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Nutritional Overview of American Samoa
– Reported, April 02, 2012
NUTRITIONAL PROBLEMS
Birth weight
In 1999, 2.9% of infants were born with a low birth weight (<2500 g). Conversely, 24.4% of infants were born weighing >4000 g (large-for-gestational-age). A slight reduction to 18% was reported in 2002
In 2000, 2.7% of infants were born with a low birth weight (<2500 g)
Infant feeding
Data collected between 1989 and 1999 (AMS Nutrition Surveillance Reports, July 1989 to June 1999) show that 94% of mothers started breast-feeding, but only 40% breast-fed for 1 month and 32% for 6 months.
The proportion of infants ever breast-fed increased from 65% in 1995 to 87% in 1997. The percentage predominantly breast-fed at 4 months of age increased from 28% to 39%, but those exclusively breast-fed decreased by half, from 40% to 20%. Almost 50% of infants received food as well as breast-milk from the first months of life in 1997.
In 2003, 34% of mothers were estimated to be breast-feeding for at least six months. A small study undertaken early in 2003 found that 70% of mothers initiated breast-feeding within the first twenty-four hours of birth, but after discharge from the hospital, that number increased to 94%. This may reflect some practices in the Maternity Department, or the common belief that a woman has no “milk” in the first few days
Nutritional anaemia
In a 1993-1994 survey among 2027 infants, 65% were found to be anaemic (Hb<11g/dl). Data collected between 1989 and 1999 (AMS Nutrition Surveillance Reports) show that the prevalence of anaemia in the third trimester of pregnancy was 33% (Hb<11g/dl). The same 1999 AMS Nutrition Surveillance Reports reported a
prevalence of anaemia of 47.4% among children 12-23 months of age.
The 2001-2002 study on helminthiasis among schoolchildren showed a prevalence of anaemia (Hb <11.5 g/dl) of 1.9% in one school and no cases of anaemia in a second school.
Obesity
A 1990 survey showed that 85% of male adults and 91% of female adults were overweight (BMI> 27.8 and >27.3, respectively). The prevalence of severe overweight (BMI>31.1) among male adults was found to rise steadily with age,from 56% in the 25-34 age group to 74% in the 55-64 age group, and then decrease to 60% in the 65-74 age group. For female adults, severe overweight (BMI>32.2) was found in 59% of the 25-34 age group, climbing to 72% in the 55-64 age group and reaching 73% in the 65-75 age group. In 1995, the prevalence of obesity in children, based on the Body Mass Index (BMI), was 31% among preschool children,40% in kindergarten children, 15% in grade 4 students and 36% in grade 8 students.Data collected between 1989 and 1999 (AMS Nutrition Surveillance Reports) show that pre-pregnancy overweight among women increased significantly with age; 45% of Samoan women aged 16-19 were overweight, compared with 80% of women aged 30-39 years.
POLICIES AND PROGRAMMES DIRECTED AT NUTRITION
There is no food and nutrition policy, but a National Plan of Action for Nutrition was drafted in 1998. While awaiting approval of the Plan, several nutrition projects and activities are being implemented.
There are no national dietary guidelines, but recommendations on complementary feeding are issued by the Public Health Nutrition Programme and the Women, Infant and Children (WIC) Programme.
Breast-feeding policies
A Breast-feeding policy for the Lyndon B. Johnson Hospital is currently being introduced. A Breast-feeding Committee was formed in March 2003 and now meets regularly.
The International Code of Marketing of Breast-milk Substitutes has yet to be incorporated into the territory’s legislation. The Department of Health continues to work to improve breast-feeding practices in collaboration with other Government Department and Federal programmes, including celebrating Breast-feeding Week every year. Government employees are entitled to six weeks paid maternity leave, but only if they have that length of time remaining from their entitlement to sick and holiday leave. If they have used those weeks up, they are only entitled to unpaid leave. In the private sector, maternity leave is usually around four to six weeks and may be paid or unpaid, with the same
conditions applying as for public employees. The tuna fish canneries (who employ approximately 30% of the AMS workforce) give women six weeks paid maternity leave in addition to paid sick and holiday leave.
In 2001, a decree was passed which gave working breast-feeding mothers a two-hour break each day to breast-feed their babies. However, few women appeared to know about this decree and even fewer have ever made use of it.
Credits: Silvia Sunia, Chief of Public Health, American Samoa
More Information at: http://www.wpro.who.int/entity/nutrition/documents/docs/ams.pdf
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