Advancing Equity and the Power of Multidisciplinary Teams
February 2017

Dr. Jeanette Kowalik, Andria Cornell, Christina Ratleff, Michelle Eglovitch, Nadia Laniyan
Women’s and Infant Health Team, AMCHP

AMCHP’s Women’s and Infant Health (WIH) team carries out the organization’s mission by increasing the capacity of Title V programs and their partners to improve the health and well-being of women and infants. Specific focus areas constantly evolve to reflect the changing needs of our membership. In 2016, the WIH team used diverse means to deliver technical assistance and support across topics in women’s and infant health, including learning collaboratives, implementation of rapid-cycle quality improvement methods and multi-stakeholder partnerships.

Looking Back on 2016

QI to improve birth outcomes: AMCHP supports the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN), in partnership with the Health Resources and Services Administration, Maternal and Child Health Bureau and National Institute for Children’s Health Quality. AMCHP serves as the lead technical assistance organization to three learning networks: the Social Determinants of Health (SDoH), Safe Sleep and the Pacific IM CoIIN Data Capacity Learning Network.

  • During 2016, the SDoH Learning Network narrowed its focus on the three WHO cross-cutting strategies for tackling social determinants of health: Health in all Policies (HiAP), Assess Organization or Agency Capacity to Change Policy and Programs, and Mapping and Monitoring Unequal Treatment and Disparities in Birth Outcomes.
  • The Pacific IM CoIIN Data Capacity Learning Network is a collaborative effort focused on improving access to quality birth and death certificates. This effort subsequently gave rise to the Pacific Basin Fetal and Infant Mortality Review (FIMR) CoIIN to increase data capacity and develop a formalized FIMR process.

Also, with support from the Robert Wood Johnson Foundation, AMCHP managed a project entitled AMCHP Birth Outcomes Collaborative: Building a Culture of Quality to Demonstrate Value and Improve Equity. This initiative complements the IM CoIIN by facilitating the development and dissemination of evidence-based practices to advance health equity and improve birth outcomes in HRSA regions IV and VI. In 2016, AMCHP convened Birth Outcomes Collaborative participants in Charleston, N.C., to facilitate state/peer sharing in order to sustain their journeys toward building a culture of quality improvement and achieving equity in birth outcomes.

Oral health: The Perinatal and Infant Oral Health Quality Improvement (PIOHQI) initiative awarded grants to five more states, bringing the total number of grantees to 16. The Children’s Dental Health Project leads PIOHQI, and AMCHP sits on the National Learning Network as a national partner. The goal of the initiative is to reduce prevalence of oral disease in pregnant women and infants through improved access to quality oral health care.

Maternal mortality: The AMCHP Every Mother Initiative, a project funded by Merck for Mothers to build the capacity of state maternal mortality review committees to translate review findings into population action, concluded in October 2016. Special thanks to the 12 states that participated over the past three years: Cohort 1 – Colorado, Delaware, George, North Carolina, New York and Ohio; and Cohort 2 – Florida, Illinois, Louisiana, Missouri, Oklahoma and Utah. As a last activity of the project, AMCHP collaborated with the CDC team to host a mock maternal mortality review at the 2016 CityMatCH Leadership and MCH Epidemiology Conference. Over 80 individuals attended to get an inside peek at how a maternal mortality review functions. AMCHP also partnered with the Association of Women’s Health, Obstetric and Neonatal Nurses on the publication of a JOGNN In Focus Series on resources and tools to track the impact of nursing practice on maternal mortality and morbidity. Finally, in the beginning of 2016, AMCHP joined a new partnership with the CDC Foundation and the CDC Division of Reproductive Health to expand support to maternal mortality reviews.

Place-based efforts: The Best Babies Zone (BBZ) initiative, funded by the W.K. Kellogg Foundation, is a place-based, multi-sectorial approach to reducing inequities in infant mortality. BBZ improves birth outcomes by mobilizing community residents and organizational partners to address the social and economic determinants of health. AMCHP partners with BBZ to provide guidance, technical assistance and support to each of the individual zones. In December 2016, three new zones were added: Portland, Ore.; Kalamazoo, Mich.; and Indianapolis, Ind.

Breastfeeding: The Workplace Support Project began in September and activities are now underway. As part of the project, AMCHP provides four grants to states desiring to develop a model breastfeeding workplace accommodation policy, enhance a lactation area in their workplace and/or replicate a best practice surrounding workplace breastfeeding accommodations. The aim is to increase the duration of breastfeeding and ensure access to breastfeeding in the workplace. The four grantees convened in a virtual meeting at the end of November to brainstorm solutions to challenges and share project activities. AMCHP also attended the Breastfeeding and Feminism International Conference.

What we read last year:

What’s Ahead in 2017?

  • Launch of Review to Action: Review to Action is a website developed by AMCHP in partnership with the CDC Foundation and the CDC Division of Reproductive Health, with funding from Merck for Mothers. It is an online portal of resources to assist maternal health stakeholders in starting and sustaining maternal mortality reviews and communicating the role of these reviews in preventing maternal death in the U.S. Key features of the site include an interactive state map, resource center, interactive discussion board, access to best practices and a ‘take action’ section. The website will formally launch at the 2017 AMCHP Conference. A key resource in the portal will be a standard data system for maternal mortality reviews, the Maternal Mortality Review Information Application. Stay tuned!
  • New CoP on Women’s Health: In partnership with the health systems transformation team, the WIH team will launch several activities to expand support to members in their efforts to improve access to and the quality of health care services for women. These activities include deeper involvement with states addressing NPM 1 by establishing a community of practice around the well-woman visit. We’ll also support the implementation of the revised Women’s Preventive Services Guidelines.
  • Building the Capacity of MCH to Advance Health Equity: With support from both the W.K. Kellogg Foundation and the Robert Wood Johnson Foundation, the WIH team continues to provide training and resources focused on enhancing the capacity of the MCH workforce to advance health equity and decrease racial/ethnic inequities in maternal and infant health. In 2017, AMCHP will host trainings on health and racial equity at the IM CoIIN Learning Session 5 and during the AMCHP Annual Conference. Additional learning opportunities will be held virtually through webinars and listening sessions. AMCHP looks forward to convening leaders and developing new partnerships and products in 2017 to expand this work.