperation Strategy, 2017; World Bank Public Expenditure Review, 2017; World Bank WDI, retrieved 2026; FSM Digital Health Strategic Plan, 2026.
Formal source
Relationships and networks
The strategy frames information interoperability across levels of care, but does not report referral completion, counter-referral or bypassing.
FSM Digital Health Strategic Plan, 2026.
Observed source
Relationships and networks
The WHO account describes observed Pohnpei outreach delivery. It does not establish a national referral-completion or bypassing rate.
World Health Organization, Pohnpei outreach, 2020.
Formal source
Reform and institutional change
The 2026 strategy is a five-year roadmap for digital health and data governance, not proof that each proposed reform has been implemented nationwide.
FSM Digital Health Strategic Plan, 2026.
Formal source
Reform and institutional change
DHSA publishes a 2024-2034 health-development framework; the source does not establish implementation outcomes.
FSM Department of Health and Social Affairs, Framework, 2024.
Open the interactive organization graph and national-subnational decision matrix
Methods, evidence, and data
Source traceability, coverage, citations, locators, source versions, and annotation materials are grouped here so the organizational synthesis remains the primary reading flow.
Directly mapped computable objects
Source-linked mappings drive the visible country synthesis and remain open for annotation. Canonical registries are reported separately so a zero in that publication layer is never mistaken for absent evidence.
| Object | Count | Meaning |
|---|---|---|
| Source-linked analytical mappings | 10 | Cited mappings rendered across the organization, decision, delivery, network, autonomy, and reform views. |
| Source-linked analytical object rows | 16 | Named graph nodes and edges, function assignments, decision cells, autonomy cells, pathways, and reform events supplied by those mappings. |
| Actors | 0 | Actors with explicit identity, territory, time, and evidence lineage. |
| Relationships | 0 | Evidence-backed actor-to-actor or actor-to-provider edges. |
| Decision rights | 0 | Actor, function, decision, and role assignments. |
| Provider organizations | 0 | Named or typed providers with evidence-backed ownership and management. |
| Autonomy records | 0 | Decision-domain authority paired with an autonomous-from actor. |
| Accountability records | 0 | Accountable-to actor and mechanism. |
| Referral designs | 0 | Formal referral, choice, bypass, and counter-referral arrangements. |
| Observed flows | 0 | Observed referral, bypass, mobility, or network flows. |
Source traceability and coverage
These six documentation measures describe the traceability available for displayed materials: domain coverage, public URLs, exact locators, source versions, and typed mappings. They do not measure health-system performance, source truth, institutional quality, or country success. A zero never means that an actor, authority, relationship, service, or activity is absent.
Documentation status: Explicit analytical mappings. All six source-traceability measures meet or exceed 80%. Materials remain open for annotation and country-specific refinement.
- Domain leads
- 100%17 of 17
- Source layers
- 100%3 of 3
- Public URLs
- 100%23 of 23
- Exact locators
- 100%23 of 23
- Source versions
- 100%23 of 23
- Typed mapping
- 100%5 of 5
Traceability gaps to address
- Review and annotate the country synthesis
All six preparation dimensions meet the target. Every source-linked finding and supporting material remains open for correction, qualification, and additional evidence through annotations.
Coverage by organizational domain
Source traceability across all 17 organizational domains
| Domain | State | Materials | URLs | Locators | Versions | Statements | Contexts | Typed |
|---|---|---|---|---|---|---|---|---|
| ActorsCritical | Direct typed mapping | 14 | 14 | 14 | 14 | 11 | 8 | 3 |
| Government responsibilitiesCritical | Direct typed mapping | 11 | 11 | 11 | 11 | 8 | 5 | 3 |
| Provider ownershipCritical | Direct typed mapping | 4 | 4 | 4 | 4 | 4 | 3 | 1 |
| Decision rightsCritical | Direct typed mapping | 6 | 6 | 6 | 6 | 6 | 3 | 3 |
| Provider autonomyCritical | Direct typed mapping | 3 | 3 | 3 | 3 | 3 | 2 | 1 |
| Primary care organizationCritical | Direct typed mapping | 15 | 15 | 15 | 15 | 12 | 8 | 4 |
| Hospital organizationCritical | Direct typed mapping | 10 | 10 | 10 | 10 | 10 | 6 | 4 |
| Referral designCritical | Direct typed mapping | 5 | 5 | 5 | 5 | 5 | 4 | 1 |
| Observed referral | Direct typed mapping | 8 | 8 | 8 | 8 | 8 | 5 | 3 |
| Provider networks | Direct typed mapping | 11 | 11 | 11 | 11 | 11 | 7 | 4 |
| Facility data | Direct typed mapping | 6 | 6 | 6 | 6 | 6 | 4 | 2 |
| Utilization | Direct typed mapping | 7 | 7 | 7 | 7 | 7 | 5 | 2 |
| Patient flows | Direct typed mapping | 8 | 8 | 8 | 8 | 8 | 5 | 3 |
| Governance and accountabilityCritical | Direct typed mapping | 13 | 13 | 13 | 13 | 10 | 5 | 5 |
| Market structure | Direct typed mapping | 6 | 6 | 6 | 6 | 6 | 4 | 2 |
| Reform historyCritical | Direct typed mapping | 6 | 6 | 6 | 6 | 6 | 3 | 3 |
| Authoritative review | Direct typed mapping | 7 | 7 | 7 | 7 | 7 | 4 | 3 |
Materials with the most complete source traceability
- Hospital beds per 1,000 people, Federated States of Micronesia
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:d60e33c99e050656a4c80f4e - Physicians per 1,000 people, Federated States of Micronesia
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:c82c5acf88c52bfcacff4913 - Assessing the Health Care System of Services for Non-Communicable Diseases in the US-affiliated Pacific Islands: A Pacific Regional Perspective
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:b4713294dca33521379a0656 - Comprehensive Assessment of Primary Care Systems
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:ad3f3318ac9b1f0a327b0f9e - Framework for Sustainable Health Development in the Federated States of Micronesia 2024-2034
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:9962f6b7bcd145ef0d30cbc5
Complete country materials
Every collected library candidate, queue record, source lead, statement, context, machine flag, and public projection assigned to this country is rendered below. Each item remains open for text-anchored annotation. A missing direct analytical mapping never hides the broader material.
- All material records
- 23
- Library documents
- 0
- Queue records
- 22
- Public-stage records
- 1
- Cited source records
- 1
- Source-linked statements
- 0
- Exact contexts
- 0
- Structured source-linked findings
- 10
- Direct typed relationships
- 0
All collected materials
23 records are rendered in full. Stage duplicates remain visible because a document candidate, triage record, statement, and exact context are separately annotatable objects.
Candidate Analytical Mapping · Open for annotation
2024 health-development framework
FSM Department of Health and Social Affairs, Framework, 2024.
Statement or annotation question
DHSA publishes a 2024-2034 health-development framework; the source does not establish implementation outcomes.
Source links
Candidate Analytical Mapping · Open for annotation
Digital data-governance direction
FSM Digital Health Strategic Plan, 2026.
Statement or annotation question
The digital strategy proposes national standards and governance for health data, not a complete observed decision-rights matrix.
Source links
Candidate Analytical Mapping · Open for annotation
Digital health roadmap
FSM Digital Health Strategic Plan, 2026.
Statement or annotation question
The 2026 strategy is a five-year roadmap for digital health and data governance, not proof that each proposed reform has been implemented nationwide.
Source links
Candidate Analytical Mapping · Open for annotation
Information interoperability is not a referral measure
FSM Digital Health Strategic Plan, 2026.
Statement or annotation question
The strategy frames information interoperability across levels of care, but does not report referral completion, counter-referral or bypassing.
Source links
Candidate Analytical Mapping · Open for annotation
National and state health alignment
FSM Strategic Development Plan, 2024; DHSA Framework, 2024.
Statement or annotation question
The cited plans frame health direction as national and state alignment, without resolving every operational decision right.
Source links
Candidate Analytical Mapping · Open for annotation
National capacity indicators
World Bank WDI, retrieved 2026; World Bank Public Expenditure Review, 2017.
Statement or annotation question
World Bank sources provide dated national density series and 2013-2014 state facility context, without current ownership or referral-flow denominators.
Source links
Candidate Analytical Mapping · Open for annotation
Observed outreach is subnational
World Health Organization, Pohnpei outreach, 2020.
Statement or annotation question
The WHO account describes observed Pohnpei outreach delivery. It does not establish a national referral-completion or bypassing rate.
Source links
Candidate Analytical Mapping · Open for annotation
Pohnpei outreach actors
World Health Organization, Pohnpei outreach, 2020.
Statement or annotation question
WHO reports a Pohnpei outreach programme involving health-service, community and traditional-leader actors; it is not a national authority map.
Source links
Candidate Analytical Mapping · Open for annotation
Provider autonomy remains unclassified
FSM Digital Health Strategic Plan, 2026; FSM Strategic Development Plan, 2024.
Statement or annotation question
The cited plans do not support a categorical autonomy score for hospitals or primary-care providers.
Source links
Candidate Analytical Mapping · Open for annotation
Public-private composition remains unquantified
FSM DHESA Primary Care Assessment, 2005; WHO Country Cooperation Strategy, 2017; World Bank Public Expenditure Review, 2017; World Bank WDI, retrieved 2026; FSM Digital Health Strategic Plan, 2026.
Statement or annotation question
Historical sources describe public state facilities and limited private services, but do not yield a current national public-private share denominator.
Source links
Country Improvement Source Lead · Open for annotation
Assessing the Health Care System of Services for Non-Communicable Diseases in the US-affiliated Pacific Islands: A Pacific Regional Perspective
Aitaoto N, Ichiho HM. Assessing the Health Care System of Services for Non-Communicable Diseases in the US-affiliated Pacific Islands: A Pacific Regional Perspective. Hawai'i Journal of Medicine & Public Health. 2013;72(5 Suppl 1):106-114. https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pmc&id=3689460
Statement or annotation question
The article metadata and abstract record a Pacific Chronic Disease Council assessment of administrative, clinical, support and data-system capacity that included FSM.
Source context or anchor
administrative, clinical, support, and data systems
Annotation prompts and machine flags
- This is a dated regional assessment. Its scope cannot establish current national delivery arrangements or a current referral measure.
Source links
Country Improvement Source Lead · Open for annotation
COVID-19 mitigation through community collaboration and outreach in Pohnpei State
World Health Organization. COVID-19 mitigation through community collaboration and outreach in Pohnpei State. 2020. https://www.who.int/about/accountability/results/who-results-report-2020-mtr/country-story/2020/micronesia
Statement or annotation question
WHO reports that Pohnpei's Department of Health Services developed a dispensary-strengthening outreach programme involving microplanning, travelling health teams and community actors.
Source context or anchor
integrated community health outreach service
Annotation prompts and machine flags
- This is an observed Pohnpei programme account, not a nationwide referral-completion series or a national provider-autonomy matrix.
Source links
Country Improvement Source Lead · Open for annotation
Comprehensive Assessment of Primary Care Systems
Federated States of Micronesia Department of Health, Education and Social Affairs. Comprehensive Assessment of Primary Care Systems. 2005. https://hsa.gov.fm/wp-content/uploads/2024/01/Comprehensive-Assessment-of-Primary-Care-Systems.pdf
Statement or annotation question
In 2005, FSM DHESA reported visiting 109 of 117 dispensaries across the four states.
Source context or anchor
109 of them (93%) were visited
Annotation prompts and machine flags
- This is a 2005 field assessment. It cannot establish current facility numbers, present referral completion, or current private-sector shares.
Source links
Country Improvement Source Lead · Open for annotation
FSM Digital Health Strategic Plan
Federated States of Micronesia Department of Health and Social Affairs. FSM Digital Health Strategic Plan. 2026. https://hsa.gov.fm/wp-content/uploads/2026/03/FSM-Digital-Health-Strategic-Plan-Signed-1.pdf
Statement or annotation question
The strategy describes fragmented information systems across states, facilities and programmes and sets out a planned interoperable system across hospitals, community health centres and dispensaries.
Source context or anchor
fragmented systems operating in isolation
Annotation prompts and machine flags
- This is a strategy and implementation roadmap. It is not evidence that every proposed digital arrangement is already operational.
Source links
Country Improvement Source Lead · Open for annotation
Federated States of Micronesia Public Expenditure Review
World Bank. Federated States of Micronesia Public Expenditure Review. 2017. https://documents1.worldbank.org/curated/en/459201506345399463/pdf/107082-REVISED-127p-FSM-PER-FINAL.pdf
Statement or annotation question
For 2013-2014, the review reports one public hospital in each state and a second private hospital in Pohnpei.
Source context or anchor
Each of the four states had one public hospital
Annotation prompts and machine flags
- This review reports dated service-structure and activity indicators. It does not provide a current ownership share, provider-autonomy score, or referral-completion rate.
Source links
Country Improvement Source Lead · Open for annotation
Federated States of Micronesia Strategic Development Plan 2024-2043
Federated States of Micronesia. Strategic Development Plan 2024-2043. 2024. https://fsm-data.sprep.org/resource/1480/download/file
Statement or annotation question
The plan aligns national and state health themes and identifies priorities spanning primary, secondary and tertiary services, health workforce, information and financing.
Source context or anchor
national and state healthcare policies that align
Annotation prompts and machine flags
- The plan describes priorities and alignment. It is not a legal allocation of staffing, procurement, capital or facility management authority.
Source links
Country Improvement Source Lead · Open for annotation
Federated States of Micronesia-WHO Country Cooperation Strategy 2018-2022
World Health Organization Regional Office for the Western Pacific. Federated States of Micronesia-WHO Country Cooperation Strategy 2018-2022. 2017. https://iris.who.int/server/api/core/bitstreams/22679675-5f7f-4532-a096-f5bd48d4d938/content
Statement or annotation question
WHO describes state departments as providing services through hospitals, community health centres and dispensaries.
Source context or anchor
Each state system is autonomous
Annotation prompts and machine flags
- The autonomous state-system description does not allocate provider-level financial, staffing, procurement, capital, operations or service-mix authority.
Source links
Country Improvement Source Lead · Open for annotation
Framework for Sustainable Health Development in the Federated States of Micronesia 2024-2034
Federated States of Micronesia Department of Health and Social Affairs. Framework for Sustainable Health Development in the Federated States of Micronesia 2024-2034. 2024. https://hsa.gov.fm/wp-content/uploads/2024/05/Framework-for-Sustainable-Health-Development-in-the-FSM-1.pdf
Statement or annotation question
The Department of Health and Social Affairs publishes the 2024-2034 national framework as a strategic health-development direction.
Source context or anchor
Framework for Sustainable Health Development
Annotation prompts and machine flags
- The framework records intended direction for 2024-2034. It does not by itself prove implementation, provider autonomy, or patient-flow outcomes.
Source links
Country Improvement Source Lead · Open for annotation
Hospital beds per 1,000 people, Federated States of Micronesia
World Bank. World Development Indicators, Hospital beds per 1,000 people, Federated States of Micronesia. Retrieved 2026-08-21. https://api.worldbank.org/v2/country/FSM/indicator/SH.MED.BEDS.ZS?format=json
Statement or annotation question
The World Bank API provides a dated national series for hospital beds per 1,000 people.
Source context or anchor
Hospital beds per 1,000 people
Annotation prompts and machine flags
- Bed density is not an ownership share, a utilisation measure, a provider-autonomy measure or a patient-flow measure.
Source links
Country Improvement Source Lead · Open for annotation
Physicians per 1,000 people, Federated States of Micronesia
World Bank. World Development Indicators, Physicians per 1,000 people, Federated States of Micronesia. Retrieved 2026-08-21. https://api.worldbank.org/v2/country/FSM/indicator/SH.MED.PHYS.ZS?format=json
Statement or annotation question
The World Bank API provides a dated national physician-density series.
Source context or anchor
Physicians per 1,000 people
Annotation prompts and machine flags
- Physician density does not allocate staffing authority, describe service volume or demonstrate patient movement.
Source links
Displayed source projection · Open for annotation
Pacific Islands-WHO multi-country cooperation strategy 2024-2029
WHO Regional Office for the Western Pacific. Pacific Islands-WHO multi-country cooperation strategy 2024-2029. 2024. https://www.who.int/westernpacific/publications/i/item/9789290620587
Annotation prompts and machine flags
- Public source projection retained as a distinct stage record.
- A recoverable source locator was retrieved from this exact public source URL in the locator-gap traceability audit.
Source links
Source Triage Record · Open for annotation
Pacific Islands-WHO multi-country cooperation strategy 2024-2029
WHO Regional Office for the Western Pacific. Pacific Islands-WHO multi-country cooperation strategy 2024-2029. 2024. https://www.who.int/westernpacific/publications/i/item/9789290620587
Annotation prompts and machine flags
- Verify the exact bibliographic citation against the original source.
- Confirm that the document applies to the named country and intended territorial scope.
- Confirm document type, issuing institution, authority, and claim-specific suitability.
- Retrieve and hash the exact source version when it is not already verified.
- Check publication date, effective period, currency, and supersession risk.
- Confirm only domains directly supported by the reviewed source.
- Add substantive feedback directly through the text-anchored annotation layer.
- A recoverable source locator was retrieved from this exact public source URL in the locator-gap traceability audit.
Source links
Targeted Source Lead · Open for annotation
Pacific Islands-WHO multi-country cooperation strategy 2024-2029
WHO Regional Office for the Western Pacific. Pacific Islands-WHO multi-country cooperation strategy 2024-2029. 2024. https://www.who.int/westernpacific/publications/i/item/9789290620587
Annotation prompts and machine flags
- Authoritative official source page or publication exposes country-specific health-system organization, governance, delivery, or primary-care context.
- Immutable source-version metadata was retrieved from this exact public source URL in the locator-gap traceability audit.
- A recoverable source locator was retrieved from this exact public source URL in the locator-gap traceability audit.