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Palau - P4H Network
Current Health Expenditure (CHE) as % Gross Domestic Product (GDP)16.4%CHE/GDP
Out-of-pocket (OOPS) spending as % of Current Health Expenditure (CHE)15%OOP/CHE
Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE)11.1%GGHE-D/GGE
Gross Domestic Product (GDP), in constant (2020) US$ in millions (M), billions (B), or trillions (T)225MGDP (USD)
Population in thousands (K), millions (M) or billions (B)18KPopulation

Palau is a Pacific island nation with a population of about 18,000 in 2021, of whom approximately 69.9% are Palauan, 15.3% Filipino and 4.9% Chinese. Palau is divided into 16 states, with 79% of the population residing in the greater Koror urban area. The life expectancy at birth is 69 years. Palau has made significant progress in its health care initiatives in recent years, resulting in high immunization coverage and low maternal and child deaths. Palau  is moving forwards in reaching SDG goals– reducing childhood deaths, substance abuse, and tobacco use in the population. However, the nation struggles with non-communicable disease (NCD) reduction.

Heavy reliance on external funds despite high government expenditures

The current health expenditure (CHE) as a share of GDP is 18% with the government spending 73% of the CHE. Out-of-pocket (OOP) payments stand at 11%.[1] Palau heavily relies on foreign aid despite being classified as a high-income country. Palau boasts a universal health care system beginning with the establishment of The Palau Health Care Fund in 2010 through the National Health Financing Act. This law provides health and social welfare benefits through the individual mandate. It has two components: the National Health Insurance, which pools funds to cover in-patient and off-island referral costs; and the Medical Savings Account, which is geared toward medical checkups and out-patient services. The law directly benefits both the people and the government and keeps medical expenses in check.

Health services are available at the Belau National Hospital (the main health facility in the country), four community centres known as super dispensaries, and four additional satellite dispensaries.[2] The health facilities have been upgraded to mitigate its vulnerability to natural disasters. As its population ages, the NCDs will become increasingly prevalent health concerns. These diseases will likely become the focus of health care initiatives in Palau’s future. 

References

[1] Global Health Expenditure Database. https://apps.who.int/nha/database. Accessed 7 Dec. 2023.

[2] World Health Organization. Palau-WHO Country Cooperation Strategy 2018-2022. World Health Organization, Western Pacific Region, 2017.