The Virgin Islands Department of Health (VIDOH) is dedicated to reducing health risks, improving access to quality healthcare, and enforcing health standards. Our mission statement guides our programs and services, which focus on preventing illness and injury, providing resources for healthy choices, regular health screenings, and vaccinations, promoting healthy living and working environments, and ensuring preparedness for emergencies. Collaboration with other government departments, agencies, and community partners is essential in achieving these goals.

VIDOH is responsible for administering the Title V Maternal and Child Health Block (MCHB) Grant, which is housed in the Maternal Child Health (MCH) and Children with Special Health Care Needs (CSHCN) Division. The MCH Division is a part of the Bureau of Health Promotion and Disease Prevention and includes several other programs such as Early Hearing Detection and Intervention (EHDI), Maternal, Infant, Early Child Home Visiting (MIECHV), State System Development Initiative (SSDI), Project Launch, Virgin Islands Child Psychiatry Access Program (VICPAP), and the Newborn Screening (NBS) program.

Our dedication is to improve the health of women, children, and families. Over the years, the MCH & CSHCN Division has provided quality healthcare to women, infants, children, adolescents, and children with special health care needs in the territory. The vision of the Maternal Child Health Division is to ensure "optimal health and quality of life for all children and youth with special health care needs and their families." This approach emphasizes the importance of creating an efficient and effective care system that addresses not only the child's needs but also those of their family and the entire community.

The Title V program serves a diverse population on the four main islands of the USVI: St. Thomas, St. Croix, St. John, and Water Island. The official language is English, and the 2020 Census reported a population of 87,146, with 17,086 children representing 19.6% of the total population. The USVI population is multi-ethnic and multiracial, with people from various backgrounds, particularly from Caribbean countries and other independent territories. The 2020 census reports, the population consists of 77% black, 10.5% white, 12.5% other races, and 17% identify as Hispanic origin.

The racial, ethnic, and cultural diversity of the USVI population presents both challenges and opportunities. Priorities to meet the needs of the Title V population include promoting safe sleep behaviors, breastfeeding, a medical home for CSHCN; encouraging physical activity among children; improving access to healthcare for women; and enhancing dental care access for children and women.

For CSHCN, priorities involve ensuring access to medical homes/primary care and improving access to mental health services for all children. Our corresponding strategies and activities intentionally embrace health equity, family partnership, transition, life course, workforce, and essential public health services to provide comprehensive support for the population we serve.

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The USVI's Title V program is driven by a five-year needs assessment and continual assessment during interim years. State priorities were identified through this assessment process, encompassing all five health domains, and addressing disparities. Nine national performance measures (NPMs) were chosen based on these priorities to guide programmatic focus.

To address priority needs and selected performance measures, various strategies are employed through health initiatives and activities. Collaborations with other health programs, other government departments and agencies, community partners, and stakeholders ensure the successful implementation of these initiatives.

The territory's Title V program plays a crucial role in providing comprehensive, coordinated, and family-centered services. Data-driven decision making is prioritized, and partnerships with other MCH programs, other DOH programs and government agencies that serve the MCH population ensure a holistic approach to serving the MCH population.

Recognizing that health outcomes are influenced by factors beyond the healthcare system, the Department takes a broader approach to improve health and achieve health equity. Under the leadership of the MCH Director, the Title V program collaborates with diverse public and private partners. Stakeholders such as government agencies, healthcare providers, employers, community groups, universities, schools, nonprofit organizations, and advocacy groups all play a role in this collaborative effort.   This collaborative and data-driven approach ensures that the USVI's Title V program is effective in addressing the unique needs of its population and striving towards improved health outcomes and health equity for all.

Based on the Needs Assessment findings, VI MCH selected the following NPMs and developed the following SPMs for the FY21-FY25 Title V MCH Block Grant Cycle:

Through NPMs, VI MCH focuses on specific areas such as well-women visits, safe sleep practices, developmental screening, preventative medical visits, medical homes for children with special health care needs, and oral health care for the children's population. SPMs encompass prenatal care and access to family support services. While the performance measures remain unchanged from the previous five-year cycle, the strategies, activities, and programming have evolved and will continue to be enhanced. Health education, family partnerships, and addressing health disparities and inequities remain central to all aspects of the Title V programming, forming the foundation of efforts to improve the health outcomes for the USVI MCH population.

The USVI provides awareness, education, support, and resources to enhance the health of women, infants, children, adolescents, and Children with Special Health Care Needs. Collaborating with other government agencies serving the MCH population is vital to ensure effective coordination of care.

Domain: Women/Maternal Health

State Priority: Increase the number of women who have well visits.

SPM: Increase the percentage of pregnant women who enroll in prenatal care through the MCH clinic in the first trimester.

NPM 1: Percent of women ages 18 through 44, with a preventative medical visit in the past year

Significance: A well-woman or preconception visit provides a critical opportunity to receive recommended clinical preventive services, including screening, counseling, and immunizations, which can lead to appropriate identification, treatment, and prevention of disease to optimize the health of women before, between, and beyond potential pregnancies.

Domain Perinatal/Infant Health

State Priority: Increase the number of families educated on safe sleep practices.

NPM 5A) percent of infants placed to sleep on their backs B) Percentage of infants placed to sleep on a separate approved.

ESM 5.1: Percent of families receiving safe sleep educational materials at District Birthing Hospital

Significance: Sleep-related infant deaths, also called Sudden Unexpected Infant Deaths (SUID), are the leading cause of infant death after the first month of life and the third leading cause of infant death overall. Sleep-related SUIDs include sudden infant death syndrome (SIDS), unknown cause, and accidental suffocation and strangulation in bed.

State Priority: Increase the number of women breastfeeding up to six months.

NPM 4 A): Percent of infants who are ever breastfed B) Percent of infants breastfed exclusively through 6 months.

ESM 4.1: Percent of infants ever breastfed.

Significance: Breastfeeding strengthens the immune system, reduces respiratory infections, gastrointestinal illness, and SIDS, and promotes neurodevelopment. Breastfed children may also be less likely to develop diabetes, childhood obesity, and asthma.

Domain Child Health

State Priority: Decrease the number of children with BMI >85%

NPM 8.1.1: Percent of children, ages 6 through 11, who are physically active at least 60 minutes per day

Significance: Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability. Physical activity in children and adolescents reduces the risk of early life risk factors for cardiovascular disease, hypertension, Type II diabetes, and osteoporosis. In addition to aerobic and muscle-strengthening activities, bone-strengthening activities are especially important for children and young adolescents because the majority of peak bone mass is obtained by the end of adolescence.

State Priority: Increase the percentage of developmental screenings done in the territory.

NPM 6: Percent of children ages 0-8 who received a developmental screening using a parent-completed screening tool in the past year.

Significance: Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home. The percentage of children with a developmental disorder has been increasing, yet overall screening rates have remained low. The American Academy of Pediatrics (AAP) recommends screening tests begin at the nine-month visit. The developmental screening measure is endorsed by the National Quality Forum and is part of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP.

State Priority: Increase access to oral health care for the Maternal Child Health population

NPM 13.2.1 Percentage of children ages 5 to 12, who had a preventative visit in the past year.

ESM: Percent of children ages5-12, who have had a preventative dental health visit in the past year.

Significance: Oral health is vitally important to overall health and well-being. Good oral health habits and access to routine dental care should be established early in life. Poor oral health can affect school attendance and a child’s ability to learn.

Domain: Adolescent Health

State Priority: Increase access to comprehensive primary and preventative health care for adolescents and pre-adolescents

NPM 10: Percent of adolescents, ages 12-17 with a preventative medical visit in the past year

ESM 10.1: The percentage of adolescents, ages 10 through 19, receiving school-based preventative health services.

Significance: Adolescence is a period of major physical, psychological, and social development. As adolescents move from childhood to adulthood, they assume individual responsibility for health habits, and those who have chronic health problems take on a greater role in managing those conditions. Initiation of risky behaviors is a critical health issue during adolescence, as adolescents try on adult roles and behaviors. Risky behaviors often initiated in adolescence include unsafe sexual activity, unsafe driving, and use of substances, including tobacco, alcohol, and illegal drugs.

Receiving health care services, including annual adolescent preventive well visits, helps adolescents adopt or maintain healthy habits and behaviors, avoid health‐damaging behaviors, manage chronic conditions, and prevent disease. Receipt of services can help prepare adolescents to manage their health and health care as adults.

Domain: Children and Youth with Special Health Care Needs

State Priority: Increase percentage of families that participate in transition planning.

NPM 11: Percent of children with and without special health care needs, ages 0 through 17, who have a medical home.

ESM 11.1 Percentage of children with and without special health care needs ages 0 through 17, who have a medical home.

SPM 2: The percent of CSHCN clients who access family support services.

Significance: A patient-centered medical home (PCMH) provides accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective medical care. It is especially advantageous for CSHCN as they require coordination of care between providers.

State Priority: Improve the percentage of developmental screenings done in the territory.

NPM 11: Percent of children with and without special health care needs, ages 0 through 17, who have a medical home.

Significance: Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home. The percentage of children with a developmental disorder has been increasing, yet overall screening rates have remained low. The American Academy of Pediatrics (AAP) recommends screening tests begin at the nine-month visit. The developmental screening measure is endorsed by the National Quality Forum and is part of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP.

Domain: Cross-Cutting/Systems Building

State Priority: Increase access to oral health care services for the Maternal Child Health population

SPM 4: Increase access to oral health care services for the child and adolescent MCH populations

SOM 4: Percentage of Children, ages 5 through 12, who have decayed teeth or cavities in the past year.

Significance: Taking care of your child’s teeth from an early age is essential. Children’s teeth are susceptible to cavities, and that can affect their overall health. Preventive dental care refers to the routine dental visits you have with your dentist. It includes a variety of procedures and treatments that help you avoid dental issues. By helping your children form good oral hygiene habits at a young age, you can ensure that they will develop healthy teeth and gums throughout their lives.