Introduction
In the period of the last five decades, the United States has documented a major reduction in the rate of infant mortality. Previously in 2003 the mortality rate has been 26 deaths in every one thousands birth. By the year 2007, the death rate was approximated at six deaths in every 1000 births (Gannaro, Shults & Garry, 2008). Various programs have since then been initiated with a major aim of reducing the rate of infant mortality. However, there is still some disparity when it comes to the mainstream population representatives in comparison to the minority populations especially in the case of the ‘Black’ Americans. With increased funding being targeted at improving the programs on child health and paternal programs, the current drive has been to ensure achievement of a goal of healthy people by the year 2013 whereby lesser deaths per live births will be the result.
This article is based on the case study of the mortality rate in the Huston Texas. In the course of evaluating the underlying issues in relation to the case study, various key points will also be addressed. In the article, the effects of improvements made to the implementation plan are examined. In addition, the study evaluates the additional ethical issues that arise in the implementation and evaluation of the intervention and the recommendations for additional improvements.
Implementation plan and effects
The Houston city has been characterized by numerous resources endowment. Following the availability of these resources, it has been possible for the population to benefit from the satisfaction of their needs in health care. There is however another sad reality. The health insurance and financial endowment is only limited to the few individuals that are able to exploit the resources in the locality. In this population, gaining access to healthcare has been a rare opportunity as many have to wait or a long time before booking an appointment with the specialty physicians. However with the recent scheduling process changes, it has been possible for the perinatal coverage to be availed in children’s health insurance. As a result, the effect has been an increase in the healthcare access and reduction of the time for waiting for prenatal care.
As a result of the improvement in the available health care intervention plan, Huston has recorded a major improvement in the healthcare system infrastructure. Through this improvement, it has been easier for the home based health care to be availed for the low income and indigent populations. In addition, there has been a dramatic increase in the number of health care centers that are federally qualified from the year 2003 when they were two to a record of 11 in the year 1007. In addition, an important role has been played by the groups such as Harris County Healthcare Alliance, St. Luke’s Episcopal Health Charities, Greater Houston Partnership and Gateway to Care in ensuring that additional health infrastructures have been developed (Banarje, Beene & Castrucci, 2010).
In the analysis of the perinatal periods of risk (PPOR), a reference point was basically highlighted as a mode that is convenient for the outcomes of the expected infant health. Through examination of the excess mortality of infant in comparison to this reference group, it is possible for the locality people to establish the place of occurrence of most of the infant deaths that can actually be prevented. In effect, the interventions have been focused on the areas where most impacts can be witnessed. At the national level, the reference group in this case consisted of the Non-Hispanic mothers of the ‘Whites’ that are aged more than twenty years.
In reference to the above described groups, the combination of the Harris County and Houston were perceived to have a sufficient number of infant deaths and births. In effect, this was the internal reference population group for the analysis in the PPOR. Therefore the Black infants and fetuses were established to be the main contributor of infant mortality in Houston (Gennaro et al., 2008). Obviously, most of these deaths took place in prematurity and maternal health components of PPOR. This translated to need for intervention to ensure that particularly, the black mothers preoccupation health was improved (Mathew & MacDorman, 2008).
Recommendations
The awareness to the men and women on the importance of preconception health should be improved. In addition, the reproductive health attitudes should be improved together with the behaviors and knowledge that is inclusive of healthy food choices, management of weight and exercising among others.
The women with negative pregnancy tests should be contacted to enhance discussion on the preconception health and planning.
The health care providers should be encouraged to address the issues of preconception health risks with the children mothers
Increase the number of available programs to address the issue of holistic and overall care such as pregnancy catering.
Ensuring that health system is an established system to determine the providers’ availability in the neighborhoods. The presence of Obstetrician, midwives or primary care providers in the neighborhoods could provide the information on what is required to enhance an improvement in the child health.
Increase the level of enlightening on the breastfeeding benefits to the baby and the mother.
References
American Academy of Pediatrics and The American College of Obstetricians and Gynecologists, (2002). Guidelines for Perinatal Care, 5th Edition. Washington D.C.: Elk Grove Village
Banarje, D., Beene, D., and Castrucci, B. (2010). Infant Mortality and Morbidity in Houston, Texas: A Report from the Neighborhood Centers Inc. California: SUNNY FUTURES Healthy Start Consortium Data Subcommittee.
Gennaro, S., Shults, J., and Garry, D. (2008). Stress and preterm labor and birth in black women. Journal of Obstetric, Gynecologic & Neonatal Nursing, 37 (5), 538-545.
Mathew, T., and MacDorman, F. (2008). Infant mortality statistics from the 2005 period linked birth/infant death data set. National Vital Statistics Reports; vol. 57 no 2. Hyattsville, MD: National Center for Health Statistics Center for Health Statistics.
