Advancing New Federal and State Policies to Improve Maternal and Infant Health and Health Care
A Convening Hosted by NEHI in Partnership with the Jewish Healthcare Foundation.
The Network for Excellence in Health Innovation (NEHI) hosted a stakeholder convening in partnership with the Jewish Healthcare Foundation on December 12, 2018, at the Kaiser Permanente Center for Total Health in Washington, DC. More than 50 participants came together to discuss opportunities for advancing federal and state policies to decrease the rates of maternal and infant mortality and support ideal maternal and infant health and healthcare in the United States.
Rather than prepared presentations, the convening consisted of discussion-based modules that were launched by a series of "thought starters":
Two legislative proposals were enacted into law mid-December 2018 at the time of the convening. Preventing Maternal Death Act of 2017 (HR1318) and the Improving Access to Maternity Care Act (HR 315) are a part of the 115th Congress.
Convening participants discussed how federal and state programs can support maternal and infant health. Echoing the "Cancer Moonshot" that was conceived during the Obama administration, participants came up with the "Maternal Health Moonshot," which will focus on improving maternal and infant health as a national priority with a goal of working toward eliminating all avoidable maternal and infant deaths by 2050. They plan to create a cross-agency strategy at the federal level to drive toward that goal, and sharply increase funding for key federal and state programs, while adding new initiatives in specific areas.
An additional consensus of the convening was that a maternal and infant health "moonshot" should raise the amount of investment and attention to the issues across the span of women's and infant's lives. This ranges from preconception health, to family planning, to safe and healthy pregnancy and delivery, to support for the mother and infant dyad at least through the first year of the child's birth, and beyond. Federal and state agencies/programs should be involved throughout the care.
Listed below are a variety of initiatives convening participants addressed in a continuum of care needs spanning from preconception through the infant's first birthday.
- Identifying overall maternal and infant health goals for the nation
- Collecting data and general surveillance
- Increasing basic science research into maternal morbidity and mortality
- Supporting maternal and perinatal quality and safety collaboratives and similar endeavors
- Providing preconception counselling and referrals for needed care
- Continuing efforts to drive down the numbers of early elective deliveries and unnecessary cesarean sections
- Changing the healthcare workforce and related services, in support of better maternal and infant care
- Incorporating screening for social determinants intro pediatric services provided under Medicaid and the Children's Health Insurance Program
- Expanding access to maternity care services
- Increasing efforts to support the inter-nationality of pregnancy
- Participating in maternal safety initiatives
- Addressing unconscious bias and promoting respectful care in order to reduce disparities
- Studying the implications of changes in insurance coverage and potential impact on maternity coverage in commercial health plans
- Providing more support for non-medical needs for low-income pregnant women
- Increasing funding under the "Title V Maternal and Child Block Grant" and align performance measure with "moonshot" goals
- Increasing funding for Early Head Start
Convening participants assembled three major strategies and tactics to promote and achieve change.
This information was taken from the meeting summary by Susan Dentzer, former president and CEO of the Network for Excellence in Health Innovation (NEHI), and Valerie Fleishman, executive director of NEHI. Research assistance was provided by Yaminah Romulus, health policy and program associate at NEHI. NEHI is grateful to the Jewish Healthcare Foundation for its support of the convening.
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