Building a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality: The AMCHP Compendium

By Tegan Callahan
Program Manager, Women’s and Infant Health, AMCHP

Since the passage of Title V of the Social Security Act, state and territorial maternal and child health programs have been striving to address the causes of poor birth outcomes throughout the United States. Recently, national initiatives have encouraged state and community partners to enhance or develop comprehensive approaches for improving birth outcomes, including setting target goals and introducing new regional initiatives. Currently, AMCHP members are partners in several regional and national initiatives, such as the HRSA Infant Mortality Collaborative, the ASTHO Healthy Babies Project, and the March of Dimes Healthy Babies are Worth the Wait.

To help our members meet the goals of these initiatives and capitalize on the momentum around reducing infant mortality, AMCHP released Forging a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality in July 2012. This resource is a synthesis of policy and program options that states can use in planning and implementing comprehensive initiatives to address infant mortality.

The groundwork for the AMCHP Compendium began in the fall of 2011. AMCHP staff had begun an informal environmental scan of state reports and recommendations on infant mortality in order to learn best practices and keep up-to-date on the strategies being implemented across states and communities. AMCHP staff realized our informal environmental scan of state level actions and initiatives needed to be formalized into a summary document that showcased not just the types of recommendations states can adopt, but also included the actionable steps states and partners can take to follow through on recommendations.

The first step toward the final compendium was the development of an organizing framework. We summarized the multiple recommendations and strategies being implemented in states and communities into seven broad recommendation areas. These broad recommendations were then aligned to the Health Impact Pyramid, presented by Dr. Tom Frieden in 2010,1 in order to promote multi-level, comprehensive approaches.

The heart of the compendium, however, is beyond the seven broad recommendations and the overarching framework. Often recommendations do not offer practical guidance on what to do. In order to provide an action-oriented resource for state- and community-level practitioners, we drilled down within each recommendation to offer sub-recommendations and action-oriented strategies to address the overarching recommendation. Finally, to bring all the pieces together, AMCHP staff highlighted California, Delaware, Kentucky, Maryland,

North Carolina, Ohio and Texas as case studies of states that were building comprehensive initiatives to improve birth outcomes. Once these pieces were compiled, AMCHP reached out to partners and experts in the field to examine the recommendations, sub-recommendations and action steps in order to provide feedback on accuracy and clarity. The final compendium incorporated the feedback of more than 30 expert reviewers.

When the first copies of the printed compendium arrived at the AMCHP offices, we were truly giddy and opened the box with an excitement reminiscent of a holiday morning. So many hours of work by staff and partners came to life when we had the final printed copies in hand! We hope the compendium helps MCH stakeholders focus efforts by providing specific, actionable ways to improve birth outcomes and facilitates learning about strategies and approaches from other states. We are pleased to now offer this resource on the AMCHP website. To access the complete compendium and other AMCHP resources on infant mortality, visit here.

1Thomas R. Frieden, MD, MPH. A Framework for Public Health Action: The Health Impact Pyramid. American Journal of Public Health | April 2010, Vol 100, No. 4, 590- 595.