In the past the women’s committees played a big role in village health but this role has declined over the years.
Recently the role has been revitalised in the fight against non-communicable diseases under the programme PEN Fa’asamoa.
PEN an acronym for the World Health Organization WHO Package of Essential Non Communicable Disease Interventions was set up by WHO to address the NCDs Non Communicable Diseases challenges.
Samoa is one of the first countries to modify the WHO PEN to fit the local context. According to the CEO of the Ministry of Health Leausa Dr Take Naseri the WHO PEN which is hospital focussed would not work in Samoa because of the small number of doctors.
Rasul Baghirov, John Ah Ching and Caroline Bollars in their article ‘Reinvigorating the Role of Women Groups’ that in 2013 there were 4 doctors and 16 nurses for every 10,000 of the population and with the exception of the two main hospitals, the public sector are almost exclusively staffed by nurses with regular clinics conducted by visiting medical officers.
PEN Fa’asamoa was piloted in the villages of Faleasiu and Lalomalava. Under this programme members of the Women committees were trained to check sugar levels and blood pressure and do other related tasks. The trial in the two villages Leausa said proved to be effective. He added that the some of the members of the village women’s committees are well educated- retired school teachers, women who had dropped out of a college and university education and are capable of doing these tasks.
As of 2018 the PEN program covers 15 villages in both Savaii and Upolu (Baghirov, Ah Ching and Bollars). The programme they said has three particular strengths in the Samoan context.
“ It is organized within the governance structure of traditional villages; it is implemented through the Komiti Tumama with the approval of the fono ( village council) and the support of the aumaga; it enables people to objectively learn their risk of NCD and empowers them to understand that NCD are silent diseases in their early stages . In addition it helps people to accept NCD are precursors of severe illnesses that can be managed and overcome if addressed in a timely manner that they are not special Samoan illnesses which can be exclusively treated by fofo (traditional healers).”
PEN Fa’asamoa they said is an example of how to engage the whole of the health sector and focus on the most vulnerable groups in society by using a community based participatory bottom up approach.
“The PEN Faasamoa integrated village outreach service for NCDs ensures early detection and increased awareness of NCD risk factors together with an established process for referral to the district health facility for treatment to follow up.”
Preliminary results of the program are positive Baghirov Ah Ching and Bollars said. “PEN Faasamoa achieved a high level of population of screening coverage in the demonstration villages in which the women the women’s committee representatives played a key role. Samoa has shown in this example how such an action can strengthen its health system by utilizing critical human resources at a community level which have proven to be essential to support the functioning of health services.”
STEPS data from 2013 showed that that 50 % of the Samoan adult population are at high risk of developing an NCD, having at least there of the five identified risk factors for NCDs and this statistic worsens with age. 49 % have at least one or two identified risk factors for NCDs and only 0.4% 0f the population were classified as having low risks for NCDs ( none of the five risks present) (Baghirov, Ah Ching and Bollars).