Throughout the needs assessment process, women’s health consistently was voiced as a priority and it became apparent that the recurring themes in this domain reflected the overall needs of the CNMI. As a result of the 2020 comprehensive MCH Needs Assessment process, Priority 1 under the Women’s Health domain was identified as “Access to health services- ability to find and see a doctor when needed.” CHCC MICAH Programs have existing successful partnerships, resources and services and at an adequate position to provide more and engage community partners, build on existing programs, and address the needs of the state’s woman/maternal population. The following actions are addressed in this priority: uniform screening, coordinated care, increased access to care through extended hours and additional locations, increased well woman visits, and understanding of preventive health coverage.

Activities to address priority areas identified during the 2020 comprehensive needs assessment for the Women/Maternal Health domain will continue to be guided by the life course framework. The MCH program will work in partnership with clinical providers and partners to ensure activities to address this priority are implemented on the islands of Saipan, Tinian, and Rota.

In FY2023, the newly acquired CHCC Mobile Clinic was implemented and focused on increasing access to primary and preventive care services including well woman visits, prenatal care and Family Planning.

Priority Need 1 is linked to National Performance Measure (NPM) 1, in which annual reporting on the percentage of women ages 18 through 44 years who access preventive medical visits will be conducted. The objective for Priority Need 1 and NPM 1 is to increase the percentage of women accessing preventive visits to 65 percent by 2025. Data to inform this domain will be gathered from the MCH jurisdictional survey as well as other programs and services that serve the women population through the CHCC.

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

National Performance Measure 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%, a 10% increase from baseline.

Strategy: Expand preventive healthcare- Increase clinic hours or service sites.

For FY2024, the CNMI MCH Title V will further expand its partnership with the CHCC Outpatient Clinics department to increase women’s health primary and preventive care access via the mobile clinic and will also continue to support monthly women’s health clinics on the island of Rota. In FY2023, the MICAH programs began offering Saturday Family Planning clinics out of the Immunization clinic located within the Division of Public Health clinic areas. The pilot Saturday Family Planning clinics will be evaluated to determine impact of the additional hours in expanding access to preventive services. The evaluation results will further guide improvements or change strategies that will be implemented to further improve access to care.

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

Evidence Based Strategy Measure (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 CareVue. The program will assess the number and percentage increase in service utilization on a monthly basis among women/maternal population seen through the following CHCC clinic locations: Women’s Clinic, Mobile Clinic, Family Planning Clinics, Rota Health Center, and Tinian Health Center.

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 with the Communications and Marketing Specialist to develop communications and advertising materials to effectively informed the community regarding available services, service sites, and hours. MICAH will reach out and connect with external partners: government and private businesses, private insurance companies and different faith-based communities and non-profit organizations as a leverage to disseminate scheduled outreach events information to their clients and members of their communities as part of efforts encourage them in accessing services.