On Mothers, Daughters and Healthcare: The Role of Report Cards

Thursday, May 11th, 2006
This post was written by Melanie Matthews

Report cards are a hot topic. On the home front, my husband and I are closely watching the report card of our 17-year-old daughter. Like many parents of high school juniors, we gently but firmly remind her how heavily this year’s results will weigh when the college application process begins in just a few months. After sitting through countless college information sessions, we’re convinced that the quality of her effort rather than the quantity of activities, associations, etc. will sway most admissions counselors. At least that’s how the admissions pendulum seems to be swinging these days.

With Mother’s Day a few days away, a sobering global healthcare quality report card was issued on May 10 by Save the Children, a U.S.-based independent global humanitarian organization. According to the organization’s State of the World’s Mothers 2006 report, 2 million babies die in the first 24 hours of life each year worldwide. Further, the study found that the United States has the second worst newborn mortality rate in the developed world, with five newborn deaths for every 1,000 births. The United States tied for 10th place with the United Kingdom, despite having more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom. Sweden, Denmark and Finland topped the list of countries with the best mother-child outcomes, while countries in sub-Saharan Africa dominate the bottom of the list.

The report ranks the status of mothers and children in 125 countries based on 10 indicators of mother and child well-being, such as a country’s adult female literacy rate and the percent of children under age 5 suffering from moderate to severe nutritional wasting.

As a mother, I am deeply saddened by these global statistics. As a developed nation, we have a huge responsibility to improve our own standing and share our knowledge and resources with developing nations. As a healthcare communicator in America, I am compelled to address the national impact of this study. It’s inconceivable to me that the United States, a global business leader, would not also head the list of best places for mother-child outcomes. Then again, disparities in the quality and availability of healthcare in this country abound. This report, which analyzed data from governments, research institutions and international agencies, found higher newborn death rates among U.S. minorities and disadvantaged groups.

In preparing an upcoming report on maternity disease management, I’m hopeful that some relief can come from this effort. Report contributor Joseph Stankaitis, MD, MPH, who is also chief medical officer at Monroe Plan for Medical Care, notes the high number of Medicaid enrollees among his high-risk ob-gyn patients—more than 40 percent—and the unique socioeconomic challenges this group faces. Dr. Stankaitis believes “attending to Medicaid members’ non-medical as well as medical needs” affords the greatest impact.

His industry colleague Thomas Smith, RN, MA, director of medical care management at Health Management Corporation, is helping his clients drive down the number of modifiable risk factors among the Medicaid population. To overcome outreach barriers, Smith and his team employ telephonic coaching, direct mail and home visits to encourage pregnant Medicaid patients to stay in their maternity disease management program and collaborate in their care with their primary care physician. Perhaps as other U.S.-based providers and health plans adopt these targeted approaches, the overall level of pre-natal care will improve and next year’s Mother’s Day report will paint a brighter picture for mothers and babies around the world—just about the time our daughter will be opening those college acceptance letters.

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