1. Building comprehensive initiatives to improve birth outcomes and reduce infant mortality

2. The Association of Maternal and Child Health Programs (AMCHP)

4. Presentation overview Background: the context behind the AMCHP’s latest resource Orientation to the compendium: Recommendations, actions, strategies, examples Organizing framework: what does it mean to be ‘comprehensive’?

7. 60 national-source recommendations 60 state-source recommendations

8. Recommendations Program examples Policy examples Evidence base Innovative ideas Best practices Action steps Strategies One resource

9. 180+ specific strategies 60 action steps 80+ program/policy examples 7 recommendations One resource

10. Seven recommendations for improving birth outcomes and reducing infant mortality 1) Implement Health Promotion Efforts 2) Ensure Quality of Care for All Women and Infants 3) Improve Maternal Risk Screening for All Women of Reproductive Age 4) Enhance Service Integration for Women and Infants 5) Improve Access to Health Care for Women Before, During and After Pregnancy 6) Develop Data Systems to Understand and Inform Efforts 7) Promote Social Equity

12. Action steps & specific strategies Action step Specific strategies

13. Action: Incorporate messages on healthy pregnancy into social marketing and education campaigns

14. Example: Louisiana Floor Talker Program

16. Washington: Shared Decision Making Policy

18. Louisiana: Health Assessment Referral and Treatment http://new.dhh.louisiana.gov/

20. Colorado: Prenatal Plus

22. West Virginia: Perinatal Connect to Care

24. Florida: CHARTS

26. Alaska, Oklahoma: Coming of the Blessing http://www.comingoftheblessing.com

27. Connecticut: Statewide Fatherhood Initiative

28. Frieden, T.R. (2010) A Framework for Public Health Action: The Health Impact Pyramid. The American Journal of Public Health, 590-595.

29. Health Impact PyramidRecommendations for Improving Birth Outcomes Tier 5: Education and Counseling Individual or public educational messages and support. 1. Implement Health Promotion Efforts Tier 4: Ongoing Clinical Interventions Evidence-based practices within clinical settings. 2. Ensure Quality of Care for All Women and Infants Tier 3: Protective, Long-lasting Offer long-lasting protection to individuals. 3. Implement Maternal Risk Screening for All Women of Reproductive Age Tier 2: Changing the Context Change the environmental context to making the healthy choice becomes the easy choice. 4. Enhance Service Integration for All Women and Infants 5. Improve Access to Health Care for Women Before, During and After Pregnancy 6. Develop Data Systems to Understand and Inform Efforts (i.e. infrastructure development) Tier 1: Addressing Socioeconomic Factors Address fundamental social conditions. 7. Promote Social Equity

30. Where does your work fit into the health impact pyramid? What level of the pyramid best characterizes your work?

31. Where are the gaps in your community? What additional areas still need to be addressed in order to have a comprehensive approach to infant mortality among your community?

32. How can you change your approach to contribute to a comprehensive initiative to improve birth outcomes? What steps do you commit to taking, individually, in your workplace or organization, in your community, to reduce infant mortality and improve birth outcomes?

33. Limitations of a compendium

34. Case studies

35. http://www.amchp.org/programsa ndtopics/womens-health/infant- mortality.aspx