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DOCUMENT RESUME
07711 - [C31069N (Restricted)
fImproving Pregnancy Outcome in the Listrict of Cclumbia].
October 31, 1978. 16 pp.
Report to Albert P. Russo, Director, Eistrict of Columbia: Dept.
of Human Resources; by Robert V. Parabaugh, Assistant Director,
Human Resources Div.
Contact: Human Resources Div.
Organization Concerned: District of Columbia.
Authority: Social Security Act, as amended. P.1. 93-641.
A review was conducted if the District of Cclumbia's
(D.C.'s) progress in improving pregnancy outcome. The District's
infant mortality rate declined from 35.3 per 1,000 live births
in 1966 to 24.9 per 1,000 live births in 1976. However, the
District's 1976 infant mortality rate is substantially bigher
than the U.S. rate (15.2 per 1,000 live births) and ranks among
the highest of all the States and large cities. Substantial
differences also exist in the infant mortality rate aacng the
District's nine health service areas. No organization has
effectively assumed overall responsibility for seeing that the
District has a concerted, systematic approach for improving
pregnancy outcome. Planning responsibility is fragmented; better
collection and use of data are needed; service delivery and
financing need to be coordinated; resources are unevenly
distributed; and many physicians are reluctant to accept
medicaid patients. More concerted and coordinated efforts are
needed to deal with adolescent pregnancy, and more concerted
community outreach efforts are needed. The Director of the D.C.
Department of Human Resources should: exert more leadership and
concerted action to address adverse pregnancy cutcome in the
District by seeing that responsibilities among agencies for
planning, financing, delivering, coordinating, and evaluating
services for mothers and infants are clearly defined,
understood, and carried out. He should also hasten the
development and implementation of a Eistrict-wide plan for
attacking this problem, work more clcsely with the Board of
Education to pinpoint responsibilities and coordinate efforts to
prevent adolescent pregnancy, assess the feasibility of
increasing medicaid reimbursement rates, take other acticn to
encourage private physicians to accept sedicaid patients, and
expand the use of nurse-midwifery services. (PBS)](ViewImageLocal?handle=hein.gao/gaobacxsb0001&div=1&collection=&method=preview&ext=.png&size=3)