title: Public health in the Republic of Palau: what we can learn from a small island country.
abstract: The Republic of Palau has a well-run public health system despite being a small, relatively isolated island country with limited resources and limited funds. Using interviews with key informants, participant observation in clinics throughout Palau, and a review of available reports, we identified themes locally regarded as central to the success of Palau's public health programs. These include a comprehensive definition of "health," a sense of community-ownership, creative efforts to identify effective behavioral modification techniques, efforts to improve internal training and infrastructure, quality assurance, the importance of leading by example, and a general willingness to collaborate and compromise. We suggest that recognition and application of these concepts would improve not only the public health systems and primary care settings of other Micronesian nations, but also help correct the increasingly dysfunctional healthcare of the United States.
authors.affiliation: Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai'i a t Manoa, Mililani, Hawai'i 96789-1192, USA.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Duerler
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Maskarinec
mesh_terms: D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration*; D004059:Diffusion of Innovation; D006295:Health Resources / Q000600:supply & distribution*; D006801:Humans; D019029:Palau; D011634:Public Health / Q000193:education* / Q000592:standards*; D015980:Public Health Practice