The central goal for the Maternal Child Health (MCH) National Training Center is to create a continuum of learning and engagement opportunities for state and territorial Title V practitioners and MCH graduate and undergraduate students to develop the competencies required of contemporary public health leaders to implement the Affordable Care Act (ACA). These competencies include healthcare access and equity, change management, systems integration, and quality improvement. Given the autonomy of states and varying roles for Title V, the primary target audience for the MCH Training Center will be diverse. Thus the Center will offer a menu of online, hybrid, and face-to-face training, technical assistance and coaching opportunities to meet the needs of states in these four competency areas.
Each of the four competency areas has a core team of experts charged with developing training, technical assistance, and coaching opportunities that meets the needs of Title V practitioners and increases their ability to understand and apply principles within the competency area. This specific core team is focused on systems integration.
To ensure optimal MCH outcomes in a time of funding restrictions and ever increasing need, systems integration across current and planned MCH programming is necessary to minimize risk factors and leverage protective factors for the promotion of health throughout the life course. Successful systems integration must address social and environmental determinants of health, engage stakeholders and consumers, align investments and demonstrate collaboration on the use of data.
The ongoing challenge for state and local MCH leaders lies in mobilizing, integrating, and managing MCH delivery systems in ways that optimize the use of resources to improve population health. These challenges are particularly acute in rural and low-resource settings which often are tasked with addressing disproportionately high levels of disease burden and risk with comparatively fewer human and financial resources. Ongoing implementation of provisions of the Affordable Care Act offers new opportunities and challenges for MCH delivery systems, including planned expansions in Medicaid coverage in many states, changes in funding and payment mechanisms for both clinical and public health services, and new incentives for hospitals, health insurers, and employers, to engage in delivering public health and prevention activities. Moreover, in order to achieve health equity, non-medical systems and other sectors, such as education, housing, social services and early childhood systems must be included to optimize collective impact. Thus the Systems Integration core will focus on improving Title V leadership and staff capacity to understand and influence public health systems through basic elements of participatory systems science, resource identification and case study examples by August 31, 2016.
The aim of the Systems Integration core team is to make improvements in the following competencies:
- Gain exposure to system science terminology and methods, and the breadth of health- related applications (i.e. network analysis, concept mapping, system dynamics and concept mapping) to current programs and MCH public health challenges.
- Learn how to identify complex problems for which different types of system science methods are useful.
- Identify new leverage points for change with MCH systems.
- Utilize system diagrams to describe and study complex system problems across multiple stakeholder groups (i.e. system dynamics causal-loop diagrams or integrated service diagrams) to facilitate collective impact and improve outcomes.
- Recognize both the promises and challenges that health reform brings to MCH system integration.