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DoH outlines remedies for decline in women’s health services during COVID

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Pago Pago, AMERICAN SAMOA — The Dept. of Health (DoH) fell short when projecting the growth of healthcare for local women in the categories of pre-natal, and preventative care over the 5 years beginning in 2019 after the COVID pandemic brought about changes in how the clinics were operating and services they were prioritizing.

Now in a submission to the U.S. Department of Health and Human Services, DoH outlines their proposal for remedying the decline in these services.


The DoH had projected that by 2024, the number of pregnant women accessing early prenatal care in the first trimester would increase by 2 percent every year for five years from 2019 (40.2% in 2019 to 45.4% in 2024).

This was outlined in their submission to the U.S Dept. of Health & Human Services. However, “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.”

The strategy outlined by the DoH will include collaboration with all Prenatal Providers and supporting programs to promote early prenatal care services.

This would include proving public service announcements such as videos and mass media campaigns to encourage pregnant women to seek early prenatal care and ensuring all health education materials and resources for selected curriculums are translated appropriately and standardized across all prenatal clinics.

The strategy intends also “to provide and support online training for providers on quality care for pregnant women and collect feedback and recommendations from pregnant women on ways to improve services for prenatal care.”

Prenatal clinics resumed regular opening hours in early June 2022 and by June 30, completed the annual needs assessment for women’s health, according to the report.

According to the report, in July ultrasounds were available again at the Tafuna Prenatal Clinic and WIC Staff was present on- site during well-baby clinics to promote breastfeeding and nutrition.”


Regarding women’s health visits, the DoH objective was that by 2024, it would seek to increase the percentage of women with a preventive medical visit in the past year by 2% every year for the five year beginning in 2019 (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 [Uniform Data System] report. This is a significant decrease of 9%.”

(The Uniform Data System (UDS) is an annual reporting system that provides standardized information about the performance and operation of health centers delivering health care services to underserved communities and vulnerable populations, according to Centers for Medicare and Medicaid Services.)

“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.”

“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.

For preventive medical visits, DoH proposes to provide mass media campaigns to promote preventive medical visits for all women in child bearing ages.

Methods include recruiting women ages 18-44 to utilize the Breast & Cervical Cancer Program (BCCP) after hour clinic for pap smear screening (MCH) and collaborating with BCCP on supplies and compensation for staff.

An innovative move is to “formulate and disseminate a women's check-up passport to improve tracking and monitoring of age-appropriate visits and screening appointments.”


•           Continue to provide health education to all women attending Tafuna Health Center for prenatal or non- prenatal care;

•           Retrieve Postpartum/ Newborn Cards from Nursery and Maternity and enter data in the SILAS database; and

•           Collaborate with the Department of Social Services, LBJ Hospital and nonprofit organizations to support services catering to women in the territory.