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Daily Court Reporter - News New initiative seeks innovative strategies for addressing the leading cause of infant death—prematurity


New initiative seeks innovative strategies for addressing the leading cause of infant death—prematurity

Effort will explore the benefit of community building among pregnant women as a means to reducing racial disparities in birth outcomes

To more directly combat prematurity, the leading contributor to infant death in Ohio, the Ohio Department of Health (ODH) has issued a request for proposals (RFP) for experts to work with the agency to develop and test new, Ohio-specific innovations. Specifically, the effort will explore the benefit of building relationships and support networks among the most at-risk pregnant women in order to address health disparities that can be factors in prematurity.

“While we have seen some progress in reducing infant mortality in Ohio, we still have a lot of work to do

– particularly in the areas of preterm births and racial disparities,” said ODH Director Lance Himes. “Providing women the support and community of a group prenatal care model is an innovative approach that we believe can reduce prematurity, including racial disparities in prematurity, and we hope to be able to quickly share any ideas that show promise.”

Prematurity-related conditions such as preterm birth before 37 weeks of pregnancy have been completed account for approximately 30 percent of infant deaths in Ohio and nationally each year. Prematurity has a significant impact on black infant mortality in Ohio – accounting for 78 percent of black infant deaths in 2017 compared to 64 percent of white infant deaths.

Prenatal care has traditionally consisted of a pregnant woman’s one-on-one visits with a clinical provider throughout her pregnancy. The “group prenatal care” approach that ODH will explore is an alternative model in which several women with similar due dates come together in a structured prenatal care program. The program is facilitated by a clinician and includes health screening and physical assessment, interactive learning, and social support. Evidence suggests that patients who have or develop strong personal support networks in this manner have better prenatal knowledge, feel more ready for labor and delivery, are more satisfied with care, and initiate breastfeeding more often, according to the American College of Obstetricians and Gynecologists.

The effort will also support participants during the 12 months after delivery—a critical time for mothers to manage the stress and anxiety of caring for a newborn that can impact maternal and infant health.

Because the Ohio-specific model will address both medical and social needs of the mother, it is expected that this approach will help reduce prematurity, including racial disparities.

The vendor who is awarded the group prenatal care project through the RFP process will be responsible for developing the curriculum for an Ohio-specific group prenatal care model based on length of care beginning during the first trimester of pregnancy and continuing through delivery and 12 months afterward. The curriculum must address prenatal and postpartum medical care as well as topics addressing how to reduce stress, increase social and community support, and address social determinants of health like health behaviors, mental health, healthcare access and housing.

The Ohio-specific group prenatal care model will be implemented in several clinical sites that serve the most at-risk women who agree to participate in the project. At the end of the project, a final report will provide analyses of birth outcomes and racial disparities, maternal outcomes including stress, appropriate weight gain and engagement in postpartum care, satisfaction with prenatal care including cultural sensitivity and social support, and engagement in prenatal care.

This project builds on work Ohio already is doing to address contributing factors to prematurity. This work includes promoting use of a hormone medication, progesterone, in at-risk women to help reduce the likelihood of preterm birth. They also include promoting smoking cessation as smoking increases the risk of preterm birth and low birth weight. Efforts also include identifying and treating women at risk of developing diabetes and high blood pressure during pregnancy, which increases the risk of having a preterm birth or low birth weight baby. They also include promoting a birth interview of at least 18 months between pregnancies to allow a woman’s body to recover and increase the likelihood of a healthy next pregnancy.

During the past eight years, Ohio has implemented a comprehensive range of initiatives to address infant mortality including prematurity, investing more than $137 million at the state and local levels to help more babies reach their first birthdays. Addressing disparities in birth outcomes was the focus on the 2018 Ohio Infant Mortality Summit held in Cincinnati on Dec. 11-12, bringing together more than 800 stakeholders from across the state committed to addressing infant mortality.

About the Ohio Department of Health

The Ohio Department of Health (ODH) is a cabinet-level agency, meaning the director reports to the governor and serves as a member of the Executive Branch of Ohio’s government. The ODH executive team helps the Director of Health formulate the agency’s strategic policy goals and objectives. The team is composed of the Chief of Staff, the Medical Director and the General Counsel. These leaders, along with agency senior-level managers and supervisors, work in tandem to ensure the state health department is responsive to the needs of Ohio’s 11.5 million residents.

ODH’s mission is to protect and improve the health of all Ohioans by preventing disease, promoting good health and assuring access to quality care.

We organize our agency (Organization Chart) according to our core public health responsibilities:

Prevent and control the spread of infectious diseases (Bureau of Infectious Diseases)

Provide direction, support and coordination in preventing, preparing for and responding to events that threaten the public’s health (Office of Health Preparedness)

Build strong communities to enable Ohioans of all ages and abilities live disease and injury-free (Bureau of Health Promotion and Office of Health Improvement and Wellness)

Address health inequities and disparities, and support access to comprehensive, integrated healthcare for all to achieve the best possible outcomes (Office of Health Policy and Performance Improvement)

Assess and monitor environmental factors that potentially impact public health including air, water, soil, food and physical and social features of our surroundings (Bureau of Environmental Health and Radiation Protection)

Assure quality in health care facilities, health care services, and environmental health through smart regulation to protect the health and safety of Ohioans (Office of Health Assurance and Licensing)

Additionally, there are several offices and bureaus within the agency that assist with internal and external operations. These include:

Bureau of Vital Statistics - Operates a statewide system for the registration of births, deaths, fetal deaths, and other “vital records.” The vital record statistics are used to assess population health and inform public health programs provided by ODH, local health departments and other providers across Ohio.

ODH Public Health Laboratory - Assists the agency, local health departments, and clinicians across Ohio in disease outbreak investigations, public health emergencies, and identification of disease causes to aid in treatment and prevention. Its services include screening for diseases of public health interest, reference support for confirmation of low incidence infectious agents, laboratory investigation to determine epidemiological patterns, and oversight of the state’s alcohol breath testing program.

Office of the Medical Director - Serves as the lead clinician for the Ohio Department of Health and advises the director and agency in all matters related to public health and the development and implementation of statewide public health policies and programs.

Office of Management Information Systems - Administers the computer-based management systems across the ODH enterprise. The office is responsible for maintaining ODH computer networks and servers and for the development and implementation of strategies that support the current and future technology needs of the agency.

Office of Human Resources - Oversees the management of ODH’s human resource needs through daily operations.

Office of Financial Affairs - Assists in the establishment of ODH’s long and short-range fiscal goals and objectives. The office provides the agency with the overall fiscal administration support through its various unit operations including accounting, purchasing, budgeting and grants administration. The office oversees the department’s Compliance and Accountability Unit and biennial budget process; provides technical assistance to agency decision-makers and provides daily monitoring and analysis of agency spending trends.

Office of Government Affairs - Directs and coordinates legislative affairs for ODH and develops policies and procedures to promote the department’s legislative agenda. The office is the primary liaison for the agency in working with the Ohio legislature and with all federal, state and local elected officials.

Office of Communications - responsible for the development of all ODH internal and external communication strategies. Its primary functions include media relations, public relations and marketing. The office leverages mass and social media channels to ensure the general public has immediate access to critical public health information.

Office of General Counsel - assists the Director of Health in defining agency goals and objectives by overseeing and coordinating all ODH legal activities. Its primary responsibilities include negotiating, developing and advocating the legal and legislative positions of the department.

Date Published: January 23, 2019


Ohio Department of Health


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