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Introduction: The level of obesity among the Samoan adult population has doubled since 1978 for both men and women and is a serious public health issue. Aim: To determine the knowledge, attitude and practice (KAP) with regard to obesity among Samoan health professionals. Methods: Interview front-line health workers in ten rural and one urban health facility using a developed questionnaire and observation of clinical practice. The sample comprised 130 (68%) registered nurses, 45 (24%) enrolled nurses and 15 (8%) doctors. Findings: Most participants were well informed about the relation between obesity and non-communicable disease and were aware of the prevalence of obesity and related health risks. Contradictory advise was often given to patients about the maintenance of a healthy body weight Discussion: There is a need to educate health workers on evidence-based weight management pathways and to develop patient care plans so overweight and obese persons attending health service facilities are informed effectively on how to lose weight.

The COVID-19 pandemic has disproportionately affected persons with disabilities in ways that include unemployment, inability to adhere to public health measures, and access to health information. T...

Gender inequality encompasses a myriad of overlapping social norms, legal and cultural structures and practices that disadvantage a group based on gender (European Institute for Gender Equality (EI...

In late 2019 and early 2020, an epidemic of measles ravaged Samoa, and nearly three people in every hundred (2.83%) in the small population were infected, with 1860 hospitalizations and 83 deaths, mainly children. In the circumstances of the 2020 Covid-19 pandemic, this case study shows that even when a proven vaccine exists for an infectious disease, circumstances may prevent its effective use. As academics and researchers who live and work in Samoa, this article seeks to shed some light into contributing factors to the measles outbreak. These include inadequate data collection, low vaccination coverage, weak institutional capacity, unpreparedness for an epidemic, lack of public information, vaccine hesitancy and anti-vaccine propaganda and public recourse to traditional and ‘alternative’ therapies. Through a combination of personal observation, analysis of media articles, government reports and historical documents, we present an overview of the circumstances of the measles epidemic. We trace the circumstances of low vaccination coverage, institutional weaknesses and an uninformed public resulting in a delayed an effective response. In conclusion we reflect on the lessons that history offers on public health services in Samoa. Keywords: Measles, Epidemic, Samoa, public health, Covid-19, vaccination.

Pelvic organ prolapse affects an estimated 40% of parous women in developed countries, but there is no prevalence data in Samoa. The impacts of pelvic organ prolapse include urinary incontinence and bowel incontinence, with many women being asymptomatic. Samoan women have high prevalence of risk factors for pelvic organ prolapse, such as obesity and parity. There are non-surgical and surgical interventions for pelvic organ prolapse. Limited sexual and reproductive health education in Samoa hinders women's knowledge of the pelvic organs and what is considered normal. This short report describes the process of developing and producing an educational video on pelvic organ prolapse in Samoan and English and the lessons learned from the process.

Background Although Samoan women have a high prevalence of obesity and multiple parity which are risk factors of pelvic organ prolapse, there is no prevalence data on this condition. Aims Translate the Pelvic Organ Prolapse-Symptoms Score (POP-SS) from English into Samoan, Materials and methods Standardised methods for translating questionnaires, individual face to face audio-recorded interviews in which women completed the POP-SS using a Think Aloud method, analysis using a Framework approach. Results The POP-SS was successfully translated in to Samoan, an additional information leaflet was developed to support women’s understanding of what prolapse is, 14 Samoan women were recruited of which 13 were interviewed and completed the POP-SS, results of POP-SS (scores), results of think aloud, results in terms of research experience. Conclusions A Samoan version of the POP-SS is now available for further evaluation of its psychometric properties prior to wider use. The team continue to collaborate on their work on establishing the prevalence of prolapse whilst building local research capacity.

Background There has been substantial progress in research on preventing violence against women and girls (VAWG) in the last 20 years. While the evidence suggests the potential of well-designed curriculum-based interventions that target known risk factors of violence at the community level, this has certain limitations for working in partnership with communities in low- and middle-income (LMIC) countries, particularly when it comes to addressing the power dynamics embedded within north-south research relationships. Methods As an alternative approach, we outline the study design for the EVE Project: a formative research project implemented in partnership with community-based researchers in Samoa and Amantaní (Peru) using a participatory co-design approach to VAWG prevention research. We detail the methods we will use to overcome the power dynamics that have been historically embedded in Western research practices, including: collaboratively defining and agreeing research guidelines before the start of the project, co-creating theories of change with community stakeholders, identifying local understandings of violence to inform the selection and measurement of potential outcomes, and co-designing VAWG prevention interventions with communities. Discussion Indigenous knowledge and ways of thinking have often been undermined historically by Western research practices, contributing to repeated calls for better recognition of Southern epistemologies. The EVE Project design outlines our collective thinking on how to address this gap and to further VAWG prevention through the meaningful participation of communities affected by violence in the research and design of their own interventions. We also discuss the significant impact of the COVID-19 pandemic on the project in ways that have both disrupted and expanded the potential for a better transfer of power to the communities involved. This article offers specific strategies for integrating Southern epistemologies into VAWG research practices in four domains: ethics, theories of change, measurement, and intervention design. Our aim is to create new spaces for engagement between indigenous ways of thinking and the evidence that has been established from the past two decades of VAWG prevention research and practice.

Although there are an increasing number of funding facilities accessible for non-government organisations in response to the global COVID-19 pandemic, critics suggest that it is still insufficient. Non-government organisations provide many essential services across the world, especially in the developing world, where they supplement or in some instances extend the government services. With services from health to gender issues to humanitarian support, non-government organisations continue to grapple with insufficiency of core and programming funding and unstable staffing. In Samoa, technical assistance through government volunteers supplemented the need for expert human resource and enabled the ability to apply for funding. With the mass repatriation of government volunteers such as Australian Volunteers, American Peace Corps and Japanese International Cooperation Agency, it resulted in a sudden and massive gap in technical human resource, equipped to apply for the rapidly expanding number of funding options. Through the experiences of a non-government organisation worker and an academic researcher based in Samoa, this piece shares the current experiences and potential repercussions of this sudden change in the non-government sector and suggestions moving forward to utilize the existing expertise in country in the academic sector to support non-government organizations to access funding.

The global pandemic of COVID-19 poses a public health danger to the Pacific island countries. Due to the imminent threat of the SARS-COV-2, the World Health Organization in collaboration with other regional stakeholders had initiated a joint task force on epidemic preparedness and management. Since Samoa is a tourism destination in the south pacific, it is highly prone to an outbreak of COVID-19 if stringent public health measures and regulations are not enforced. This article, thus, highlights different opinions and various stand points regarding epidemic preparedness and emergency response in case there is an outbreak of COVID-19 in Samoa.

Samoan food systems have undergone a dramatic nutrition transition, with dietary patterns changing concurrently with increased rates of obesity and non-communicable disease. Whilst policy action and environmental interventions play an important role in improving access to and consumption of healthy food, the success of these relies on a greater understanding of individuals’ food knowledge and behaviours. This study aimed to explore these behaviours using the construct of food literacy in an adult Samoan population. A cross-sectional interviewer-administered questionnaire of a convenience sample of 150 adult Samoans (≥20 years) assessed the four domains of food literacy: plan/manage, select, prepare, and eat. Participants generally plan to include healthy food (87%) and budget money for food (87%). The majority know where to find nutrition labels (68%), of which 43% always use them to inform their food choices. Participants were mostly confident with cooking skills, although food storage practices require further investigation. Over 90% agreed or strongly agreed that food impacts health, although understanding of the Pacific Guidelines for Healthy Living was lacking. Understanding the ability of Samoans to plan/manage, select, prepare, and eat food is an important consideration for future interventions aiming to assist this population in navigating the modern-day food system.

As studies continue into the development of a vaccine for COVID-19, research to understand and address the concerns raised by anti-vaxxers about vaccinations should also be undertaken in tandem. Using the experience of Samoa, which was recently impacted by a measles epidemic, the authors discuss the importance of vaccination to developing countries and the devastation that can be wrought by vaccine-preventable diseases. There are fewer laws on vaccination of adults when compared to those applicable for children, and not all countries have mandatory vaccination laws in place. With increasing anti-vaxxer rhetoric towards the COVID-19 vaccine that is currently in development, the focus has been on reducing the spread of the misinformation through penalties or company interventions, but less so on addressing the underlying concerns of the anti-vaxxer community. The authors suggest that involving anti-vaxxers in the discussion is critical to the acceptance and uptake of the vaccine to COVID-19 when it becomes available.

In this chapter, Penelope Schoeffel, Ramona Boodoosingh, and Galumalemana Steven Percival explore understandings of gender roles and gender violence within rural Samoan villages, applying approaches from development studies and filmmaking as their theoretical key. Using Percival’s 2015 documentary on gender violence in Samoa (Raise the Sennit Sail) as the starting point for their discussion, they consider the complicity of cultural and Christian traditions in perpetuating gender inequalities, gender violence, and rape-supportive social discourses. Samoa is a country whose cultural identity has become irrevocably intertwined with Western ideations of Christian piety, brought over to these islands during the colonial period. The legacy of the Christian mission thus remains powerful, with the result that, within today’s postcolonial milieu, male violence and predatory male sexuality continue to be excused or tolerated, while women and girls are blamed (and encouraged to blame themselves) for the sexual and physical victimization inflicted upon them with disturbing frequency. Schoeffel, Boodoosingh, and Percival discuss the implications of this, drawing on theories of performativity to consider the cultural functions of discourses that render gender violence an accepted part of Samoan culture. They contend that violence against women requires urgent attention in this region, and that the church must take on a more active role in tackling this crisis of social injustice.