1. Dr Carmichael Patu MBBS Lecturer Oceania University of Medicine Samoa
NCD situation in Samoa
Dr Carmichael Patu MBBS
Lecturer
Oceania University of Medicine Samoa

2. How I got here…

3. Finally…..

4. Samoa Total Land Area: Population: Average Life Expectancy: 2934 km2
180,741
56% (15-65)
Mean Age- 20.5
Average Life Expectancy:
Male yrs
Female yrs
Source: Samoa Census 2006
-Independent nation
-Least developed country

5. Health System structure
Health reform 2006
Public Sector
MOH
Regulatory role
NHS
Service provider
Private Sector
GPs Association
NKF
OUMS
SAMOA HEALTH SECTOR

6. Lets get into it now

7. The biggest killers…(Mortality)
ICD- Code
Description of Underlying Cause
Sex
Male
Female
Total 1
E10-E14
Diabetes Mellitus 33 20 53 2
C00-D48
Cancers (All sites) 24 22 46 3
I60-I69
Cerebrovascular Diseases 42 4
I26-I51
Ischaemic Heart Diseases 15 35 5
J12-J18
Pneumonia 17 12 29 6
A40-A41
Septicaemia 13 25 7
S00-T65
Injuries & Poisoning 18 8
I20-I25
Other Heart Diseases 16 9
I10-I14
Hypertension Diseases 10 14
K71-K92
Liver Diseases
Source: Annual Report:PATIS / WHO ICD-10 ( )
NCDs
Table 5: Ten Leading Causes of Mortality for all deaths reported to All Public Health Facilities for FY 2007/2008

8. Ten leading causes of Morbidity (2007-2008)
ICD- Code
Diseases Description
Number 1
J12-J18
Pneumonia
1,427 2
O20-O29,O67-O71, O70-O75,O81-O84
Other complications of pregnancy and delivery
1,066 3
S00-T65
Injuries and Poisoning
852 4
L00-L08
Infections of skin and subcutaneous tissue
761 5
E10-E14
Diabetes Mellitus
599 6
J20-J21
Acute Bronchitis and acute bronchiolitis
436 7
I10
Essential (primary) hypertension
412 8
O30-O43,O47-O48
Other maternal care related to fetus and amniotic cavity
318 9
A09
Diarrhea and gastroenteritis
310 10
A01
Typhoid and paratyphoid fevers
274
Source: PATIS (Patient Information System)

9. NCD outlook in Samoa Data collection:
Utilization of WHO STEPwise approach to chronic disease risk factor surveillance (STEPS)
Step 1
Demographic information
Behavioural measurements (SNAP)
Step 2
Physical measurements (BP, HR, BMI, WC)
Step 3
Biochemical measurements (Glucose, Lipids)
-developed from this WHO intrument

10. Samoa STEPS Implemented in 2002 Population studied: Some issues:
25-65ys
2804 (total)
Some issues:
Yet to be published
Problems with data entry
Manpower issues
Fiji, Nauru, Am Samoa, Tokelau

11. Samoa NCD Risk Factors STEP report:
Smoking status
40.3 %
2 in every 5 adults
Alcohol use
29.4 % (current drinkers)
Diet
35.6% have fruitless diets
Tinned fish was the most popular
Define current Drinkers

12. Samoa NCD Risk Factors STEP report:
Physical Activity:
50.3% were physically inactive
1 in 2
Obesity/Overweight:
85.2% were classified as overweight
Women > men
Mean BMI – 31.4kg/m2
Hypertension:
21.2% were identified as Hypertensives
1 in 5 adults

13. Samoa NCD Risk Factors STEP report:
Diabetes:
21.5 % were found to be Diabetics
1 in 5 adults
16.7% - impaired Fasting Glucose levels
38.2% with Diabetes and Pre-Diabetes
Blood Cholesterol:
13.7% - levels > 5.2 mmol/L
33.8% of the adult population had at least 3 of the 5 risk factors studied (1 in 3 adults)

14. What is the Samoa Health Sector doing about it?
Top Health priority
NCD Policy 2010
Spearheaded by the MOH
Key Areas:
Strengthen health promotion and primordial prevention
Quality health care service delivery
Governance, Human Resources for Health and Health System Strengthening
Health Financing
Partnership Commitment
Donor Participation and Harmonization
- Review NCD strategy

15. Health Sector Activities
MOH
Regulator
Policy pusher
Health Promotion/Education programs
Smokefree sports/
Physical activity programs
Healthy eating programs
NHS
Primary health care (GPs)

16. Health Sector Activities
Private Sector:
Oceania University of Medicine
Rotary 5000 program

17. Successes Resurrection of Primary Health care Tobacco Health Act
Smoke-free Schools, workplaces, Public Transportation, clubs etc.
Health nutrition programs implemented on all islands
Food and drugs act
Banning of Turkey tails
Country-wide Physical Activity programs

18. Difficulties Surveillance Information System (PATIS)
Minimal integration within the Health sector
Reform still new

19. Challenges Changing the culture Manpower
Being Bigger is a sign of wealth
Manpower
“Many talk few walk”
Brain drain

20. Faafetai Tele Lava