Infant mortality is an international measure of how well a society ensures the health of its people, particularly its women and children. Our poor performance relative to other high-income countries requires a critical look at our society, institutions, and our methods for identifying and implementing solutions. Racial disparities across key maternal and infant health indicators, including infant mortality and preterm birth, have roots in actions that began centuries ago that together created a system of advantage benefitting White people at the disadvantage of Black, Native American, and other people of color. Without intentional focus on disrupting these systemic inequities and restoring power to those made marginalized through historical and current policies and practices, we will continue to see stagnating progress in birth outcomes despite important expanded work in areas such as access to reproductive, well woman, and prenatal care.
Below are some of the efforts AMCHP leads or supports to build member capacity to disrupt structural inequities, scale up what's working in communities, and promote person-centered, community-driven, respectful and equitable care.
Healthy Beginnings with Title V: Preterm Birth Priming and Planning
In 2020 AMCHP, in partnership with birth equity thought leaders, created a series of webinars and corresponding issue briefs about anti-racist strategies for preterm birth prevention for Title V MCH programs. AMCHP also hosted an in-person meeting that brought together national public health, health care, and community thought leaders and institutional partners with a role in preterm birth prevention. The purpose of the meeting was to develop joint strategic actions to improve birth outcomes for the mother-baby dyad, particularly related to preventing preterm birth. To watch the webinars, read the issue briefs, and review key take-aways from the in-person meeting, please visit the project webpage.
State-Level Support for Maternal Health and Early Child Feeding – Birth to 2 Years
AMCHP, in partnership with the Association of State Public Health Nutritionists and the United States Breastfeeding Committee, developed a series of learning modules for Title V staff about how to more fully incorporate early child nutrition into Title V work. The modules feature state and local examples of ways Title V can apply the Policy Systems and Environmental Change Framework to create transformational changes in early child nutrition. To learn more and access the learning modules, please visit the project webpage.
Forging a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality (AMCHP Compendium on Improving Birth Outcomes, July 2012)
This compendium presents a series of policy and programmatic options state agencies and their partners can use to accelerate progress in improving birth outcomes, reducing prematurity and infant mortality and narrowing glaring health disparities. Click here to access the full compendium.
Toolkit for Engaging Partners in Improving Birth Outcomes Now Available
AMCHP is proud to release a suite of tools, guides, and templates to support the engagement of diverse stakeholders and partners in designing and implementing a comprehensive initiative to improve birth outcomes at the state level. This suite of tools complements the AMCHP document Forging a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality, the birth outcomes compendium, released in 2012.
The materials in the toolkit assist state MCH leaders and local partners in considering the complete story of activities taking place at the community and regional levels. With these tools, MCH leaders can collectively identify assets or strengths to maximize and accelerate progress already underway through the implementation of state infant mortality reduction plans and participation in the National Infant Mortality CoIIN. AMCHP hopes the steps supported by the toolkit will facilitate integrated systems of care for women and children and sustained programmatic supports and alignment of resources. Frameworks that serve as the foundation for this work include the Health Impact Pyramid and the principles of collective impact. The suite of tools includes step-by-step resources to assist state MCH leaders in completing the following activities:
Designing and distributing an assessment or inventory of programs and services available at the local level that are serving women and infants in your state and impacting birth outcomes
Organizing and communicating assessment findings in a way that assists partners in understanding how their programs or services fit into a statewide picture
Planning and executing in-person regional meetings that build partnerships across stakeholder groups and identify a shared commitment or agenda to strengthening approaches for improving birth outcomes
Evaluating the impact of the regional meetings on partnerships and relationship formation in the state
AMCHP would like to thank the Kansas Department of Health and Environment (KDHE) and the March of Dimes Greater Kansas Chapter (MOD) for their participation in efforts leading to this toolkit. AMCHP partnered with KDHE and MOD to pilot an initiative aimed at improving the health of Kansas mothers and infants, beginning with the Southeast public health region of Kansas, which experiences the worst rates of preterm birth and smoking during pregnancy. This effort focused on forging partnerships to address issues families face in the context of their communities. The tools from this initiative have been adapted for broad use by the MCH community. Please click here for a message from Kansas.
AMCHP/ASTHO Webinar: Improving Birth Outcomes in the U.S.: State Efforts to Reduce Prematurity (July 12, 2012)
This webinar highlighted state efforts and strategies from Alaska, Oklahoma and Vermont to reduce prematurity and improve birth outcomes. The webinar recording and slides can be accessed here.
Partnership to Eliminate Disparities in Infant Mortality (PEDIM) (February 2011)
In 2008, CityMatCH, the Association of Maternal & Child Health Programs (AMCHP), and the National Healthy Start Association (NHSA), with funding from the W.K. Kellogg Foundation, created the Partnership to Eliminate Disparities in Infant Mortality, with an aim to decrease racial disparities in infant mortality in U.S. urban areas. From this collaboration, a report and a toolkit were produced.
To access the report, Taking the First Steps: Experiences of Six Community/State Teams Addressing Racism's Impact on Infant Mortality, click here.
To access the toolkit, Exercises for Team-Building and Community Action Planning, click here.
Emerging, Promising and Best Practices on Improving Birth Outcomes
This table summarizes current practices successfully reviewed and accepted into AMCHP’s Innovation Station that relate to infant mortality and improving birth outcomes, including preconception and interconception health. To access this table click here.
State Infant Mortality Collaborative (SIMC) (2004-2006)
In partnership with the Centers for Disease Control and Prevention and the National March of Dimes Birth Defects Foundation, AMCHP supported data to action initiatives in five states. Teams used epidemiology to discern the underlying factors responsible for excess infant mortality and identify opportunities for intervention. Click here to access the full report of the SIMC project.