By Michael R. Fraser, PhD, CAE
The core functions of public health are familiar to many of us: assessment, assurance and policy development. These three functions take place within a context – a system. Simply defined, a system is a constellation of parts that is held together by a common purpose, communicates and adjusts as needed to move forward toward the shared goal. MCH programs have long taken a "systems" perspective in their work. MCH leaders know that there are many parts and players in the work we do to improve the lives of women, children, fathers and families. No single entity can truly impact MCH outcomes. Instead, we work together to improve and sustain systems that support health. Contemporary public health practice involves "systems building" to address the issues and concerns of MCH. Often, the Title V MCH Services Block Grant is the only source of funding in a state to support cross-cutting, systems-building work. Other funding streams limit the extent to which a program can reach out of its silo to develop and advance shared goals. As such, one of the most valuable aspects of Title V is its flexible, systems-building perspective to meeting state MCH needs.
No one understands the positive and negative aspects of a system better than those who work with and care for CYSHCN. Complex needs require complex care; care that takes a systems perspective by definition. Indeed, quality care involves multiple providers from many different sectors working together to address the health needs of a child and their family. Good care for kids with complex health care needs does not come easily but it makes a huge difference: when caregiving is coordinated and goals are aligned, the child and family do better, providers are more effective, and care is delivered more efficiently. While care for CYSHCN is often held up as the place where "systems of care" are the most important, a systems-based approach to care for all kids is our ultimate aim – what we do for children with complex health care needs also will help improve care for typical children.
This issue of Pulse highlights some of the ways that MCH programs take a systems-building perspective in their work. I can think of few other disciplines that are so readily adept at coordinating, collaborating and communicating to reach a shared goal. MCH brings multiple sectors together to leverage and enhance care for many different groups of folks within a community, region or state. I hope this issue encourages your own attempts to build and sustain MCH systems in your work. Use this issue to help guide your efforts, learn from peers and contribute to systems building in your state! You’ll be glad you did!