Samoans in San Francisco: Assessing cultural competence during prenatal care

This project provided a portrait of the perinatal health needs of Samoan women by identifying their level of knowledge about prenatal care guidelines and the level of Samoan cultural competency among health service providers.

A literature search showed that data on Samoans were uncollected or incomplete. Samoans were often bundled with all Asian-Americans. Thus, the health status/health experiences of Samoans were difficult to characterize. However, data showed that Samoans have high rates (48.4%) of late/delayed entry into perinatal care. Further, Samoans are severely underrepresented in the healthcare workforce. For example, there are only 20 Samoan physicians in California.

To gain local and detailed information through interviews, twelve Samoan women and twenty-five health service providers were contacted: four of the former and seven of the latter consented. To protect the women's privacy, all were referred by peers. They reported significant knowledge of the importance of early perinatal care and where to access it. However, all entered care late. They reasoned that pregnancy is a “natural process, not a medical case” and that they had “unexpected travel for family events.” None of the providers self-identified as Samoan. All but one had an almost complete lack of knowledge, awareness, and understanding about Samoan traditions and culture and an overgeneralization of Samoans from the little they knew. All asked “what Samoans think of exercise and diet” during the interview. In order to promote early prenatal care among Samoan women, it is critical for providers to gain an understanding of Samoan healing tradition and culture.