Women/Maternal Health – Annual Report

Priority: Prenatal Care

National Performance Measure: Percent of women with a past year preventive medical visit

The percentage of women with a preventive medical visit decreased from 38% in 2017 to 34% in 2021.

The Palau MCH program encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care.

In 2021, Palau’s projected population based on the 2015 census was 18,526.  Approximately 3,360 or 39% are women of reproductive age (ages15-44).  Like the rest of the Pacific Islands Countries, Palau continues to battle with substance use and abuse (tobacco and alcohol) and non-communicable diseases.

According to the 2017 Hybrid Survey, 40% of women reported having issues with infertility, about 3% had ectopic pregnancies and 11% reported having had pelvic inflammatory disease (PID).  Palau continues to see low fertility levels below replacement fertility in the past 5 years. The overall fertility rate for Palau in 2021 was 1.9 per 1,000 women.  Fertility rates of women within the high-risk group of <20 years old was 28.1, a slight decline from 29.0 per 1,000 women in 2017.  Furthermore, the fertility rate of women ≥35 years old was at 39.8 in 2021. 

47.8% of females delivering a live birth received prenatal care beginning in the first trimester in 2021.  About 38.8% received prenatal care in the second trimester and 12.5% received care in the 3rd trimester.  Less than 1% did not receive any prenatal care.  25% of women said they did not get prenatal care as early as desired.  23% said they had too many things to do; 39% said did not know she was pregnant; 15% said other reason and 15% said they could not get an appointment.  about 60% of pregnant women who participated in the Prenatal Psychosocial Needs Assessment Survey (PPNAS) said they did not plan pregnancy.  About 4% said they did not accept the pregnancy and 4% were not happy with the pregnancy.

Cesarean delivery rate in Palau has doubled in the past 5 years.  42% of women who gave birth in 2021 had a cesarean delivery.  50% had no indication of complications, and13% were repeated CS. Furthermore, 60% of women had inter-birth interval of 1 year and maximum of 19 years.

Additionally, 51% of Palauan women said they use tobacco with betelnut daily, and about 18% binge drink or consume more than 4 alcohol drinks per day. Tobacco use among pregnant women in Palau increased in 2021 at 65% as compared to 52% in 2017 (PPRASS). About 25% said they decreased tobacco use during pregnancy, 36% said it remained the same, and none (0%) quit tobacco use.