Cross Cutting

Plan for Coming Year:

Continue to strengthen ongoing efforts and collaborations with external partners on this priority need. Work with other public health programs to incorporate strategies into their daily activities. Continue to provide trainings for providers on counseling in the area of substance use.

FHU continues to work with its collaborative partners and the schools in developing educational strategies and providing trainings on how to effectively work with adolescents in preventing substance use. FHU through the annual Health and PE workshop continues to support schools in developing health initiatives that address this measure.

This was a need identified through most of the stakeholder's meeting and providers meeting.  About 62.2% of pregnant women who participated in the 2014 PPRASS indicate use of betel nut with tobacco. This is an increase from the 2010 figure of 50.9%. The program continues to work with the Behavioral Health Cessation Program to address the use of tobacco during pregnancy. In 2015, the 'Palau Pregnancy Risk Assessment Surveillance System (PPRASS) shows that only one (1) of the surveyed mothers was smoking in the last three months of pregnancy. However (61% or 66/109) said that they were 'chewing betel nut with cigarette' during the last three months of pregnancy; Average of 64.5% of pregnant mothers chewed betel nut with cigarette from 2011-2014.  Only 34.7% of women received dental care before and during their recent pregnancy.

The 2014 School Health Screening revealed that about 7% of school age children who participated in the annual health screening were using tobacco. The program continues to work with various prevention programs including Behavioral Health, Oral health and NCO program to prevent tobacco use among children and adolescents. The 2015 school health screening shows that 11.1% (122/1103) screened students admitted to be using tobacco products either through smoking or chewing betel nut. Average age of initiation is at 12 years old (min.3/max 17). 63.9% or 78/122 of these students said they smoke tobacco and 86.1% (105/122) said they chew tobacco with betel nut.

Overall, this affects all areas of the MCH population.  Women who chew betelnut with tobacco (cigarettes or loose tobacco) that can affect the fetus and young children that chew that can cause tooth decay.  Chewing betelnut with tobacco can cause oral cancer in the entire MCH population and that is why it is of great concern.  Prevention is the key work that needs to be strengthened however, for those that have been identified to be users, cessation programs must be implemented and incorporated into their daily activities.  Supporting the Division of Behavioral Health in implementing tobacco control activities/awareness and also clinical implementation of the tobacco screening and brief counseling in health care and public health settings through training and documentation of the 5A’s.  Continue to strengthen ongoing efforts and collaborations with external partners on this priority need.  Work with other public health programs to incorporate strategies of tobacco prevention and cessation into their daily activities. Continue to provide trainings for providers on counseling in the area of substance use.  FHU continues to work with its collaborative partners and the schools in developing educational strategies and providing trainings on how to effectively work with adolescents in preventing substance use and also cessation (for current users).  FHU through the annual Health and PE workshop continues to support schools in developing health initiatives that address preventive work in tobacco use/abuse.  There are efforts to create policies in support for a tobacco free working environment and the program will support those efforts of establishments and offices that implement those.  For example, most restaurants and outdoor eating establishments have designated smoking areas for their patrons and for their tobacco free employees.  For identified pregnant women, they will be referred to the behavioral unit where the 5A’s will be implemented if they are willing to accept the intervention and education is given for all pregnant women on the effects of the tobacco use.  Data collection (survey) will be conducted on the number of legislations or policies (internal/private businesses, state or national government) in place.  Number of women using tobacco and are counseled and referred to a cessation program, dental care or further intervention services.