By Brittany Argotsinger, MPH
Program Manager, Women's and Infant Health, AMCHP
With the 2015 transformation of the Title V MCH Services Block Grant, state Title V programs were charged with improving the health of women and mothers in new, more explicit ways. In addition to new outcome measures of maternal mortality and severe morbidity, all states are now accountable for improvements in one of two national performance measures within a new Women's and Maternal Health population domain: 1) percent of women with a past year preventive (well-woman) visit; and 2) percent of cesarean deliveries among low-risk first births. Currently in the process of identifying their priorities for the next five years, Title V programs are already looking ahead to the selection of related evidence-based or evidence-informed strategy measures (ESMs) in 2016.
To support states in planning for comprehensive maternal health initiatives at the state level or in partnership with local communities, AMCHP released a new publication for MCH programs and their partners, Health for Every Mother: A Maternal Health Resource and Planning Guide for States. The guide was released in conjunction with National Women's Health Week 2015 and is available for immediate download from the AMCHP website. Organized by six core elements of a comprehensive maternal health initiative, the guide offers a menu of program and policy options, supplemented by a wealth of national resources. Planning tools offer a framework to assess current initiatives, their alignment with national performance measures (and the accountability standards of partners), and untapped opportunities for state and local action.
Arguably of greatest value to states are the nearly 80 implementation examples shared by Title V peers and partners in the field. In Minnesota, for example, Title V leaders have successfully implemented hard stop policies for early elective delivery and have joined the table to advance systems thinking to address social determinants of health. MCH leaders in Delaware are partnering with providers to enhance communication and quality across birthing hospitals as part of a longstanding perinatal collaborative. They also partnered to implement environmental changes that promote physical activity and nutrition, launched successful reproductive life planning campaigns, and improved access to enhanced service bundles for women at risk for poor birth outcomes. In Massachusetts, housing initiatives and support for pregnant and parenting teens address social determinants of health for those most vulnerable, while home visiting programs – including a universal home visiting pilot – offer patient-centered approaches to maternal health screening and support. In California, data capacity and partnerships make possible the development of clinical toolkits that address leading causes of maternal morbidity and mortality. Women's cardiovascular health promotion and care management initiatives in North Carolina are complemented by tobacco cessation and other clinical interventions across the care continuum. In Washington, cross-program coordination, health care innovation, and shared decision making initiatives, among others, are in place to improve the health of mothers.
Understanding the current maternal health landscape in your state will be an important first step toward synergy and collective action across programs serving women of reproductive age. Hard copies of the guide may be requested by contacting Brittany Argotsinger, firstname.lastname@example.org or (202)