FOR IMMEDIATE RELEASE
March 8, 2013

KDHE Office of Communications
communications@kdheks.gov, 785-296-0461


KDHE, March of Dimes announce joint initiative to reduce the rate of pre-term birth

TOPEKA, Kan.—Today, in a joint press conference March of Dimes and Kansas Department of Health and Environment announced that they have accepted a challenge from the Association of State and Territorial Health Officials (ASTHO) to reduce the rate of premature birth by 8% by the end of 2014.  The March of Dimes 2012 Premature Birth Report Card shows that the premature birth rate in Kansas is currently at 11.2%.  This 8% reduction will bring Kansas to 10.3%, which translates to roughly 350 babies. 

“We are glad to work with March of Dimes and accept the challenge by ASTHO to lower our preterm birth rate,” said Robert Moser, M.D., KDHE Secretary and State Health Officer. “We know that Kansas babies and their families will benefit from our efforts. KDHE has many programs in place addressing this health indicator, and this new opportunity to partner only strengthens those initiatives.”

“We don’t know everything about premature birth, but we know there are steps that can make a difference, such as improving access to health care, providing community education and ending early elective deliveries,” said Ken Jackson, Kansas State Director, March of Dimes. “We applaud Dr. Moser and KDHE for taking the initiative to implement proven strategies to address this problem.”

Preterm birth -- before 37 weeks of pregnancy -- is a serious health problem that costs the United States more than $26 billion annually, according to a 2006 Institute of Medicine report. It is the leading cause of newborn death, and one million babies worldwide die each year due to preterm birth. Babies who survive an early birth often face lifelong health challenges, such as breathing problems, cerebral palsy and learning disabilities.

One way state health officials are tackling the issue is by conducting an educational campaign with the March of Dimes to let pregnant women and their health care providers know that “Healthy Babies Are Worth the Wait.”  Through patient and provider education, women will be advised that if their pregnancy is healthy, it’s best to wait for labor to begin on its own rather than scheduling an induction or cesarean section. 

In addition, the Greater Kansas Chapter of the March of Dimes, KDHE and numerous agencies and organizations will be implementing the following initiatives:

Kansas Blue Ribbon Panel on Infant Mortality (KBRP)
The Kansas Blue Ribbon Panel on Infant Mortality was formed in June 2009 with the charge to identify key issues contributing to Kansas infant mortality rates and to provide intervention recommendations to the director of the Kansas Department of Health & Environment.  A statewide evaluation was conducted in the first six months to identify those communities with the combination of high infant mortality rates and a significant birth numbers.  The counties identified were Sedgwick, Geary, Shawnee and Wyandotte. Key issues were identified and recommendations for possible interventions were developed and published (see attached).  The identified leading causes for infant mortality in Kansas were premature birth/low birth weight, birth defects and Sudden Infant Death Syndrome (SIDS).  The intervention recommendations covered four broad categories: 1) improve data and surveillance 2) expand research, 3) increase public awareness through  education and 4) increase access to care and services through implementation of programs and targeted interventions. One key finding was that birth disparities in Kansas were significant with a 2:1 ratio for black/white infant death.

In response to the recommendations, stakeholders on the KBRP worked in partnership to develop resources and initiatives to address identified problems in the targeted communities. These initiatives include:

 

Becoming A Mom/Comenzando bien Birth Disparities Programs
Immediately following the release of the Kansas Blue Ribbon Panel recommendations, the Kansas Chapter of the March of Dimes developed plans for implementing birth disparities programs in targeted communities across the state.  The philosophy was that every effort should be made to prevent the occurrence of preterm birth and reduce the associated infant mortality rate. The intent was to advance consumer education, assist and augment existing public health services, and clinically intervene in prenatal and pre/interconception periods. The primary goal was to decrease preterm birth by increasing awareness of causal factors while changing the attitudes and behaviors in order to impact community-specific risk factors and to implement prevention strategies.  

The Kansas Chapter of the March of Dimes developed a pilot birth disparities program in Salina, Kansas in 2010.  The foundation for this pilot was the development of a community collaborative bringing together the county health department, the federally qualified health center (FQHC), the Smoky Hills Family Medicine Residency Program and Salina Regional Medical Center. The community collaborative model creates a long-term, sustainable public/private partnership among clinical and public health partners at the local and state level.  It leverages existing resources (staff, educational materials, facilities, clinical services, etc.) supported by Title V funding, Medicaid and foundation grants. Since 2010, the March of Dimes has invested approximately $250,000 to develop and replicate this very successful community collaborative pilot in Sedgwick, Shawnee and Geary counties.  MOD’s committed financial investment in these collaborative efforts will continue through 2014 at a minimum.

In Kansas, the birth disparities projects focus on two priority areas – eliminating birth disparities and eliminating elective birth procedures (c-sections/inductions) prior to 39 weeks gestation.   The community health education component (provided by county health departments) utilizes the March of Dimes Becoming a Mom and Comenzando bien curricula - each tailored to a specific ethnic group.  The hospital component utilizes the March of Dimes 39 Weeks Toolkit (see below) – a tested program that provides a road map to assist with system evaluation and implementation of “hard stop” policies to prevent elective birth procedures and reduce the instance of early-term births and subsequent neonatal intensive care (NICU) admissions.  Both programs have standardized evaluation tools and systems are being created to measure outcomes at the community and statewide levels.

Eliminating non-medically indicated deliveries before 39 weeks
As a leader in maternal and infant health for more than 70 years, with a proven track record in perinatal quality improvement, the March of Dimes is a trusted source of information for women, families, clinicians and hospitals.  Efforts to improve the quality and safety of perinatal care have received increased focus during recent years and with the publication of Toward Improving the Outcome of Pregnancy III in 2010 (marchofdimes.com/tiop). Research has shown that early elective delivery without medical or obstetrical indication is linked to neonatal morbidities with no benefit to the mother or infant.  In 2010, The Joint Commission released a new set of perinatal quality measures that includes the

 

reduction of non-medically indicated deliveries performed before 39 weeks gestational age. Concurrently, the March of Dimes, in partnership with the California Maternal Quality Care Collaborative (CMQCC) and the California Maternal Child
and Adolescent Division within the state Department of Health, created a toolkit entitled Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age1. This toolkit outlines steps that hospitals can take to begin a quality improvement initiative to eliminate elective deliveries prior to 39 weeks.

 

The toolkit:
• Helps make the case for eliminating elective deliveries before 39 weeks
• Outlines an implementation strategy
• Describes suggested data collection and quality improvement measurement tools
• Provides recommendations for clinician and patient education including March of Dimes materials
• Includes hospital case studies, a clinician slide presentation and references

Numerous Kansas hospitals have implemented “hard stop” policies and developed 39 week initiatives.  In Kansas City these include ten Health Corporation of America (HCA) hospitals, three hospitals in the Saint Luke’s Health System, Shawnee Mission Medical Center and North Kansas City Hospital. Wesley Medical Center (Wichita), Stormont Vail HealthCare (Topeka), Geary Community Hospital (Junction City) and Salina Regional Medical Center (Salina) have implemented programs as well.  These institutions are represented in the Kansas Perinatal Quality Collaborative and will promote statewide implementation and development of a universal evaluation system.

Kansas Perinatal Quality Collaborative (KPQC)
The Greater Kansas Chapter of the March of Dimes is coordinating the formation of the Kansas Perinatal Quality Collaborative to improve service quality and access to care for women and babies statewide. Among the top priorities will be hospital quality improvement projects related to preterm and early term births. One of the first projects of the Kansas Perinatal Quality Collaborative (KPQC) will be the elimination of elective deliveries before 39 weeks of gestation. A contracted consultant through the March of Dimes will be developing KPQC infrastructure, working with KPQC leadership to develop a prioritized, strategic plan that highlights a statewide 39 weeks Initiative, convening quarterly KPQC as well as annual stakeholders meetings, and coordinating regular communication between collaborative members and partners that facilitate development and attainment of goals.  The March of Dimes three-year financial investment is $60,000. 

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies®, March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org. Find us on Facebook -Marchofdimeskc.