Languages

Topbar Menu EN

Publication
Sustainable health care financing in the Republic of Palau

Published by: ADB


About

Financing health care is challenging and costly in the Pacific developing member countries (DMCs) of the Asian Development Bank (ADB). Financing sources are limited, and are dominated by general tax revenues. In the face of fiscal constraints, national health systems have been perennially underfunded, limiting the quality and equitability of health care. These problems, common to all developing countries, are compounded in most Pacific DMCs by their small, dispersed populations and by health care needs that are growing faster than in other regions. The Republic of Palau has for some time been among the Pacific DMCs looking to reform its health-care financing arrangements, with reform proposals dating back to 1995. Health-care delivery in Palau was satisfactory in many respects, but the cost was high and unsustainable. This policy brief describes the successful development in 2008-2009 of draft legislation aimed at reforming health-care financing in Palau, and its enactment by the legislature and signature by the President of the country in 2010. The brief was prepared by ADB to disseminate experience and lessons learned in Palau that may be found applicable elsewhere in the Pacific, in keeping with ADB's Pacific Approach 2010-2014.

View online / download

External Link

Links to external publications on the SDG Library are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by the SDG Fund or the UN of any of the products, services or opinions of the corporation, organization or individual. The SDG Fund or the UN bear no responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.


General Information

SDGs Goal 3: Good health and well-being Goal 10: Reduced inequalities
Published
2011
Array ( [#theme] => field [#weight] => 0 [#title] => External Link URL [#access] => 1 [#label_display] => hidden [#view_mode] => full [#language] => und [#field_name] => field_external_link [#field_type] => text [#field_translatable] => 0 [#entity_type] => node [#bundle] => publication [#object] => stdClass Object ( [vid] => 3508 [uid] => 1990 [title] => Sustainable health care financing in the Republic of Palau [log] => [status] => 1 [comment] => 1 [promote] => 0 [sticky] => 0 [nid] => 1367 [type] => publication [language] => en [created] => 1482593843 [changed] => 1488787137 [tnid] => 0 [translate] => 0 [revision_timestamp] => 1488787137 [revision_uid] => 1 [field_sdgs] => Array ( [und] => Array ( [0] => Array ( [target_id] => 225 [entity] => stdClass Object ( [vid] => 5471 [uid] => 1 [title] => Goal 3: Good health and well-being [log] => sysadmin replaced http://www.sdgfund.org with http://www.sdgfund.org via Scanner Search and Replace module. [status] => 1 [comment] => 1 [promote] => 0 [sticky] => 0 [nid] => 225 [type] => sdg [language] => en [created] => 1450137423 [changed] => 1517561646 [tnid] => 225 [translate] => 0 [revision_timestamp] => 1517561646 [revision_uid] => 1 [field_icon] => Array ( [und] => Array ( [0] => Array ( [fid] => 291 [uid] => 1 [filename] => E_SDG_Icons_NoText-03.jpg [uri] => public://E_SDG_Icons_NoText-03.jpg [filemime] => image/jpeg [filesize] => 51062 [status] => 1 [timestamp] => 1450137423 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 466 [width] => 466 ) [alt] => [title] => [height] => 466 [width] => 466 ) ) ) [field_body] => Array ( [und] => Array ( [0] => Array ( [value] =>

Ensure healthy lives and promote well-being for all

Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases. In 15 years, the number of people newly infected by HIV each year has dropped from 3.1 million to 2 million and over 6.2 million lives were saved from malaria. Since 1990, maternal mortality fell by 45 percent, and worldwide there has been an over 50 percent decline in preventable child deaths globally.  

Despite this incredible progress, AIDS is the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV are not accessing life-saving antiretroviral therapy. New HIV infections continue to rise in some locations and in populations that are typically excluded or marginalised.

Chronic and catastrophic disease remains one of the main factors that push households from poverty into deprivation. Non-communicable diseases (NCDs) impose a large burden on human health worldwide. Currently, 63% of all deaths worldwide stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The cumulative economic losses to low- and middle-income countries from the four diseases are estimated to surpass US$ 7 trillion by 2025. Additionally, there continues to be underinvestment in the social circumstances and environmental factors affecting health. The job on HIV and health is far from done.

Recognizing the interdependence of health and development, the Sustainable Development Goals (SDGs) provide an ambitious, comprehensive plan of action for people, planet and prosperity and for ending the injustices that underpin poor health and development outcomes.

SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all. Supporting research and development for vaccines is an essential part of this process as well as expanding access to affordable medicines.

Promoting health and well-being is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 3.

[format] => full_html [safe_value] =>

Ensure healthy lives and promote well-being for all

Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases. In 15 years, the number of people newly infected by HIV each year has dropped from 3.1 million to 2 million and over 6.2 million lives were saved from malaria. Since 1990, maternal mortality fell by 45 percent, and worldwide there has been an over 50 percent decline in preventable child deaths globally.  

Despite this incredible progress, AIDS is the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV are not accessing life-saving antiretroviral therapy. New HIV infections continue to rise in some locations and in populations that are typically excluded or marginalised.

Chronic and catastrophic disease remains one of the main factors that push households from poverty into deprivation. Non-communicable diseases (NCDs) impose a large burden on human health worldwide. Currently, 63% of all deaths worldwide stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The cumulative economic losses to low- and middle-income countries from the four diseases are estimated to surpass US$ 7 trillion by 2025. Additionally, there continues to be underinvestment in the social circumstances and environmental factors affecting health. The job on HIV and health is far from done.

Recognizing the interdependence of health and development, the Sustainable Development Goals (SDGs) provide an ambitious, comprehensive plan of action for people, planet and prosperity and for ending the injustices that underpin poor health and development outcomes.

SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all. Supporting research and development for vaccines is an essential part of this process as well as expanding access to affordable medicines.

Promoting health and well-being is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 3.

) ) ) [field_the_sdgf_work] => Array ( [und] => Array ( [0] => Array ( [value] => SDG Fund’s programmes contributing to SDG 3 [format] => [safe_value] => SDG Fund’s programmes contributing to SDG 3 ) ) ) [field_icon_with_text] => Array ( [und] => Array ( [0] => Array ( [fid] => 292 [uid] => 1 [filename] => E_SDG_Icons-03.jpg [uri] => public://E_SDG_Icons-03.jpg [filemime] => image/jpeg [filesize] => 82134 [status] => 1 [timestamp] => 1450137423 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 466 [width] => 466 ) [alt] => [title] => [height] => 466 [width] => 466 ) ) ) [field_the_sdg_fund_response] => Array ( [und] => Array ( [0] => Array ( [value] =>

The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

  • In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.
  • In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.
  • In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.
[format] => full_html [safe_value] =>

The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

  • In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.
  • In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.
  • In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.
) ) ) [field_targets] => Array ( [und] => Array ( [0] => Array ( [value] =>
  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
  • By 2020, halve the number of global deaths and injuries from road traffic accidents
  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
[format] => full_html [safe_value] =>
  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
  • By 2020, halve the number of global deaths and injuries from road traffic accidents
  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
) ) ) [field_sdg_targets_headline] => Array ( [und] => Array ( [0] => Array ( [value] => Goal 3 targets [format] => [safe_value] => Goal 3 targets ) ) ) [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [path] => Array ( [pathauto] => 1 ) [name] => sysadmin [picture] => 0 [data] => a:2:{s:7:"contact";i:0;s:7:"overlay";i:1;} ) [access] => 1 ) [1] => Array ( [target_id] => 239 [entity] => stdClass Object ( [vid] => 5485 [uid] => 1 [title] => Goal 10: Reduced inequalities [log] => sysadmin replaced http://www.sdgfund.org with http://www.sdgfund.org via Scanner Search and Replace module. [status] => 1 [comment] => 1 [promote] => 0 [sticky] => 0 [nid] => 239 [type] => sdg [language] => en [created] => 1450139062 [changed] => 1517561646 [tnid] => 239 [translate] => 0 [revision_timestamp] => 1517561646 [revision_uid] => 1 [field_icon] => Array ( [und] => Array ( [0] => Array ( [fid] => 313 [uid] => 1 [filename] => E_SDG_Icons_NoText-10.jpg [uri] => public://E_SDG_Icons_NoText-10.jpg [filemime] => image/jpeg [filesize] => 53758 [status] => 1 [timestamp] => 1450139062 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 466 [width] => 466 ) [alt] => [title] => [height] => 466 [width] => 466 ) ) ) [field_body] => Array ( [und] => Array ( [0] => Array ( [value] =>

Reduce inequality within and among countries

It is well documented that income inequality is on the rise, with the richest 10 percent earning up to 40 percent of total global income. The poorest 10 percent earn only between 2 and 7 percent of total global income. In developing countries, inequality has increased by 11 percent if we take into account the growth of population.

These widening disparities are a call for action that require the adoption of sound policies to empower the bottom percentile of income earners and promote economic inclusion of all regardless of sex, race or ethnicity.

Income inequality is a global problem that requires global solutions. This involves improving the regulation and monitoring of financial markets and institutions, encouraging development assistance and foreign direct investment to regions where the need is greatest. Facilitating the safe migration and mobility of people is also key to bridging the widening divide.

Reducing inequalities is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 10.

[format] => full_html [safe_value] =>

Reduce inequality within and among countries

It is well documented that income inequality is on the rise, with the richest 10 percent earning up to 40 percent of total global income. The poorest 10 percent earn only between 2 and 7 percent of total global income. In developing countries, inequality has increased by 11 percent if we take into account the growth of population.

These widening disparities are a call for action that require the adoption of sound policies to empower the bottom percentile of income earners and promote economic inclusion of all regardless of sex, race or ethnicity.

Income inequality is a global problem that requires global solutions. This involves improving the regulation and monitoring of financial markets and institutions, encouraging development assistance and foreign direct investment to regions where the need is greatest. Facilitating the safe migration and mobility of people is also key to bridging the widening divide.

Reducing inequalities is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 10.

) ) ) [field_the_sdgf_work] => Array ( [und] => Array ( [0] => Array ( [value] => SDG Fund’s programmes contributing to SDG 10 [format] => [safe_value] => SDG Fund’s programmes contributing to SDG 10 ) ) ) [field_icon_with_text] => Array ( [und] => Array ( [0] => Array ( [fid] => 314 [uid] => 1 [filename] => E_SDG_Icons-10.jpg [uri] => public://E_SDG_Icons-10.jpg [filemime] => image/jpeg [filesize] => 79518 [status] => 1 [timestamp] => 1450139062 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 466 [width] => 466 ) [alt] => [title] => [height] => 466 [width] => 466 ) ) ) [field_the_sdg_fund_response] => Array ( [und] => Array ( [0] => Array ( [value] =>

The SDG Fund response

The SDG Fund programmes undertake situation analysis to understand what inequalities underpin the challenges in the communities and countries where we work. By doing this, the programmes pay special attention to inequalities suffered by women, girls, indigenous people, older people, youth, and those living in geographical isolated communities. Our initiatives take inequalities into account and put into practice solutions to address them, responding to the 2030 Agenda’s mandate of leaving no one behind.

For example,

  • In Tanzania, the SDG Fund is working with the national government to scale-up one of its existing national programmes to reach all the extreme poor living below the food poverty line. In particular, it’s targeting women, children, youth, elderly, people living with disabilities and people living with HIV and AIDS. The programme employs conditional cash transfers, promoting employment through public works programmes, family planning awareness and primary and secondary school education.
  • In Bangladesh, the SDG Fund is working with ultra-poor women, particularly with those who are widowed, divorced or abandoned.  The programme is supporting the most vulnerable households to move out of poverty through public works jobs, education and financial literacy.
  • In Paraguay, the SDG Fund is supporting the government’s efforts to find integrated solutions to undernutrition and to address other health problems faced by indigenous and vulnerable rural households, particularly female-headed ones, to produce nutritious and diversified food production.
[format] => full_html [safe_value] =>

The SDG Fund response

The SDG Fund programmes undertake situation analysis to understand what inequalities underpin the challenges in the communities and countries where we work. By doing this, the programmes pay special attention to inequalities suffered by women, girls, indigenous people, older people, youth, and those living in geographical isolated communities. Our initiatives take inequalities into account and put into practice solutions to address them, responding to the 2030 Agenda’s mandate of leaving no one behind.

For example,

  • In Tanzania, the SDG Fund is working with the national government to scale-up one of its existing national programmes to reach all the extreme poor living below the food poverty line. In particular, it’s targeting women, children, youth, elderly, people living with disabilities and people living with HIV and AIDS. The programme employs conditional cash transfers, promoting employment through public works programmes, family planning awareness and primary and secondary school education.
  • In Bangladesh, the SDG Fund is working with ultra-poor women, particularly with those who are widowed, divorced or abandoned.  The programme is supporting the most vulnerable households to move out of poverty through public works jobs, education and financial literacy.
  • In Paraguay, the SDG Fund is supporting the government’s efforts to find integrated solutions to undernutrition and to address other health problems faced by indigenous and vulnerable rural households, particularly female-headed ones, to produce nutritious and diversified food production.
) ) ) [field_targets] => Array ( [und] => Array ( [0] => Array ( [value] =>
  • By 2030, progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average
  • By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
  • Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard
  • Adopt policies, especially fiscal, wage and social protection policies, and progressively achieve greater equality
  • Improve the regulation and monitoring of global financial markets and institutions and strengthen the implementation of such regulations
  • Ensure enhanced representation and voice for developing countries in decision-making in global international economic and financial institutions in order to deliver more effective, credible, accountable and legitimate institutions
  • Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies
  • Implement the principle of special and differential treatment for developing countries, in particular least developed countries, in accordance with World Trade Organization agreements
  • Encourage official development assistance and financial flows, including foreign direct investment, to States where the need is greatest, in particular least developed countries, African countries, small island developing States and landlocked developing countries, in accordance with their national plans and programmes
  • By 2030, reduce to less than 3 per cent the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5 per cent
[format] => full_html [safe_value] =>
  • By 2030, progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average
  • By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
  • Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard
  • Adopt policies, especially fiscal, wage and social protection policies, and progressively achieve greater equality
  • Improve the regulation and monitoring of global financial markets and institutions and strengthen the implementation of such regulations
  • Ensure enhanced representation and voice for developing countries in decision-making in global international economic and financial institutions in order to deliver more effective, credible, accountable and legitimate institutions
  • Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies
  • Implement the principle of special and differential treatment for developing countries, in particular least developed countries, in accordance with World Trade Organization agreements
  • Encourage official development assistance and financial flows, including foreign direct investment, to States where the need is greatest, in particular least developed countries, African countries, small island developing States and landlocked developing countries, in accordance with their national plans and programmes
  • By 2030, reduce to less than 3 per cent the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5 per cent
) ) ) [field_sdg_targets_headline] => Array ( [und] => Array ( [0] => Array ( [value] => Goal 10 targets [format] => [safe_value] => Goal 10 targets ) ) ) [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [path] => Array ( [pathauto] => 1 ) [name] => sysadmin [picture] => 0 [data] => a:2:{s:7:"contact";i:0;s:7:"overlay";i:1;} ) [access] => 1 ) ) ) [field_thematic_area] => Array ( ) [field_downloads] => Array ( ) [field_delivering_as_one] => Array ( ) [field_country_entity] => Array ( [und] => Array ( [0] => Array ( [iso2] => PW [value] => PW [country] => Entity Object ( [entityType:protected] => country [entityInfo:protected] => Array ( [label] => Country [entity class] => Entity [controller class] => EntityAPIControllerExportable [base table] => countries_country [fieldable] => 1 [module] => countries [entity keys] => Array ( [id] => cid [name] => iso2 [label] => name [revision] => [bundle] => ) [bundles] => Array ( [country] => Array ( [label] => Country [admin] => Array ( [path] => admin/config/regional/countries [access arguments] => Array ( [0] => administer site configuration ) ) [rdf_mapping] => Array ( ) ) ) [view modes] => Array ( [full] => Array ( [label] => Country [custom settings] => ) [token] => Array ( [label] => Tokens [custom settings] => ) ) [static cache] => 1 [field cache] => 1 [load hook] => country_load [translation] => Array ( ) [base table field types] => Array ( [cid] => serial [iso2] => char [iso3] => char [name] => varchar [official_name] => varchar [numcode] => int [continent] => char [enabled] => int [language] => varchar ) [schema_fields_sql] => Array ( [base table] => Array ( [0] => cid [1] => iso2 [2] => iso3 [3] => name [4] => official_name [5] => numcode [6] => continent [7] => enabled [8] => language ) ) [label callback] => countries_i18n_country_entity_label [token type] => country [configuration] => ) [idKey:protected] => cid [nameKey:protected] => iso2 [statusKey:protected] => status [defaultLabel:protected] => [wrapper:protected] => [cid] => 170 [iso2] => PW [iso3] => PLW [name] => Palau [official_name] => Republic of Palau [numcode] => 585 [continent] => OC [enabled] => 1 [language] => und [rdf_mapping] => Array ( ) ) [safe_value] => Palau [safe] => Palau ) ) ) [field_body] => Array ( [und] => Array ( [0] => Array ( [value] => Financing health care is challenging and costly in the Pacific developing member countries (DMCs) of the Asian Development Bank (ADB). Financing sources are limited, and are dominated by general tax revenues. In the face of fiscal constraints, national health systems have been perennially underfunded, limiting the quality and equitability of health care. These problems, common to all developing countries, are compounded in most Pacific DMCs by their small, dispersed populations and by health care needs that are growing faster than in other regions. The Republic of Palau has for some time been among the Pacific DMCs looking to reform its health-care financing arrangements, with reform proposals dating back to 1995. Health-care delivery in Palau was satisfactory in many respects, but the cost was high and unsustainable. This policy brief describes the successful development in 2008-2009 of draft legislation aimed at reforming health-care financing in Palau, and its enactment by the legislature and signature by the President of the country in 2010. The brief was prepared by ADB to disseminate experience and lessons learned in Palau that may be found applicable elsewhere in the Pacific, in keeping with ADB's Pacific Approach 2010-2014. [format] => [safe_value] => Financing health care is challenging and costly in the Pacific developing member countries (DMCs) of the Asian Development Bank (ADB). Financing sources are limited, and are dominated by general tax revenues. In the face of fiscal constraints, national health systems have been perennially underfunded, limiting the quality and equitability of health care. These problems, common to all developing countries, are compounded in most Pacific DMCs by their small, dispersed populations and by health care needs that are growing faster than in other regions. The Republic of Palau has for some time been among the Pacific DMCs looking to reform its health-care financing arrangements, with reform proposals dating back to 1995. Health-care delivery in Palau was satisfactory in many respects, but the cost was high and unsustainable. This policy brief describes the successful development in 2008-2009 of draft legislation aimed at reforming health-care financing in Palau, and its enactment by the legislature and signature by the President of the country in 2010. The brief was prepared by ADB to disseminate experience and lessons learned in Palau that may be found applicable elsewhere in the Pacific, in keeping with ADB's Pacific Approach 2010-2014. ) ) ) [field_year] => Array ( [und] => Array ( [0] => Array ( [value] => 2011-01-01 00:00:00 [timezone] => America/New_York [timezone_db] => America/New_York [date_type] => datetime ) ) ) [field_publication_keywords] => Array ( ) [field_publisher] => Array ( [und] => Array ( [0] => Array ( [value] => ADB [format] => [safe_value] => ADB ) ) ) [field_region] => Array ( [und] => Array ( [0] => Array ( [target_id] => 260 [entity] => stdClass Object ( [vid] => 1020 [uid] => 1 [title] => Asia [log] => [status] => 1 [comment] => 1 [promote] => 0 [sticky] => 0 [nid] => 260 [type] => region [language] => en [created] => 1450896508 [changed] => 1450896508 [tnid] => 260 [translate] => 0 [revision_timestamp] => 1450896508 [revision_uid] => 1 [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [name] => sysadmin [picture] => 0 [data] => a:2:{s:7:"contact";i:0;s:7:"overlay";i:1;} ) [access] => 1 ) ) ) [field_thumb] => Array ( [und] => Array ( [0] => Array ( [fid] => 2064 [uid] => 1 [filename] => healthcare-financing-palau-1.jpg [uri] => public://healthcare-financing-palau-1.jpg [filemime] => image/jpeg [filesize] => 89848 [status] => 1 [timestamp] => 1488787124 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 792 [width] => 612 ) [alt] => [title] => [height] => 792 [width] => 612 ) ) ) [field_featured] => Array ( ) [field_file_fr] => Array ( ) [field_file_ar] => Array ( ) [field_file_pt] => Array ( ) [field_file_es] => Array ( ) [field_external_link] => Array ( [und] => Array ( [0] => Array ( [value] => https://www.adb.org/sites/default/files/publication/29496/healthcare-financing-palau.pdf [format] => [safe_value] => https://www.adb.org/sites/default/files/publication/29496/healthcare-financing-palau.pdf ) ) ) [field_external_link_text] => Array ( [und] => Array ( [0] => Array ( [value] => External Link [format] => [safe_value] => External Link ) ) ) [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [name] => Library Manager 1 [picture] => 0 [data] => a:1:{s:7:"contact";i:0;} [entity_view_prepared] => 1 ) [#items] => Array ( [0] => Array ( [value] => https://www.adb.org/sites/default/files/publication/29496/healthcare-financing-palau.pdf [format] => [safe_value] => https://www.adb.org/sites/default/files/publication/29496/healthcare-financing-palau.pdf ) ) [#formatter] => text_plain [0] => Array ( [#markup] => https://www.adb.org/sites/default/files/publication/29496/healthcare-financing-palau.pdf ) [#description] => Please enter the full URL, e.g. http://www.example.com [#printed] => 1 )