Improving Services for Chronic Non-communicable Diseases in Samoa - An Implementation Research Study Using the Care Cascade Framework

Jul 19, 2026

Upload by Sage

Samoa must intensify its response to the rising burden of non-communicable diseases. This mixed-methods implementation research identifies bottlenecks across the care continuum and proposes actionable solutions. Using the care cascade framework with hypertension as a tracer condition, the study integrates household survey data, medical record review of hypertension patients, and focus group findings from patients and health care providers.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages30

Reading Time1 h 16 min

Abstract

Objective

Methods

Results

Conclusions

Implications for Public Health

Key message

Keywords

Public Disclosure Authorized Public Disclosure Authorized AUTHOR ACCEPTED MANUSCRIPT FINAL PUBLICATION INFORMATION Improving Services for Chronic Non-communicable Diseases in Samoa An Implementation Research Study Using the Care Cascade Framework The definitive version of the text was subsequently published in Australian and New Zealand Journal of Public Health,, 2021-07-26 Published by John Wiley and Sons, Inc. and found at [http://dx.doi.org/10.1111/1753-6405.13113](http://dx.doi.org/10.1111/1753-6405.13113) THE FINAL PUBLISHED VERSION OF THIS MANUSCRIPT IS AVAILABLE ON THE PUBLISHER’S PLATFORM This Author Accepted Manuscript is copyrighted by World Bank and published by John Wiley and Sons, Inc.. It is posted here by agreement between them. Changes resulting from the publishing process—such as editing, corrections, structural formatting, and other quality control mechanisms—may not be reflected in this version of the text. You may download, copy, and distribute this Author Accepted Manuscript for noncommercial purposes. Your license is limited by the following restrictions: (1) You may use this Author Accepted Manuscript for noncommercial purposes only under a CC BY-NC-ND 3.0 IGO license [http://creativecommons.org/licenses/by-nc-nd/3.0/igo](http://creativecommons.org/licenses/by-nc-nd/3.0/igo). (2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy. (3) You must attribute this Author Accepted Manuscript in the following format: This is an Author Accepted Manuscript by Fraser-Hurt, Nicole; Naseri, Leausa Take; Thomsen, Robert; Matalavea, Athena; IeremiaFaasili, Victoria; Reupena, Muagatutia Sefuiva; Hawley, Nicola L.; Pomer, Alysa; Rivara, Anna C.; Obure, Dayo Carol; Zhang, Zhang Improving Services for Chronic Non-communicable Diseases in Samoa © World Bank, published in the Australian and New Zealand Journal of Public Health 2021-07-26 CC BY-NC-ND 3.0 IGO [http://creativecommons.org/licenses/by-nc-nd/3.0/igo](http://creativecommons.org/licenses/by-nc-nd/3.0/igo) [http://dx.doi.org/10.1111/1753-6405.13113](http://dx.doi.org/10.1111/1753-6405.13113) © 2022 World Bank Improving services for chronic non-communicable diseases in Samoa: an implementation research study using the care cascade framework Abstract Objective: Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. Methods: The mixed-methods study used the cascade framework as analysis tool and hypertension as tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and health care providers. Results: Hypertension prevalence was 38. 1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. Conclusions: In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions, and health service redesign with a focus on primary health care and effective patient and community engagement Implications for Public Health: The proposed actions can improve the reach, accessibility, quality and effectiveness of Samoa’s chronic care services. Health system redesign is necessary to ensure continuity of care and more effective primary prevention. The findings are useful for other countries in the region facing similar challenges. Key message Using hypertension as a tracer condition for chronic NCDs, this mixed-methods study shows that the primary health care system in Samoa needs to be re-designed and hea

FAQs

What was the objective of the study in Samoa?

The study assessed bottlenecks in the care continuum and identified possible solutions to strengthen Samoa’s response to non-communicable diseases.

How did the researchers analyze care delivery in the study?

The researchers used the care cascade framework and applied it to hypertension as a tracer condition, combining household surveys, medical record data, and focus group discussions.

What were the main findings regarding hypertension control in Samoa?

Hypertension prevalence was 38.1%, but only 4.7% of individuals with hypertension had controlled blood pressure, with major gaps especially in screening and referral.

Jul 19, 2026

Upload by Sage