LIHU’E — Kaua’i has the state’s highest percentages of infant deaths and infants born with diseases. In addition, over 20 percent of Kaua’i mothers don’t get prenatal care, or seek it late in their pregnancies. To address these sobering statistics,
LIHU’E — Kaua’i has the state’s highest percentages of infant deaths and
infants born with diseases.
In addition, over 20 percent of Kaua’i mothers
don’t get prenatal care, or seek it late in their pregnancies.
To address
these sobering statistics, state officials and community leaders have mounted a
campaign to improve birth outcomes on the island.
The percentage of
low-birthweight babies (under 5.5 pounds) on the island in 1997 (the last full
year’s statistics available) was around 7 percent, and the percentage of teen
mothers (ages 18 and under) was even less than that, according to state
Department of Health statistics.
“A lot of people, pediatricians are
finding out, do not go to prenatal care, and when they come to prenatal care
it’s almost like too late — they’re almost giving birth,” said Roy Nishida,
Gov. Ben Cayetano’s liaison on Kaua’i.
A $350,000 anonymous donation is
fueling the Malama Kaua’i program. “Malama” means “to care for” in the Hawaiian
language.
“It’s a prenatal, infant-care program,” said Nishida.
“Women
are isolated by several geographical barriers and have limited access to
community health options since there is only private-provider care available,
with no services designated for under-served populations,” according to printed
information about the program.
The funding for the program is handled
through the Kaua’i Rural Health Association, in partnership with the state
Department of Health Kaua’i district office and Kaua’i Malama Partners, who are
community stake-holders for five regional sites the program plans to establish
across the island, Nishida explained.
“One of the key elements in the grant
is this neighborhood woman concept,” he said.
“They have a woman in the
community that people look up to, people can trust, and they talk to them about
why they need to go to prenatal care,” he said.
“And they also know the
traditional medicine concept,” with Native Hawaiians, Filipinos, and others
practicing traditional healing methods, such as massaging to relieve stomach
gas, he said.
The program has three definite locations selected — Nana’s
House in Waimea, Hale Halawai ‘Ohana O Hanalei, and the Hanapepe Clinic — and
is looking to establish sites in Kapa’a and either Koloa or Kalaheo.
Tammy
Napoleon, a community health nurse, is the program’s only staff member.
She has conducted meetings in nine communities around the island, “finding
out, basically, what are the concerns of these people,” in terms of prenatal
and post-partum care.
Dr. Dyanne Alfonso and June Shibuya are
co-investigators, working with Napoleon’s findings and coming up with a program
to meet the community’s needs for prenatal and post-partum care, he
said.
“It’s a community-driven type of program,” where the community will
determine the types of programs it needs.
There are at least 24 community
partners, including individuals and big businesses and organizations like Big
K-Mart, Wilcox Health System, ‘Ohana Physicians Group, Kaua’i Veterans Memorial
Hospital, and the Native Hawaiian health program, Ho’ola Lahui Hawai’i, Nishida
said.
The three identified sites are partners, as are the DOH Public Health
Nursing Services employees.
The Kiwanis Club of Kaua’i is another
community partner, he continued.
Nishida got involved in the program after
attending a conference for a similar type of program on the Big Island.
“We
liked the concept because it was community-driven,” using traditional healing
techniques as well as clinic and hospital care, he said.
Mary Jo Sweeney,
with DOH maternal child health services, and Joyce Chuang, with DOH Public
Health Nursing Services, play key roles in the project, Nishida
commented.
The goals of the project are to lower the incidences of infant
mortality, low-birthweight babies and infant morbidity rates, and to increase
opportunities for early prenatal care for mothers-to-be, Nishida
said.
Organizers of the Malama Kaua’i program have applied to the federal
government’s Rural Health Outreach program for a three-year grant to extend the
program.
Even without the funds, the DOH Public Health Nursing Services
branch can carry on with the concept, if not the program.
That’s one reason
the community partners are so important, he continued.
“We want the people
to get the concept that malama is caring, and we all can work together in
partnership,” he said.
Working under the assumption that there will be no
state funds available for the program, Malama Kaua’i organizers are actively
pursuing other federal and private resources to continue it, he said.
