Convening a Region and a State Around Equitable, Culturally-Sensitive Comprehensive Maternal and Infant Health
After reports highlighted that the Pittsburgh region ranked high in infant and maternal mortality, particularly among women of color, the Jewish Healthcare Foundation devoted significant attention and resources to improving the safety of maternal care in Pennsylvania. JHF has secured funding and recognition for local organizations promoting and embodying best practices in maternal care, and spurred data sharing and quality improvement collaboration among the state’s birthing hospitals. How does this build trustworthiness? Reducing infant and maternal mortality will improve the trust that patients have in the health care system to care for their most essential needs.
How It Works
We took a group of women on a study tour to Australia to view in detail what we considered one of the best and most comprehensive state-sponsored maternal health programs. We were extremely impressed with what we saw and developed a vision for a redesign of the US approach to maternity. In Australia, the state supports women and families according to need (financial, behavioral, medical, social, material) from conception through post partum until the family unit is stabilized and secure. We recognized the critical role of midwives and doulas in bringing support to marginalized and wary ethnic, religious, and linguistic communities. We have organized statewide (and participated nationally) in efforts to extend scope of work and achieve fair compensation. We have become ardent supporters of a strengthened and expanded state WIC program and have organized a statewide coalition. We have engaged legislators, community agencies and other health funders in Pennsylvania to join with us in this effort. Early on we produced an issue of our magazine Roots that traced the history of maternity practices in the US and considered how the medicalization of childbirth has had both good and bad effects–some unintended. I think this brought a lot of attention to the critical social/cultural/behavioral influencers of pregnancy outcomes.
Skills and Competencies
Our work is data driven and research-based in order to establish credibility and trust. But we supplement that with financial support through resource development and our own funds. We are skilled conveners and serial collaborators. When necessary, we have regional, statewide and national networks on whom we call. We have honed and nurtured these relationships over many years. We also draw on our knowledge of policy change in general, as well as health professions education and reimbursement, medical and nursing leadership, behavioral health, and community organization.
We wanted to unite the women’s groups in our area around a single problem focus after the January 2017 women’s marches around the world led to no clear agenda. We wanted a regional agenda for women’s activism and a clear target. We held a broad community “competition” for a winning idea. We even had a big event at a performing arts theatre with a panel of distinguished judges to choose the area for focus. I believe this created a lot of trust and encouraged widespread competition from the outset.
All our birthing centers in Pennsylvania are regularly sharing data now through our state Perinatal Quality Collaborative, and they meet monthly to share best practices. The agendas for these full or half day sessions are rich in improvement ideas. We are carefully charting our progress in terms of birth outcomes. Our WIC program has won an innovation grant and is in the process of redesigning its statewide efforts. We have secured funding and recognition for local organizations that are promoting and embodying best practices–from the grassroots to the most distinguished medical facilities. We have a national network that is working together on maternal workforce issues and our President and Chief Executive Officer sits on the board of the March for Moms. We are a sponsor and supporter of the federal “Momnibus” Bill.
It is definitely scalable and what we’re doing regionally is having an impact both nationally and statewide. We are part of a burgeoning movement to reduce infant and maternal mortality in the US. Most importantly, we hope that we will ignite a redesign of maternity in the US and adopt some or all of the practices we observed in Australia.