Highlighting Private-Public Partnerships to Improve Health
Maternal and infant mortality rates are two critical measures used to help determine the development of a region. These two measures are inextricably linked. According to the National Women’s Law Center, South Carolina is ranked 33 in maternal mortality and the rate of infant mortality in South Carolina is 7.63 per 1000 live births, which is significantly higher than the national average of 5.63 deaths per 1000 live births. To address these numbers, the South Carolina Department of Health and Human Services launched the Birth Outcomes Initiative (BOI) in 2011. This effort listed core objectives that needed to be addressed in order to increase the overall health of both babies and mothers in South Carolina. Since the creation of the initiative, there have been many successes in the improvement of health outcomes that can be attributed to the joint effort of private and public organizations. The increase in maternal and child health can be attributed to such multi-sphere collaborations spurred by the BOI. Below are descriptions of some of these programs.
The Nurse-Family Partnership (NFP) is a home visitation program offered to first-time, low-income families. Nurses create a relationship with the family to understand their needs and create a plan to give the family the support and care they need to have a healthy pregnancy. The mother is visited throughout her pregnancy and till two years after. Funding for the NFP comes from the The Duke Endowment, South Carolina Readiness and the Blue Cross Blue Shield of South Carolina Foundation. Other leaders in this program included South Carolina Department of Health and Environmental Control and the Children’s Trust of South Carolina. Since the initiation of this private-public collaboration in 2009, the NFP has served more than 2,620 families with the following statistics:
-90% of babies were born full term
-89% of babies were born a healthy weight
-72% of mothers initiated breastfeeding
-19% reduction in smoking
Decreasing Elective Deliveries before 39 weeks
Research has shown babies born before 39 weeks have lower birth weights, poorer overall health outcomes and higher health care costs. This is a critical issue to address because disorders related to shorter gestation times and lower birth weights are the leading cause of infant death in South Carolina. The work of the BOI resulted in both Medicaid and Blue Cross Blue Shield, which cover nearly 85% of the insured in the state, stopping payments to hospitals for elective inductions for women who had not yet reached 39 weeks, unless of a medical reason. This was an unprecedented collaboration, which made South Carolina the first state in which Medicaid and a commercial insurance company decided to adopt a policy of nonpayment together. From 2011 to 2013, elective inductions have decreased nearly 50%. Of the 45 hospitals that deliver babies in SC, only 18 still occasionally perform early elective inductions.
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CenteringPregnancy in South Carolina
CenteringPregnancy is an innovational type of prenatal care that is an effort to promote healthier moms and babies. This program allows women with similar gestational ages to interact in a small group setting. Health care providers mediate the 2-hour sessions in which women discuss, support and educate each other. Important topics like nutrition, breastfeeding, family relationships and more are covered. Research has shown that CenteringPregnancy group prenatal care helps to improve the rate of preterm birth. Offered by the Greenville Hospital System, funded by the March of Dimes, and covered by both Medicaid and BlueCrossBlue Shield, this is another paradigm of public-private partnerships doing positive things for maternal and child health in South Carolina.