The availability of SSDI funds has enable ASMCH Title V to develop, enhance, and expand data capacity to execute annual needs assessment activities and performance measure reporting requirements in the MCH Block Grant. Such enhanced MCH data capacity enables ASMCH and its key stakeholders to engage in informed decision-making and resource allocation that supports effective, efficient and quality services for women, infants, children, including CSHCN, and their families. SSDI complements the MCH Block Grant by improving the availability, timeliness, and quality of MCH data. Utilization of these data is instrumental to program assessment, planning, implementation, and evaluation efforts, along with related investments, in the yearly MCH Block Grant Application/Annual Report.

The decision to have a Cross-cutting Population Domain for American Samoa was based on the need to address Title V priority specifically focused on data systems and infrastructure arose from the ongoing commitment of ASMCH to ensure evidence-based practice and data-driven decision-making. The state action plan for this priority covers two broad goals that are strongly tied to the SSDI goals and objectives, including improving data infrastructure and systems, increasing epidemiologic production and use, and forging partnerships that improve data capacity and infrastructure.

As documented on Form 12, certain strengths are obvious in timely reporting of births in the SILAS database. Current partnerships with Newborn Babies Hear ensures accessibility to birth records as soon as they are entered in SILAS. Whereas Vital Death Records for 2020 are currently being entered into SILAS and may not be complete until December 2021. Certain databases ASMCH is not yet linked to, such as WIC and Medicaid, may need to be included in a revised IAA with these two agencies in FY2022.

Current SSDI goals and objectives align with Title V data capacity priorities, enabling ongoing Title V program assessment, monitoring and reporting:

Goal 1: Build and expand MCH data capacity to support the Title V MCH Block Grant program activities and contribute to data-driven decision making in ASMCH, including assessment, planning, implementation, and evaluation.

Objectives 1.1: The MCH Data Matrix will be updated with all NPMs, SPMs, and NOMs and reported quarterly by the MCH Title V Program to Program Director and key partners via emails and hard copies.

Objectives 1.2: All quarterly reports will be compiled and the data matrix will be updated and presented to the MCH Data Core Workgroup by the end of May, annually.

Objectives 1.3: Key Partners meet twice a year to review and assess key findings on state priorities and update program activities.

Objectives 1.4: A factsheet with past year data dashboard is included in the executive summary of the Title V annual report and application and disseminated to other partners and the community for feedback.

Goal 2: Provide partnership and on-site support for the development and implementation of a data collection tool/process that will enable tracking of Title V MCH Block Grant National Performance Measure (NPM) data.

Objectives 2.1 Build upon completed Standard Operating Procedures for Data collection and reporting.

 Objectives 2.2 Assist the Public Health Surveillance office to link MCH to the SILAS program Helping Babies Hear is utilizing to produce an electronic birth defect registry.

Current SSDI Project funds a fulltime Data Tech Ms. Ruta Ropeti, who most recently passed her Field Epidemiology Tech Certification. She worked closely with MCH Epidemiology, Ms. Mata’uitafa Faiai to ensure SSDI Core Data Sets are updated quarterly and disseminate findings in a timely manner to evaluate progress and advance data-driven initiatives. In 2020, these core data sets were instrumental in conducting the Five-Year Needs Assessment and assist prioritizing health disparities for ASMCH Title V to target for 2021-2025.

The ASDOH Public Health Surveillance Office is managed by Dr. Aifili John Tufa, who oversees all Epidemiological efforts including reportable disease surveillance, syndromic surveillance, collecting vital records, validating UDS data and other program data. This office also administers BRFSS and is responsible for all DOH Data Surveillance oversight. ASMCH Epi team works closely with Dr. Tufa for epidemiologic support to ensure ongoing Title V needs assessment are carried out accordingly and data is collected in a timely manner. This past year was challenging because of Measles Outbreak and COVID-19 pandemic. Most data capacity activities were canceled or rescheduled due to social restrictions. Data that was routinely collected such as Vital Stats Death certificates and was put on hold for a while because ASMCH staff members were assigned to other stations to support the department mission.

Having direct and timely access to MCH health data is another important component of the Title V performance monitoring process. American Samoa Vital Records files (Live Birth, Fetal Death, linked infant death/live birth files, linked Maternal Mortality Files) and other data sources are collected by the Public Health Surveillance office, and oversee by the ASDOH Epidemiologist. As part of the American Samoa SSDI project, the Data Tech routinely collects and reports on certain MCH Health Indicators and reports to the MCH Epi, who then informs clinical supervisors on these findings and recommendations made to improve these irregularities. Clinical in-service trainings are then implemented to improve documentation and clinical capacity. Example; providing surveillance over delivery and birth records, analyzed, interpreted and communicated not only to Title V staff but to MCH stakeholders working to reduce infant mortality and other adverse birth outcomes. SSDI initiative fosters timely data collection, identify needs for quality improvement projects and provides recommendations to improve on these findings.

Even with the large number of linked data files that are currently available to ASMCH, there is always room to expand on current data capacity. Various programs in a collaborative effort are working closely with the MCH Epi team, CSHCN Client Navigators, Helping Hands Early Intervention and Newborn Hearing EDHI program to see how programs can maximize utilizing the EHDI web-based data reporting system SILAS to assist in monitoring and generating data reports on a regular basis. This will assist in the possibility of establishing several new MCH-related data linkages, including Birth Defects Registry data linked to EDHI, Early Intervention, CSHCN, Immunizations and Vital Records. It is ASMCH’s long term goal to have MIECHV, WIC and Medicaid link into the SILAS system as well. This will assist to improve the timeliness of data extraction and reporting especially if linked between Birth Defects Registry, Zika Registry, birth and death certificate data.

Both SSDI and MCH- Zika Services grants had cost-shared the building of MCH reporting templates and Ad Hoc reports on SILAS. Reports generate about 50% of all MCH Title V NPM, NOMs and ESMs. It is in the plans, to continue working with Family Trac, the owner and administrator of SILAS to build the RHD registry in the next 12 months as well as generate more ad hoc reports to populate majority of data that’s left if not all.

Half of the American Samoa SSDI grant funded the very first MCH Title V Jurisdictional Survey in American Samoa in 2019 and again a second one completed this past month, July 2021. Data from the Jurisdictional Survey is definitely beneficial to small island jurisdictions like American Samoa who can now have some data trends to compare and make informed decisions based on key findings and data trends.