Alec Ekeroma

Alec Ekeroma
The National University of Samoa · Chancellery

ONZM MBBS, DipObs, FRANZCOG, FRCOG, MBA, MInsD, PhD

About

101
Publications
81,810
Reads
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1,628
Citations
Introduction
Vice Chancellor and President National University of Samoa Apia, Samoa Chief-in-Editor, Pacific Journal of Reproductive​ Health Chief-in-Editor, Pacific Health Dialog
Additional affiliations
January 2020 - present
The National University of Samoa
Position
  • CEO
June 2011 - June 2014
University of Auckland
Position
  • Building research capacity
Description
  • Research and audit support workshop
October 1996 - present
Middlemore Hospital
Position
  • Head, Pacific Womens Health Research & Development Unit
Description
  • Conduct and facilitate reproductive heath research with a special interest in Pacific women.
Education
December 2011 - December 2016
University of Auckland
Field of study
  • Health Sciences
August 1993 - June 1997
Keele University
Field of study
  • Health Executive
January 1989 - December 1995

Publications

Publications (101)
Article
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Introduction: Newborn vitamin D status is largely determined by maternal vitamin D status during pregnancy. New Zealand (NZ) has a sun avoidance health policy and minimal dietary vitamin D fortification. Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50nmol/L) is present in 57% of a sample of newborns from Christchurch an...
Article
IntroductionAdopting the modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosing gestational diabetes mellitus (GDM) will increase the prevalence of GDM resulting in increased resource utilisation and an unknown effect on clinical outcomes.AimsTo determine the prevalence of GDM by the modified IADP...
Article
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Background Clinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5. Research training, mentoring and a supportive participatory research environment have been shown to increase research activity and capacity in low to middle income countries (LMI...
Article
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Research capacity building of clinicians in low to middle income countries may be the most powerful intervention to strengthen health systems, improve clinical standards and address inequities in healthcare. Research training in the form of workshops, postgraduate courses and collaborations are interventions that have been used to increase research...
Article
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Background Although Samoan women have a high prevalence of obesity and multiple parity which are risk factors of pelvic organ prolapse, there is no prevalence data on this condition. Aims Translate the Pelvic Organ Prolapse-Symptoms Score (POP-SS) from English into Samoan, Materials and methods Standardised methods for translating questionnaires,...
Article
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The Covid-19 outbreak in Aotearoa/New Zealand is a timely reminder of the chronic inequities in health and the importance of socioeconomic factors in the origins of the disease. The pandemic has affected mainly indigenous Maori and Pacific people. There were 5,371 confirmed and probable cases of Covid-19 as at 13 November 2021, of which 2,104 (39%)...
Article
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The Guttmacher-Lancet Commission report on Sexual and Reproductive Health and Rights called for the acceleration of progress to achieve SRHR that is essential for sustainable development. To integrate the essential services defined in this report into universal health coverage in the 11 sovereign nations in the Pacific, quality data is required to...
Article
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INTRODUCTIONThere are important changes in the health care needs of women presenting to general practice in New Zealand, which prompted an evaluation of postgraduate training needs of general practitioners (GPs) who care for women in the community.AIMTo evaluate the perceived relevance of the curriculum of Otago University postgraduate programmes i...
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Article
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This short communication explores the challenges and ways forward for the delivery of sexual and reproductive health care in Pacific Island countries during the pandemic and the responses in relation to contraception, the management of unintended pregnancies, and gender-based violence.
Article
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INTRODUCTIONThere are few studies of user perceptions of the Levonorgestrel Intrauterine System (LNG-IUS; Mirena™), which now has the potential to play an important role in the treatment of women with hyperplasia or early stage endometrial cancer. There is limited evidence on how well the Mirena™ is perceived and accepted by women in this context....
Article
Background: Studies in southern New Zealand indicate that up to a quarter of women experienced infertility, likely due to delay in childbearing. However, these findings may not be generalisable to the whole population. Aims: To assess the lifetime prevalence of infertility and evidence for disparities for New Zealand men and women in a nationall...
Article
Diarrheal diseases have been known to cause death in many children below the age of five years, and rotavirus infection represents a major health problem in the world today, particularly in developing countries. The recent outbreak of rotavirus gastroenteritis in Samoa led to the introduction of her debut national immunization program on rotavirus...
Article
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The COVID-19 pandemic and Pacific resilience
Article
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Objective To gain a deeper understanding of women’s experiences of accessing care for abnormal uterine bleeding (AUB) in order to inform future strategies to improve care pathways, including the early detection of endometrial cancer. Design We conducted semistructured interviews with 15 women who attended their first gynaecological specialist cons...
Article
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Background: Although Abnormal Uterine Bleeding (AUB) can have serious medical consequences and significantly impacts daily life, the overall trend is that most women do not seek care for these symptoms. The objective of this review was to synthesise factors impeding women's access care for AUB. Methods: Systematic literature review of qualitativ...
Research
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Six research projects - celebrating evidence generation and service innovation in reproductive health in the Pacific region.
Article
Incidence of endometrial cancer is increasing rapidly in the developed world and is the most common gynaecological cancer in Australia and New Zealand. In line with obesity rates, the landscape and average age of women diagnosed with endometrial cancer are changing. There is still unmet need in early diagnosis, directed treatment, management of com...
Article
Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population size...
Article
Pacific island countries and territories (PICTs) face the challenge of a growing cancer burden. In response to these challenges, examples of innovative practice in cancer planning, prevention, and treatment in the region are emerging, including regionalisation and coalition building in the US-affiliated Pacific nations, a point-of-care test and tre...
Article
This Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple b...
Article
Objective To assess whether antenatal exercise in overweight/obese women would improve maternal and perinatal outcomes. Design Two-arm parallel randomised controlled trial. Setting Home-based intervention in Auckland, New Zealand. Population and sample Pregnant women with body mass index ≥25 kg/m2 . Methods Participants were randomised to a 16-we...
Article
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This report adds to the limited existing literature concerning dermatoses in Samoa. Conditions encountered during a 4‐day private clinic are reported. Amongst the 75 patients reviewed, eczema was the most frequent condition diagnosed. This was followed by infective dermatoses particularly pityriasis versicolor and tinea infections. Reassuringly, in...
Article
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Within the context of our Pacific communities in New Zealand, this heart-wrenching atrocity has caused serious soul-searching and reflection. There are a few themes that come to mind. Of immediate concern are issues with institutional racism and cultural competence in health care and the impact on our Pacific communities, and what leaders and all t...
Article
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Background: Cervical cancer is the leading cause of death in young women in developing countries which includes those in Small Island Developing States (SIDS). Some of the highest rates of cervical cancer deaths in the world occur in the Atlantic, Indian Ocean, Mediterranean, South China Seas (AIMS) and Pacific SIDS. The objective of this systemati...
Article
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Background: Cervical cancer is the most common cancer for Samoan women aged 15-44, and Samoa's estimated incidence is the sixth highest out of 26 Asia-Pacific countries. Cervical cancer is easily prevented if pre-cancers are detected and treated early. Currently, Samoa has no preventive screening programme and the population is unvaccinated against...
Article
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The research agenda in developing countries, such as those in the Pacific Ocean, has often been determined by off-shore funders and researchers without the input of local govern- ments or researchers. There has been a failure of research policies and practice to require that research projects con- ducted on Pacific Island populations result in an i...
Article
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Objective: Our objective was to test the primary hypothesis that maternal non-left, in particular supine going-to-sleep position, would be a risk factor for late stillbirth (≥28 weeks of gestation). Methods: A multicentre case-control study was conducted in seven New Zealand health regions, between February 2012 and December 2015. Cases (n = 164...
Article
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div> Background: Cardiac disease in pregnancy is the third most common cause of maternal mortality in Fiji. The aim of this study was to determine the characteristics of pregnant women with heart disease presenting to the Colonial War Memorial Hospital (CWMH). Method: A retrospective review of case notes of all pregnant women identified with heart...
Article
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p>Benjamin Franklin has been quoted as saying that there are only two things certain in life – death and taxes.<sup>1</sup> But there is a third certainty - change. Much has changed over 20 years. For organisations to survive, they have to be relevant, sustainable and flexible. Inflexible organisations do not last long. </p
Thesis
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Introduction The importance of health research in addressing equity, health outcomes and development is recognised by world leaders and yet there is a lack of research outputs from low to middle income countries, such as those in the Pacific Islands, where the burden of disease is higher. A lack of research generation and utilisation is a manifesta...
Article
Introduction: To evaluate the effectiveness of the levonorgestrel intrauterine system (LNG-IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. Methods: Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding (HMB) who agreed to treatment with the LNG-I...
Article
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p>Huge investments into research capacity building in low to middle-income countries<sup>1</sup> have resulted in a significant increase in the critical mass of research scientists.<sup>2</sup> However, the increase in researchers and research output has been more easily achieved in larger countries with a multitude of research institutions. Effort...
Technical Report
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The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has been pleased to collaborate with the Pacific Society for Reproductive Health (PSRH) in compiling the Pacific Emergency Maternal and Neonatal Training (PEMNeT) Facilitator’s Guide. The PEMNeT Facilitator’s Guide provides facilitators and teachers with a c...
Article
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Background: Research performance assessments have proliferated, but research indicators for use amongst clinicians in poorly resourced countries have been ill-defined. The aims of the present paper were to determine a set of indicators as determined by clinician participants from the Pacific Islands and a panel of research experts for use in the p...
Article
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And that is where our biggest problem with pregnancy and intrapartum care lies in the Pacific – there is an outrageous underinvestment in training opportunities to increase the numbers of nurses, midwives and doctors. We simply do not have enough nurses, midwives and doctors to have engaging discussions on relationships and guaranteeing every woman...
Article
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Background: Human milk is typically low in vitamin D activity (VDA). Whether the vitamin D content of breast milk at birth can be increased by supplementing the mother during pregnancy has not been reported to the best of our knowledge. Objective: We examined the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the firs...
Article
Objective: To assess whether antenatal exercise in overweight/obese women would improve maternal and perinatal outcomes. Design: Two-arm parallel randomised controlled trial. Setting: Home-based intervention in Auckland, New Zealand. Population and sample: Pregnant women with body mass index ≥25 kg/m(2) . Methods: Participants were randomi...
Article
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New Zealand tertiary institutions building medical capacity in the Pacific Islands
Article
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Building the research capacity of clinicians in the Pacific Island countries is important in addressing evidence gaps relevant to local policy and clinical practice. This paper aimed to assess the effectiveness of a reproductive health research workshop in increasing research knowledge and intention to perform research amongst a diverse group of cl...
Book
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The Pacific Society of Reproductive Health, the editors Alec Ekeroma and Matthews Mathai, and the authors of various chapters, need to be congratulated for producing this important and concise training manual. The chapters cover almost all emergencies that can happen to the mother, the fetus and the newborn. The time to have achieved the Millennium...
Article
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Why a new journal and why in the Pacific? Are there not already many journals concerning reproductive science and the clinical aspects of human reproduction, its outcomes and a broad women’s health context? The answer to the second question, in part answers the first. Yes there are excellent journals with very high impact factors in reproductive he...
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Article
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It has been exciting journey getting the Journal thus far and I am optimistic that reproductive health researchers and clinicians in the Pacific Islands and Pacific-rim countries will share in the excitement and the journey that lies ahead as we take the Journal forward.
Article
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Objective: To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and methods:...
Article
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Aim To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Methods Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose ≥7.8...
Article
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Abstract Aim To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Methods Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glu...
Article
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Aim To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Methods Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose ≥7.8...
Conference Paper
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Introduction Specialists in obstetrics and gynaecology (O&G) in the Pacific Island Countries (PIC) often work in professional isolation. Opportunities for professional development were lacking. The O&G specialists through the Pacific Society for Reproductive Health (PSRH) approached the Royal Australian and New Zealand College (RANZCOG) and a Conti...
Article
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INTRODUCTION: Chlamydia trachomatis (C. trachomatis) is a common sexually transmitted infection (STI), and routine antenatal screening to reduce the risk of vertical transmission is recommended in New Zealand (NZ). AIM: To determine the proportion of pregnant women who have been screened for C. trachomatis in selected hospitals since the 2008 NZ Mi...
Article
AimTo determine whether vitamin D supplementation reduces primary care visits for acute respiratory infection (ARI).MethodsA randomised, double-blind, placebo-controlled trial was conducted inNew Zealandand powered to determine the vitamin D dose needed to achieve normal vitamin D status during infancy.Healthy pregnant women, from 27weeksgestation...
Technical Report
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This draft was used as a discussion document with stakeholders. The final draft of the curriculum is a property of the National University of Samoa.
Article
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Obesity during pregnancy is associated with adverse outcomes for the offspring and mother. Lifestyle interventions in pregnancy such as antenatal exercise, are proposed to improve both short- and long-term health of mother and child. We hypothesise that regular moderate-intensity exercise during the second half of pregnancy will result in improved...
Article
Objective: To determine the vitamin D dose necessary to achieve serum 25-hydroxyvitamin D (25(OH)D) concentration ≥ 20 ng/mL during infancy. Methods: A randomized, double-blind, placebo-controlled trial in New Zealand. Pregnant mothers, from 27 weeks' gestation to birth, and then their infants, from birth to age 6 months, were randomly assigned...
Article
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To describe Pacific students in the first year of health sciences at tertiary level, their academic performance, and factors associated with academic outcomes. Routinely collected data for students who enrolled in the Health Sciences First Year (HSFY) programme at the University of Otago between 2007 and 2011, including their school National Certif...
Article
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To determine factors associated with vaginal birth after caesarean section (VBAC) in women delivering at Middlemore Hospital (MMH). Retrospective descriptive study. All women in 2008-2009 who had a previous caesarean section and was deemed suitable for a trial of labour (TOL). Of the 1543 women who had one or more previous caesarean sections, 806 (...
Article
Aim To describe Pacific students in the first year of health sciences at tertiary level, their academic performance, and factors associated with academic outcomes. Method Routinely collected data for students who enrolled in the Health Sciences First Year (HSFY) programme at the University of Otago between 2007 and 2011, including their school Nati...
Article
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To obtain the views of the Pacific community about their involvement in a Pacific Immersion Programme, to determine the programme's viability as a resource for medical education. The Pacific Immersion Programme run by the Dunedin School of Medicine had four attachments (March, April, June and September) with local Pacific communities in 2011. Commu...
Article
Stillbirth remains an important public health problem in Australia and New Zealand. The role that antenatal care plays in the prevention of stillbirth in high-income countries is unclear. Methods: Cases were women with a singleton, late stillbirth without congenital abnormality, booked to deliver in the Auckland region and born between July 2006 an...
Article
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What is needed to support the skilled health workforce in maternal, reproductive and child health in the Pacific?
Article
There is a keen interest to develop research systems and increase research output in the 14 Pacific Island Forum Countries (PIFC) to support development of policies and practice based on locally relevant research evidence. To assess the quantity and characteristics of reproductive health research output by each country (14 PIFC) from 2000 to 2011 u...
Article
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To determine the screening rate for, and the prevalence rate of, sexually transmitted infections (STIs) in pregnancy at Middlemore Hospital. A list of all 6795 women who had a baby at Middlemore Hospital in 2009 was provided by the hospital's information systems. Details of the women including their swab results were then obtained from the Healthwa...
Article
Full-text available
Aims To determine the screening rate for, and the prevalence rate of, sexually transmitted infections (STIs) in pregnancy at Middlemore Hospital. Method A list of all 6795 women who had a baby at Middlemore Hospital in 2009 was provided by the hospital's information systems. Details of the women including their swab results were then obtained from...