Providing a dental home for pregnant women: a community program to address dental care access--a brief communication.
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OBJECTIVE: This paper describes a community-based intervention to provide a dental home for women covered by Medicaid in Klamath County, Oregon. In 2001, 8.8 percent of pregnant women served by Medicaid in Oregon received care. The long-term goal of the program is to promote preventive oral care for both mothers and their new infants. METHODS: Pregnant women received home/Women, Infant and Children visits and were assigned a dental home under a dental managed care program [Dental Care Organization (DCO)]. All initial care was provided at the Oregon Institute of Technology Dental Hygiene Clinic under the contract with the DCO. Emergency, preventive, and restorative care was provided. RESULTS: Between February 2004 and January 2006, 503 pregnant women were identified; 421 women were contactable. Of these, 339 received home visits (339/421, 80.5 percent) and 235 received care (235/339, 69.3 percent). Overall, 55.8 percent of eligible women received care (235/421). Most who did not have a visit either moved or were not the caretaker of the baby. The missed appointment rate was 9 percent. CONCLUSION: A community health partnership led to a successful and sustainable model extending care to pregnant women and is being extended to promote preventive care for both new mothers and their offspring. (+info)
Infant death and interpretive violence in Northeast Brazil: taking bereaved Cearense mothers' narratives to heart.
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WIC program participation--a marketing approach.
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Recent evaluation studies have described the benefits accruing to low-income women and children who participate in the Special Supplemental Food Program for Women, Infants, and Children (WIC). However, participation is not uniform among all groups of eligible persons. This study examines the geographic variation in WIC participation rates of eligible pregnant women in Rhode Island to determine whether the program is effective in reaching the neediest segments of the population. Eight groups of small geographic areas in Rhode Island (census tracts) were formed on the basis of need for maternal and child health services, as determined from a statistical method employing factor and cluster analysis of existing health and sociodemographic data. Among these eight groups, participation rates in WIC during 1983-84 ranged from 46 percent to more than 100 percent of estimated eligible pregnant women. The rates were positively correlated with measures of need, strongly (r = 0.92) with an index of maternal risk, and less strongly (r = 0.79) with an index of birth outcomes. The results of this study have enabled the Rhode Island WIC Program to direct its outreach efforts more specifically to geographic areas where the need for the program's assistance is greatest. The procedures described in this report comprise a technique that can be generally applied to measure program effectiveness in marketing and outreach where relevant data are available by small geographic areas. The data requirements are (a) population-based estimates of program need and (b) program utilization measures. If these data can be aggregated to a common set of small geographic areas, the use of marketing analysis techniques becomes possible, and program benefits in the area of outreach and recruitment can be realized. (+info)
Strategic Demarche in a mother and child hospital unit.
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Child guardianship in a Canadian home visitation program for women who use substances in the perinatal period.
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BACKGROUND: Retaining guardianship of one's infant is often a priority for pregnant women who use substances, and may be beneficial to infants when they are safe in their mothers' care. Previous studies from the United States have identified several maternal psychosocial characteristics associated with the ability to keep an infant free from abuse or neglect; however, little is known about the impact of multiple risk factors on guardianship, particularly in Canadian intervention programs. OBJECTIVE: To describe maternal characteristics associated with child guardianship among pregnant women at risk of an alcohol and/or substance exposed pregnancy who attended a Canadian home visitation program. METHODS: Guardianship status at 6 months post-enrolment was extracted from a provincial program's records for all women enrolled between November 1999 and May 2005 (n=64). Bivariate analyses were performed to determine client characteristics most likely to have retained guardianship. RESULTS: At follow-up, 70% of participants were guardians of the index infant. Higher income, more prenatal care, no history of sexual abuse, better alcohol and psychiatric scores, and fewer risk factors on a cumulative risk index were significantly associated with retaining guardianship at 6 month follow-up (p<0.05). CONCLUSIONS: Retaining child guardianship may be the greatest challenge and opportunity for women experiencing problems in multiple domains of their lives, including those associated with substance dependence. Programs targeted at women who use substances while pregnant may best assist mothers to retain guardianship of their infants by supporting clients to address the complex social and health problems often found in conjunction with addictions. (+info)
Potential role of traditional birth attendants in neonatal healthcare in rural southern Nepal.
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The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly-selected TBAs (n=93) were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. Practices, such as using a clean cord-cutting instrument (89%) and hand-washing before delivery (74%), were common. Other beneficial practices, such as thermal care, were low. Trained TBAs were more likely to wash hands with soap before delivery, use a clean delivery-kit, and advise feeding colostrum. Although mustard oil massage was a universal practice, 52% of the TBAs indicated their willingness to consider alternative oils. Low-cost, evidence-based interventions for improving neonatal outcomes might be implemented by TBAs in this setting where most births take place in the home and neonatal mortality risk is high. Continuing efforts to define the role of TBAs may benefit from an emphasis on their potential as active promoters of essential newborn care. (+info)
The contribution of clinic-based interventions to reduce prenatal smoking prevalence among US women.
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