The US-Affiliated Pacific Islands (USAPIs) face chronic public health workforce shortages, impacting sustainable health systems. In response, the Pacific Island Health Officers' Association (PIHOA) health leadership called for the establishment of a regional public health workforce training program. The Pacific Public Health Fellowship Program (PPHFP) was developed through a partnership between PIHOA and the US Centers for Disease Control and Prevention. PPHFP is the first regional cross-cutting public health fellowship model implemented across the USAPIs, aiming to create a sustainable and competent local public health workforce pipeline. PPHFP is a 2-year, mentorship and competency-based model providing full-time experiential training and placement in local health departments, combined with structured mentorship, comprehensive curriculum, and an individualized work plan mapped against 45 public health core competencies. In 2025, an independent mixed-methods impact evaluation was conducted for PPHFP Fellows in the first 5 cohorts. Results indicate strong satisfaction and local workforce retention rates. Overall program satisfaction was 100% among all Fellows (n=43) and host site supervisors (n=35). Among graduates (n=27), 81% secured local USAPI public health positions, and a further 11% enrolled in health-related university-led education in the Pacific region. Fellows addressed health priorities, through the delivery of 27 projects establishing new health registries, dashboards, standard operating procedures, and other interventions influencing data-driven decisions. Evaluation findings demonstrate PPHFP as an effective model for strengthening a local public health workforce pipeline in resource-limited Pacific Islands. Additionally, strengthening transition planning to the workforce, expanding mentorship structures, and introducing a dual-track model may support long-term workforce sustainability.
Sharps injury is an occupational hazard to health care workers with risk of exposure to bloodborne infectious diseases. The Belau (Palau) National Hospital (BNH) Infection Prevention and Control (IPC) Protocol recommends initial blood work on the day of injury, followed by 4 follow-up appointments after 1, 2, 3, and 6 months, and clearance blood work after 12 months. Health care workers with 12-month blood work that indicates no new infection are considered to have completed clearance from exposure to bloodborne diseases. The objective of this research study was to examine factors affecting completion of sharps injury clearance at BNH from 2013 to 2024. Data were collected from the IPC program and the electronic health record sharps injury registry. From 2013 to 2024, 88 health care workers sharp injuries were included in the study and 30 (34%) completed clearance. The proportion of health care workers that completed clearance was similar across demographic characteristics, length of employment, and whether they had previously reported a sharps injury. Among health care workers who attended all 4 follow-up appointments, 100% (n=8) completed clearance. Among health care workers who missed at least 1 of their follow-up visits, 28% (n=22) completed clearance. Health care workers who attended the 6-month appointment had higher odds of completing clearance (OR 5.6, 95% CI [1.9, 16.2]) than those who did not attend the 6-month appointment. These findings indicate the need to strengthen IPC program efforts by providing appointment reminders to all health care workers who sustain sharps injuries, and educating new and existing staff about the IPC sharps injury clearance protocol.
