Orthopedic surgery in Palau-Current capacity, needs, and future directions.

Area of Science:

• Global Health
• Surgical Outreach
• Health Systems Strengthening

Background:

• Palau, a Micronesian island nation, experiences a shortage of specialized medical services, particularly in orthopedics.
• Orthopedic conditions are a leading cause of expensive medical referrals from Palau to off-island facilities.

Purpose of the Study:

• To evaluate the existing orthopedic surgery capacity and identify needs within Palau.
• To inform targeted interventions for improving orthopedic care access and quality.

Main Methods:

• Utilized needs and capacity assessment tools developed by global surgical outreach experts.
• Gathered data through discussions with key stakeholders in Palau (n=6).
• Reported findings using descriptive analysis.

Main Results:

• Finance, community impact, governance, and professional development scored lowest on the Capacity Assessment Tool for orthopedic surgery (CAT-os).
• Administrators identified governance and finance as top priorities for capacity building, followed by professional development and partnerships.
• Belau National Hospital possesses adequate surgical infrastructure; common procedures needed include skin grafting, soft tissue procedures, infection management, and amputation.

Conclusions:

• A framework for orthopedic capacity-building in Palau is presented, potentially guiding collaborations between Palau's healthcare system and global outreach organizations.
• This study demonstrates a model for benchmarking, planning, and re-evaluating capacity-building efforts.
• The findings and framework can be applied to other medically underserved areas to improve access to high-quality orthopedic care.