WIH Team: Building Capacity to Promote Women’s Health, Leverage MCH Epidemiology for Knowledge Generation, and Advance a Life Course Approach

By the AMCHP WIH Team (Erin Bonzon, Piia Hanson, Caroline Stampfel, Brittany Argotsinger, Andria Cornell and Megan Phillippi)

The AMCHP women’s and infant health (WIH) team collaborates with numerous partners to implement projects that span diverse topics such as home visiting, infant mortality, health reform and health system redesign, maternal mortality, chronic disease, and preconception health. As the team reflected on 2013, three cross-cutting themes emerged: building capacity to address maternal and child health priorities across the life course, supporting the spread of effective MCH practices, and convening and leading strategic alliances to advance health equity in women’s and infant health. As we look ahead to 2014, our work in these areas will continue and we will focus on expanding the reach of the Life Course Metrics Project and supporting the Region IV, V, and VI Infant Mortality CoIIN while renewing efforts to meet member needs with respect to quality improvement and return on investment.

Building Capacity to Address MCH Priorities across the Life Course: Life Course Metrics and Improving Women’s Health

In October 2013, AMCHP released 59 life course indicators as the culminating product of the Life Course Metrics Project, an initiative funded with support of the W.K. Kellogg Foundation. This year-long effort was a collaboration with seven state teams and a National Expert Panel and responded to the need expressed by MCH programs and partners for standardized metrics to measure progress using the life course approach to improve maternal and child health. Since the release of the indicators, AMCHP focused on releasing companion narratives for each individual indicator and a national comparison set to assist states in calculating the indicators. At the 2014 AMCHP Annual Conference, Dr. William Sappenfield, National Expert Panel member, offered technical assistance to individuals calculating the life course indicators, and Caroline Stampfel, senior epidemiologist, moderated a workshop on life course indicator development. For more information, please visit our Life Course Indicators page. In the coming year, we will shift our focus from the dissemination of the indicator set to supporting MCH programs in applying the indicators in their work. We will continue to support epidemiology capacity to calculate the indicators, but also provide resources and assistance to translate the indicators to opportunities such as Title V needs assessments and engage MCH program staff in using the indicators for program planning and evaluation.

With funding from Merck for Mothers US, AMCHP launched the Every Mother Initiative in 2013. This three-year initiative will help states address maternal health issues in their community through strengthening state maternal mortality surveillance systems and using data to take action in developing and implementing population-based strategies to prevent maternal death and improve maternal health. The initiative includes two rounds of 15-month action learning collaboratives (ALCs) for six state maternal mortality review programs, and teams also will have the opportunity to pilot test the new CDC Maternal Mortality Review Database System to help enhance and streamline data collection and case abstraction for their review programs . The first ALC launched in September 2013 with partners from the CDC Division of Reproductive Health, ACOG, SMFM, and AWHONN. For more information, visit our maternal mortality page. In addition to launching the next 15-month ALC this summer, AMCHP is excited to begin work on a new Compendium on Women’s and Maternal Health. Modeled after the AMCHP Compendium on Infant Mortality, the new compendium will serve as a menu of policy and program options for states to use in translating the findings from their maternal mortality and morbidity reviews. AMCHP appreciates the ongoing support from Merck for Mothers that enables us to continue and expand this exciting work.

In 2014, AMCHP will prioritize equity and reducing disparities in women’s health across the life span by focusing on the following topics that address growing areas of concern and interest for MCH programs: the association between discrimination and segregation and women’s health, building on lessons learned from the ALC – Partnership to Eliminate Disparities in Infant Mortality, exposure to stressors during pregnancy, leveraging the preconception health indicators, and advancing women’s health in the postpartum period. Activities will include featuring topics in the Women’s Health Info Series, the WIH team webinar program, and disseminating findings from surveys and other activities that engage women’s voices in program and policy change.

Supporting the Spread of Effective MCH Practices: Training and Tools

The WIH team enhanced the skills of the MCH workforce through design and delivery of trainings on quality improvement, return on investment and collective impact. Through a cooperative agreement with the Division of Reproductive Health at CDC, we offered two full-day enhanced training opportunities at the 2014 AMCHP Annual Conference targeted specifically to epidemiologists, data analysts, and other MCH practitioners wishing to build their skills in these areas.

The WIH team continues to be instrumental in educating our members and partners about the collective impact approach. In 2013, we operationalized the principles of collective impact to improve women’s and infant health through trainings with the Every Woman Southeast Coalition (EWSE), the Optimizing Health Care Reform to Improve Birth Outcomes ALC state teams, the Best Babies Zone sites, and also a mini-plenary at the AMCHP Annual Conference. Collective impact occurs when organizations from different sectors agree to solve a specific social problem using a common agenda, aligning their efforts, and common measures of success. 

In addition to these trainings, the WIH team spread effective MCH practices and innovations through the Women’s Health Info Series. In 2013, we partnered with multiple organizations including EWSE, ACOG, American Academy of Pediatrics (AAP), American Society for Investigative Pathology (ASIP) and Project Impact to host and promote nine webinars. Topics included: collective impact, infant mortality and safe sleep, birth settings, the impact of racism on MCH populations, implementation of the Affordable Care Act, and the AMCHP Life Course Metrics Project. Recordings and slides are in the Women’s Health Info Series 2013 archive.

Along with providing direct trainings, the WIH team released the State Infant Mortality (SIM) Toolkit for states to assist with the analysis and interpretation of available perinatal-related data. It is envisioned that a standardized approach to the infant mortality assessment process presented in the toolkit will help those with infant mortality programs and data in their states, counties, urban areas, tribal regions, or other population-based areas identify needs and tailor programs aimed at improving maternal, child and infant health. For more information, please visit our SIM Toolkit page.

This year, we will continue to identify ways to meet member needs that focus on using data to improve and demonstrate the value of public health programs and investments. Through a new partnership with the Council of State and Territorial Epidemiologists (CSTE), we will be following up a return on investment (ROI) training that took place at the AMCHP 2014 Annual Conference with a series of virtual “community of practice” meetings that will allow participants to discuss the progress they have made and obstacles they have encountered in their ROI projects. Additionally, through continued support of the CoIINs to reduce infant mortality and the new MCH Workforce Development Center, we will identify opportunities to synthesize and coordinate efforts around quality improvement to maximize learning and address member needs.

Convening and Leading Strategic Alliances to Advance Health Equity and Improve Maternal and Child Health

WIH team members participated in multiple committees, coalitions, meetings and conferences to provide input around issues related to improving health of women and infants. Through our work with the Best Babies Zone, AMCHP and partners coordinated and facilitated three think tank meetings in Oakland, CA that provided a forum for teams to learn about working collaboratively across the economic, education, health, and community sectors to promote innovative solutions and strategies to improve the lives of children born into each zone.

AMCHP also convened national stakeholders for a Connecting the Dots meeting where we discussed the multitude of national initiatives to improve birth outcomes and identified areas of connectivity and commonality and issues related to disconnect in coordination and implementation.

In 2013, team members and partners also coordinated and facilitated CoIIN meetings for Regions IV, V and VI and hosted a session on the national CoIIN rollout at the 2014 AMCHP Annual Conference.

Lastly, with generous support from the Doris Duke Charitable Foundation, AMCHP, along with partners from the CDC Division of Violence Prevention, National Association of County and City Health Officials (NACCHO) and Healthy Heartland, participated in a project to develop and disseminate the Raising of America documentary to MCH directors nationwide. The documentary is a project from California Newsreel, the producers of Unnatural Causes, and is funded by the W.K. Kellogg Foundation. The Raising of America , which was screened at the AMCHP Conference thanks to funding from the Doris Duke Charitable Foundation and the W.K. Kellogg Foundation, explores how a strong start for all our kids can lead to a healthier, stronger and more equitable America.

We look forward to continuing our partnerships with the WK Kellogg Foundation, Best Babies Zone, and regional CoIINs in 2014 to address disparities and improve birth outcomes.