Current Activities (2022):

1. Prenatal clinics resumed regular prenatal visits and women health services in January, 2022. After-hour clinics were reopened to cater to Breast and Cervical Cancer screening and referrals. Clinics then slowed down on February 21 when DOH reported the first case of COVID-19 community transmission in American Samoa. From February COVID-19 prevention support efforts across the territory (vaccinations and testing) picked up, including incentives to boost numbers for children 5 years and older.
2. Prenatal clinics resume regular opening hours in early June, 2022.
3. By June 30th, completed the annual needs assessment for women’s health.
4. Completed Women and Maternal Health Stakeholders meeting on July
5. Ultrasounds available again at the Tafuna Prenatal Clinic which alleviates the long waiting list for pregnant women.
6. Continue to provide health education to all women attending Tafuna Health Center for prenatal or non- prenatal care. 
7. Retrieve Postpartum/Newborn Cards from Nursery and Maternity and enter data in the SILAS database.
8. Collaboration with the Department of Social Services, LBJ Hospital and nonprofit organizations to support services catered to women in the territory. 
9. WIC Staff present on- site during well-baby clinics to promote breastfeeding and nutrition.

Plan for Upcoming Year (2023):

OBJECTIVE 1.1: By 2024, increase the percentage of pregnant women accessing early prenatal care at first trimester by 2% every year for the next five years (40.2% in 2019 to 45.4% in 2024).

In 2021, the percentage of women accessing prenatal care at the first trimester decreased by almost 7% from 38.7% to 31.4%. This was expected given the numerous changes in healthcare services since the start of the pandemic. It is obvious that the percentage of pregnant women seeking initial care at the first trimester declined due to these changes. Also, because clinics were closed so that the workforce could administer COVID vaccinations in large settings or those providers were not present or available to deliver the service; women were not receiving this important service.

Strategies:

1.  Collaborate with all Prenatal Providers and supporting programs (BCCP, MEICHV, NCD, Intersection Inc., WIC) to promote early prenatal care services.

2.   Provide public service announcements such as videos and mass media campaigns to encourage pregnant women to seek early prenatal care.

3.   Ensure all health education materials and resources for selected curriculums are translated appropriately and standardized across all prenatal clinics.
4.   Provide & support online training for providers on quality care for pregnant women.

5.   Collect feedback and recommendations from pregnant women on ways to improve services for prenatal care.

ESM: 1.1:  Percent of women who report scheduling a preventive visit based on information obtained through various media outlets. (REVISED)

NPM:  Well-Woman Visit

Priority: Women’s Health Visit

OBJECTIVE 1.2: By 2024, increase the percentage of women with a preventive medical visit in the past year by 2% every year for the next five year (35.4% in 2019 to 44.1% in 2024).

In 2020, the percentage of women with a preventive medical visit decreased by almost 2% from 35.4% to 27.7%.  In 2021, the percentage dropped further to 18.8% according to the UDS report. This is a significant decrease of 9%.

This was expected given the numerous changes in healthcare services since the start of the COVID-19 pandemic. It is obvious that the percentage of women seeking preventive care visits was also at a decline due to the changes brought forth by the response of our local government towards COVID-19.  Clinics were often closed and providers were stranded elsewhere, leaving services for women at a bare minimum.

According to the Jurisdictional Survey, this rate increased by 8%. Women may feel confident that seeing a clinician to get their COVID vaccination is a preventive medical visit.

Strategies:

1.   Provide mass media campaigns to promote preventive medical visits for all women in child bearing ages.

2.   Recruit women ages 18-44 to utilize the Breast & Cervical Cancer Program (BCCP) after hour clinic for pap smear screening (MCH will collaborate with BCCP on supplies and compensation for staff).

3.   Formulate and disseminate a women's check-up passport to improve tracking and monitoring of age-appropriate visits and screening appointments.

4.   Provide & Support online training for providers on quality care for non-pregnant women.
5.   Collect feedback and recommendations from all women on ways to improve services for care.

ESM: 1.2.1:  Percent of Providers receiving Technical Assistance Training in Prenatal Care Standards of Care and Provider Competencies.

ESM: 1.2.2: Percentage of women who received the COVID-19 vaccine during a wellness visit. (REVISED)

OBJECTIVE 1.3: By 2024, increase the percentage of postpartum women who received a postpartum depression screening by 2% every year for the next five year (35.4% in 2019 to 44.1% in 2024).

ESM: 1.3: Percent of postpartum women who received a depression screening and was referred to a behavior health Counselor/Psychologist. (REVISED)