The CNMI MCH Title V priority for women/maternal health continues to focus on access to health services. The MCH program will work in partnership with clinical providers and other partners to ensure activities to address this priority are implemented on the islands of Saipan, Tinian, and Rota. Additionally, the newly acquired mobile clinic that arrived in the Summer of 2022 will be a critical component for strategies identified for expanding and increasing access to preventive healthcare for women within the territory. Partnerships with the CHCC outpatient clinics, Family Planning Program, and clinical providers will be leveraged to support activities under this health domain.  

Priority 1, Ability to find and see a doctor when needed (access to health services) is associated with NPM 1, Percent of women, ages 18 through 44, with a preventive medical visit in the past year. The objective is to increase the percentage of women who access preventive visits to 65% from the baseline of 56%.  The CNMI will utilize the strategy of increasing clinic hours and services to improve the percentage of women in the CNMI accessing preventive health services.

Priority Need 1: Ability to find and see a doctor when needed (access to health services)

NPM 1: Percent of women, ages 18 through 44, with a preventive medial visit in the past year.

Objective: By 2025, increase the number of women who access preventive visits to 65%, an increase from the baseline of 56%

Strategy: Expand preventive healthcare access- increase clinic hours and service sites.

The MICAH programs will work with the CHCC outpatient clinics and Family Planning programs to conduct activities to increase the number of community mobile clinics, by utilizing the newly acquired Mobile Clinic. Expanded service hours will be prioritized providing clinic on evening and/or weekend hours.

Additionally, MCH will partner with Family Planning to increase women’s preventive health services by offering Saturday Family Planning clinics at the Immunization clinic.  

For FY 2023, October 2022 thru September 2023, the following activities provide an outline of the strategy that will be implemented for improving access to preventive health services for women:

Mobile Clinic

• Develop and finalize a schedule for women’s health services to be offered via the mobile clinic. Mobile clinic schedule will include expanded hours’ availability (evening or weekends) and will identify village settings for outreach services.
• Conduct community awareness to inform the community regarding mobile clinic outreach schedules by publishing social media advertisements and providing flyers to target populations, such as food stamp and WIC recipients, a month ahead of the clinic schedule.
• Conduct monthly monitoring and assessment of outreach activity to include: number of patients seen, type of preventive services provided, etc.
• Integrate screening for social determinants of health and implement referrals for patients who identify a need for connecting with other available community services (i.e. Medicaid, education programs, housing programs, etc.)

Weekend Family Planning Clinics

• Partner with the Immunization Program and Family Planning to finalize a schedule, secure providers and supplies to offer Saturday Family Planning clinics.
• Conduct community awareness to inform the community regarding expanded Family Planning service hours and site by publishing social media advertisements and providing flyers to target populations, such as food stamp and WIC recipients, and teens a month ahead of the clinic schedule.
• Conduct monthly monitoring and assessment of expanded Family Planning hours to include: number of patients seen, type of services sought, etc.
• Integrate screening for social determinants of health and implement referrals for patients who access services who identify a need for connecting with other available community services (i.e. Medicaid, education programs, housing programs, etc.)

There is moderate evidence that supports that the strategy of increasing or extending clinic hours is an effective intervention for improving women preventive healthcare access[1].

This strategy will be measured by an Evidence Based Strategy Measure (ESM) developed to monitor the impact of the strategy on the women population targeted:

ESM 1.1: Percentage of women accessing preventive health services at CHCC Clinics.

Data to inform this ESM will be gathered through query of the CHCC Electronic Health Records (EHR). Both the mobile clinic outreach and Family Planning clinics will utilize the EHR for documenting patient visits and therefore can be queried to determine number of patients and types of services accessed on a monthly basis.

Strategy: Provide community awareness regarding women’s preventive health services.

Community awareness activities will continue to be a vital component to activities conducted by the CHCC MICAH programs. The MCH Program will work to develop communications and advertising materials to effectively inform the community regarding available services, service sites, and hours. Additionally, heath communication materials will focus on improving awareness and knowledge within the CNMI population regarding the importance of women’s preventive healthcare. MICAH programs provide will connect with external partners: private clinics, private insurances and different faith-based organizations to disseminate information on services and health communication materials. Social media, radio and newspapers will also be leveraged for publishing information and for reaching a wide segment of the CNMI population. 

For FY 2023, October 2022 thru September 2023, the following activities provide an outline of the strategy that will be implemented for community awareness on women’s health services:

• Develop slide presentations, radio scripts, social media content, posters, and brochures/flyers to disseminate in the community.
• Conduct at least 6 presentations to community agencies regarding available women’s health services and expanded service availability via the mobile and Saturday clinics.
• Develop a survey to utilize at mobile clinic events and at Saturday Family Planning clinics to evaluate communications materials.
• Conduct monthly assessment of social media advertisements identifying the number of individuals reached.

[1] Women’s and Children’s Health Policy Center John Hopkins University. (2017). Strengthen the Evidence Base for Maternal and Child Health Programs NPM 1: Well Woman Visit. Retried on July 29, 2022 from https://www.mchevidence.org/documents/reviews/npm_1_well_woman_visit_evidence_review_brief_june_2017.pdf