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Republic of Palau (BELAU) PIHOA Presentation


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Title: Republic of Palau (BELAU) PIHOA Presentation

Republic of Palau (BELAU) PIHOA Presentation
  • Gregorio Ngirmang, Minister of Health of the
    Republic of Palau

Ministrys Vision
  • The Ministry of Health is committed to healthy
    communities with access to high quality
    healthcare services. The efforts undertaken by
    the Ministry and its staff focused on providing
    comprehensive accessible healthcare services for
    our patients and community.

AUTHORITY Two parts of the Constitution of the
Republic of Palau address the governments
responsibility for health care services. The 23rd
Amendment to Article VI requires positive
government action to promote health and social
welfare of the citizens through the provision of
free or subsidized health care and the 24th
Amendment requires provisions of free preventive
health care for every citizen as prescribed by
law. The Ministry of Health is responsible for
implementing action to meet these governmental
mandates. According to PNC Title 2, Section 107,
The Ministry of Health shall be responsible for
promoting and protecting the public health,
providing clinical medical services to the
public, operating and managing public medical
facilities, and related matters.
Health of the Nation
  • The Health of the Nation is at a critical
    crossroad. There has been a dire
  • increase in Non-Communicable Diseases and risk
    factors such as cancer, heart disease, obesity,
    diabetes and high blood pressure rates. This has
    resulted in more people suffering from chronic
    conditions, and has led to the unfortunate and
    unnecessary loss of life and suffering of
  • Palau is one of the few countries that have
    universal healthcare coverage that is made
    affordable through government subsidies, the new
    National Health Insurance scheme or provided free
    through our federally funded Public Health
  • However, the increasing medical cost to treat
    patients with NCD is of serious concern to the
    government. Financially, NCDs account for 65 of
    hospital costs and almost ninety percent of our
    medical referral costs. Even more alarming is the
    threat to future generations of Palauans, our
    children. Current data indicate that 33 percent
    of school children are either overweight or
    obese. If this trend continues, healthcare costs
    will not only be unsustainable, the human cost
    would be unimaginable

NCD Challenge
  • Although the Ministry of Health is mandated by
    the Constitution with the responsibility of
    promoting and protecting the health of the
    nation, we cannot do this alone. The average
    total expenditure for health is roughly 9 of
    GDP, which ranks Palau as number 18th in world.
    Yet despite, our high ranking, Palauans have some
    of the worst rates of obesity, diabetes,
    hypertension, alcohol and tobacco use in the
  • We know from our experience that funding alone
    will not solve the issue. We may have the best
    doctors, nurses, and best hospital, but unless we
    make the changes we need to make in our laws, our
    churches, our schools, and our homes, our efforts
    will prove fruitless. Yet, there are some
    positive cost effective examples of our how
    collaboration with our policy makers and
    community can make a difference in our effort to
    reduce NCDs.

National Policy Change
In an effort to reduce Palaus high mortality
rates due to NCDs, we are focusing our resources
and coordinating our efforts through the Office
of the President, the Olbiil Era Kelulau (OEK)
and relevant Ministries to combat this threat to
the health of our nation Recent legislation
passed by the OEK and signed into law by the
President in 2014 raised taxes on all tobacco
products and helped discourage our unhealthy
addiction to tobacco Furthermore, the President
issued Executive Order 372, an initiative to
promote health for Palaus youth, mandating the
Ministry of Education and the Ministry of Health
to work together to promote physical activity,
health education, and good nutrition in our
schools and our community. This Year, the
Ministry announced that the Belau National
Hospital and all the Ministrys agencies will be
completely Tobacco and Betel Nut Free for all
staff, patients and the general public. The
Ministry will work with Office of the President
to make all Government Ministries, agencies and
programs to be Tobacco and Chew Free
Zones Health and Education have spearheaded
efforts to make the following changes in
schools Change Lunch Program to include more
vegetables, fruits, less salt and serve only
water Increase Physical Education and Classes on
Health Promotion Sugar and Salt Free Zones
International Partners/Institutions
  • USA
  • University of Arizona Professor Andrew Weil,
    Integrated Medicine Program/Residency Program
  • University of Northern Arizona Behavior and
  • Roanoke College Anthropology/Palauan Culture and
  • University of California, San Francesco
    Professor William Byerly, Study of Genetics of
    Schizophrenia in Palauan Population
  • Oklahoma State University Masters and Bachelors
    Degree Program in Prevention Services
  • University of Maine at Fort Kent Online Nursing
    Degree BSN Program
  • Republic of China, Taiwan
  • Shin Kong Hospital, Taiwan, Republic of China
    Nutrition and Impact on Performance/Medical
    Referral Program
  • Show Chwan Hospital Medical Cloud
    System/Community Health
  • Taiwan Adventist Hospital Medical
  • I-Shou University Four Year Medical School in
  • Fiji
  • Fiji National University (FNU) Degree
    Programs/Online and Distance Learning

  • Philippines
  • Cebu Doctors University Philippines Degree
    Program in Medicine, Nursing, Ancillary Services
  • The Medical City (TMC) Medical Referral /Medical
  • Global City St. Luke Medical Referral/Medical
  • Japan
  • Kanazawa Medical UniversityMedical Exchange
    Radiology Program
  • Osaka UniversityPublic Health and NCDs
  • Nagoya University Public Health Study on NCDs
  • Cuba
  • Elam University in Cuba Medical School
  • India
  • Fortis Hospitals Medical Referrral/Medical

Medical School in Cuba
  • Cuban Government Offers three (3) Scholarships
    to Palau every year to attend the Latin American
    School of Medicine to pursue a degree in Medicine
    (7 years total)
  • Palau began sending students in 2011 with 13
    students enrolled so far
  • Classes entirely in Spanish with no preliminary
  • Afterward they complete their final year students
    will be integrated into a special program in
    preparation for the United States Medical
    Licensing Exams (USMLEs)
  • During the program they will be relocated to the
    Higher Institute of Medical Sciences in Havana,
    the Faculty Salvador Allende which is accredited
    by the World Health Organizations and the
    California Medical School Board.
  • ELAM (Latin American School of Medicine) was
    established in 1999
  • Enrollment with approximately 19,550 students
    from 110 countries with international students
    from Latin America, Caribbean, Africa and Asia.

Commitment to Health
  • This Ministry has a vision of healthy communities
    with access to comprehensive health care
    services. We must commit to change, to a greater
    focus on holistic care, to a strengthening of our
    systems, and to better integration of services,
    as well as continue developing respectful and
    effective partnerships with our staff, patients,
    community, and other partners so that all of us
    have the support and care we need for a healthy

  • Thank you