An assessment of non-communicable diseases, diabetes, and related risk factors in the Republic of Palau: a systems perspective.

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Republic of Palau and describes the burden due to selected NCD (diabetes, heart disease, hypertension, stroke, chronic kidney disease); and assesses the system of service capacity and current activities for service delivery, data collection, and reporting as well as identifying the issues that need to be addressed. There has been a 7.1% increase in the population between 2000 and 2010. Significant shifts in the age groups show declines among children and young adults under 34 years of age and increases among adult residents over 45 years of age. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors are associated with overweight and obesity and subsequent NCD that play a significant role in the morbidity and mortality of the population. The leading causes of death include heart disease and cancer. A 2003 community household survey was conducted and 22.4% of them reported a history of diabetes in the household. A survey among Ministry of Health employees showed that 44% of the men and 47% of the women were overweight and 46% of the men and 42% of the women were obese. Other findings show significant gaps in the system of administrative, clinical, and support services to address these NCD. Priority issues and needs for the administrative and clinical systems were identified.

Chronic disease surveillance systems within the US Associated Pacific Island jurisdictions.

In recent years, illness and death due to chronic disease in the US Associated Pacific Islands (USAPI) jurisdictions have dramatically increased. Effective chronic disease surveillance can help monitor disease trends, evaluate public policy, prioritize resource allocation, and guide program planning, evaluation, and research. Although chronic disease surveillance is being conducted in the USAPI, no recently published capacity assessments for chronic disease surveillance are available. The objective of this study was to assess the quality of existing USAPI chronic disease data sources and identify jurisdictional capacity for chronic disease surveillance. The assessment included a chronic disease data source inventory, literature review, and review of surveillance documentation available from the web or through individual jurisdictions. We used the World Health Organization's Health Metric Network Framework to assess data source quality and to identify jurisdictional capacity. Results showed that USAPI data sources are generally aligned with widely accepted chronic disease surveillance indicators and use standardized data collection methodology to measure chronic disease behavioral risks, preventive practices, illness, and death. However, all jurisdictions need to strengthen chronic disease surveillance through continued assessment and expanded support for valid and reliable data collection, analysis and reporting, dissemination, and integration among population-based and institution-based data sources. For sustained improvement, we recommend investment and technical assistance in support of a chronic disease surveillance system that integrates population-based and institution-based data sources. An integrated strategy that bridges and links USAPI data sources can support evidence-based policy and population health interventions.

Pacific island partnership: the Pacific Cancer Initiative.

BACKGROUND: Cancer is a leading cause of mortality in the US Associated Pacific Island Nations (USAPIN) due to few resources for prevention, screening, and treatment. METHODS: We describe the formation of the Pacific Cancer Initiative (PCI), and the Cancer Council of the Pacific Islands (CCPI)to address the rising cancer burden in USA PIN. Since their inception, PCI and CCPI have conducted cancer needs assessments, developed strategic cancer plans, and acquired additional cancer program funding for USAPIN. RESULTS: We emphasize the importance of international/regional partnerships and participatory development in assuring sustainability of cancer programs in USAPIN. CONCLUSIONS: The USAPIN speak with a unified voice.

Cancer in the Republic of Palau (Belau).

This study, funded by the National Cancer Institute, assessed cancer awareness and service needs in the Republic of Belau (Belau) in April 2003. Cancer prevention and control is a concern for Belau, and this country maintains a cancer registry to track cases and outcomes. However, assistance is needed to strengthen and expand existing cancer-related services. Key informants requested help to develop a comprehensive cancer prevention and control program, increase the capacity of professional staff in diagnosing and treating cancer, and improve laboratory and pathology services.