Samoa: Population Health Management

In an effort to redesign the health system to better address the growing burden of chronic disease, Samoa is drawing from its long tradition of village-based governance1 to shift away from a hospital-centric model and revitalize primary health care at the community level.23 Since the 1920s, Village Women’s Committees have played an important role in health promotion. Accordingly, the PEN Fa’a Samoa Initiative (Package of Essential Noncommunicable Disease Interventions Samoa) adapts the WHO package of essential noncommunicable disease (NCD) interventions to the local Samoan context through women-led, village-health activities to promote person-centered primary health care.

The PEN Fa’a Samoa initiative trains women in the village to measure key NCD metrics, detect at-risk individuals, raise awareness, and counsel about NCDs, and refer individuals to the health system for further care. To promote person-centered design and coordination across the health system, the PEN Fa’a Samoa pilot initiative was developed through a three-stage process.4 In the first stage, the Samoan Ministry of Health, National Health Service, and the World Health Organization adopted national guidelines and adapted the PEN package to the Samoan context. Additionally, villages were instructed to designate up to three members of women as local facilitators. The local facilitators then partnered with health care workers to create cross-disciplinary outreach teams who followed up with at-risk individuals with a personalized management plan, risk factor consultation, or both. This initiative is in the process of scale-up, viewed as an opportunity to leverage a person-centered community-based approach to improve health outcomes and achieve universal health coverage.2


  1. Schoeffel P. Revitalization of Samoa’s Village Women’s Committee for Public Health Promotion.
  2. Chaumont C, Bitton A. Samoa: Engaging people for health promotion. World Health Organization; 2018.
  3. WHO | Fa’a Samoa – island families come together to combat NCDs [Internet]. [cited 2018 Dec 12]. Available from:
  4. Bollars C, Naseri T, Thomsen R, Varghese C, Sørensen K, de Vries N, et al. Adapting the WHO package of essential noncommunicable disease interventions, Samoa. Bull World Health Organ. 2018 Aug 1;96(8):578–83.