Needs Assessment Update

The needs assessment for the interim year 2022 was somewhat a challenge given the multiple events surrounding COVID 19 community spread in the territory.  Nevertheless, understanding the importance of continually monitoring the current health needs of women and children in American Samoa, the MCH Team were strategic in formulating new ways to continually collect and review the data, analyze the data to inform decisions, and evaluate program progress based on stakeholder input.  MCH Team also used a collective approach with information that was shared through consumer interviews, advisory councils, and social media feedback. 

Through this needs assessment, some noted changes in the health status for this reporting year compared to the year before indicates not much significant change in the healthcare delivery system.  This may be attributed to the shifting of focus from MCH daily operations to supporting overall governmental initiatives that addressed the spreading of COVID 19 in the community. The decline in numbers of women, pregnant women, infants and children, including CYSHCN served in the past couple of years is evident due to preparing for and combating COVID19.  As of April 1, 2020, American Samoa’s population was 49,710, representing a decrease of 10.5% from the 2010 Census population of 55,519b. Even with this decrease, it is expected that each year the population will continue to see a decline due to the decrease in birth rate and the increase death rate due to the non-communicable disease crisis and the limited healthcare services available on the islands. 

In the past year, Title V program capacity remained consistent, despite the challenges COVID brought into the community.  Although MCH staff were dispersed to different assignments in support of COVID operations, a continuity of support was maintained from wherever the staff was operating.  This was done mainly through phone calls to check on families during shut down periods to determine specific needs that MCH can support during COVID.  If needs were reported, MCH staff would prioritize arrangements for these needs to be met utilizing resources and partners in the community. Families of CYSHCN were supported by connecting them to transportation services that could take these families to vaccination sites and back home.  Medical professionals from CDC and the federal government who were deployed to American Samoa during the pandemic were instrumental in providing onsite training and specialized approaches to vaccinating CYSHCN, increasing confidence in families to access healthcare services during COVID19. 

This past year has seen a continued increase in the partnerships and collaborations between MCH and other partners who serve the same populations.  Such partnerships may have existed years before but were not actively collaborating to address the needs of the MCH population.  This past year MCH team strengthened associations with special education by being a proactive member in their advisory council, and recruiting family members of CYSHCN to join and use their voices to advocate for issues that benefit their children with disabilities.  MCH also became a contributing member of the advisory committee for the Money Follows the Person (MFP) Initiative that will support transitioning of individuals with disabilities from institutions to the home.  MCH team attends these meetings and contributes to policy development, informant interviews, and pre-implementation activities. 

On the federal level, MCH continually worked with CDC and WHO in developing Risk Communication and Community Engagement (RCCE) activities during the COVID pandemic for the Department of Health and government overall.  MCH leaders in the creation and dissemination of public information regarding COVID, with special consideration and focus on MCH populations.  Opportunities to also work with Non-Profit Organizations who received funding to assist with COVID projects allowed MCH to learn more about the capacity of local non-profits who could partner in addressing MCH priorities based on the needs assessment.  Organizations such as EPIC (Empowering Pacific Island Communities) and Intersections Inc. are just some of the local nonprofits who are continually working closely with MCH to address critical health issues pertaining to adolescents and children such as suicide prevention and sexual abstinence. 

Efforts are continually being taken to operate the Five-Year Needs Assessment process and findings.  This year, the MCH team came together to formulate a plan in data collection and held several meetings to closely evaluate the data and have discussions around how this information could be used to monitor progress and achievements in the program.  Careful processes were taken to validate this data and because there were several ports data was collected from, the team also had discussions around which data systems were to be used for the reporting and why such systems for preferred. 

Interviews were conducted with contacts who shared data from LBJ Hospital, the WIC Office, the DOH surveillance office, and the Community Health Centers.  Once the data was verified and analyzed, the MCH team then prepared a brief report of the findings to have as points of discussion during the stakeholder meetings. For this year’s stakeholder meeting, MCH team decided to conduct these meetings virtually.  This was the first time for MCH to use a virtual platform to conduct a stakeholder meeting. 

Stakeholder meeting was split into two separate meetings to accommodate sufficient time for partners to discuss findings from the data collection.  Partners were invited to participate in time slots according to the populations they were serving, whether it was women, perinatal/infant, children, adolescents, or CYSHCN.  Partners were also given opportunities to ask questions, comment, or request for more information throughout these virtual meetings.  Each member of the MCH team were delegated a population to present findings and initiate a discussion among the groups to determine new and continued priorities.

Given that this was a first virtual stakeholder meeting with our partners, the expectation was not certain as to how many would attend.  However, MCH was pleased to witness close to 20 partners signed in to take part for each of these very important meetings.  Partners were able to share insights on the data that was reported and make recommendations as well as highlighting emerging issues from their perspective to be considered in addressing the overall health and wellbeing of women and children in American Samoa. 

After completing the Stakeholder meetings, the MCH Team again gathered to align recommendations from the partners together with findings from the previous year, and finalize the workplan for the new funding year.  This method permitted the entire team to closely review and evaluate how we, as a team, can work towards achieving set priorities from the initial Five-Year Needs Assessment but also to determine how the COVID pandemic impacted the progress of this five-year plan and how we can get back on track. This process has allowed our team to gain more insight on how we can progress in improving the lives of our MCH population for all of American Samoa.

Within the Department of Health, the MCH Program is currently under the supervision of the Deputy Director, Mrs. Fara Utu and the Assistant Deputy Director Ben Sili.  All programs within the DOH fall under their supervision and are to consistently communicate all program matters for their awareness.  The Department of Health Director, Motusa Tuileama Nua, has direct oversight and final decision on all program matters.