Like many island countries in the Pacific region, the Independent State of Samoa has one of the highest rates of non-communicable diseases (NCD) in the world. NCDs, such as diabetes, ischemic heart disease, cardiovascular disease, asthma, and chronic obstructive pulmonary disease account for 75 percent of the total disease burden. Alarmingly, the rates continue to rise.
One major contribution is the lack of systematic NCD disease management in the country, resulting in poor quality NCD services. Low screening rate, weak follow-up and referrals, and the lack of a patient tracking system are some of the gaps identified in the current NCD care model. Indeed, the World Bank’s Samoa Hypertension Cascade study found gaps at all stages of the care continuum. Early detection, referral, treatment, and care of NCD patients are vital and have a direct impact on the reduction of preventable disability and death.
The government of Samoa, in collaboration with the World Health Organization (WHO), initiated a Samoan version of the WHO’s Package of Essential Tools for Non-Communicable Disease Interventions known as PEN. This community engagement strategy highlights the country’s return to Fa’a Samoa or the Samoan way of delivering primary health care to its rural communities to lessen dependence on just a few main hospitals. The community-based intervention is anchored around a multi-disciplinary team based at the rural district hospital. It empowers and trains members of the Village Women’s Committees (VWC) to run health promotion activities that address NCD risk factors, measure key NCD metrics, and refer villagers with identified risks to district hospitals for further care.
The World Bank, through the Samoa Health System Strengthening Program, is also supporting the government of Samoa to scale up NCD screening in the communities with the School Nurse Program and the expansion of PEN Fa’a Samoa screening to rural villages.
The Advance UHC Multi-Donor Trust Fund (MDTF) provides technical assistance to the School Nurse Program whereby the nurses, as members of the multi-disciplinary team stationed at rural district hospitals, visit primary schools in their catchment areas regularly. School children are provided with health education and preventive and screening services. They also receive body mass index (BMI) screening at the start of the school year with continuous monitoring of child health indicators twice every year. Children who are overweight or obese and identified as being at risk of NCDs will be referred to special nutrition and physical activity programs which aim to change their diet and lifestyle and reduce their weight. These nutrition and physical activity sessions adopted a whole of community approach, going beyond the classroom to involve parents, teachers and other students.