The availability of SSDI funds continues to ensure ASMCH Title V develops, enhances, and expands 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. Vital Statistics birth certificates are also being entered on SILAS, which started back in 2020. Unfortunately it is not always readily available and time lapse may vary from a week to months. Whereas Vital Death Records for 2021 were entered for the months of January up to September, there are no records for 202o still. ASMCH had planned to link other databases such  as WIC, and Medicaid, to be included in MOUs and revised IAA with these two agencies in FY2022 but because of the covid operations and community transmission this year, we have yet to initiate these activities. We plan to resume these revised activities once we are done with our annual applications.

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 fact sheet 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 Data Tech Ms. Ruta Ropeti, who most recently completed her studies of Practical Nursing at the local community college, ASCC. She had closely with MCH Epidemiology, Ms. Mata’uitafa Faiai before she left 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 2021, these core data sets continue to be instrumental in monitoring MCH data to complete annual Needs Assessment.

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 assessments are carried out accordingly and data is collected in a timely manner. This past year was challenging because of COVID-19 pandemic. Most data capacity activities were canceled or rescheduled due to social restrictions.

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 overseen 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 training 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. This was done at our 3 day Stakeholders meeting, in the month July, 2022.

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 the majority of data that’s left if not all. Plans were set back but can be resumed now that the second mini surge of COVID is plateauing.

American Samoa is currently writing up the new SSDI application due on August 24, 2022 on grants.gov. Plans for the next 5 years are currently being drafted. SSDI funds were utilized by MCHB to complete 2 jurisdictional surveys across the USAPI including American Samoa. One completed in 2019 and another last year. Because portions of the SSDI funding were utilized for these surveys, ASMCH had to be strategic in utilizing its 50K annually. For the next 5 years, states and territories are going to receive a ceiling of 100K to assist improve data capacity and infrastructure. This will go a long way to hiring much needed staff (or contract much needed Epidemiologists) and resources as well as assisting in enhancing and maintaining our current database.