Priority Need: Prevent Maternal Mortality

NPM 1: Well-Women Visit

Percent of women, ages 18 through 44, with a preventive medical visit in the past year
 

NPM 1 Strategies:

1.1.a Meet or exceed the CDC guideline of providing ≥75% of federally funded screening mammograms to women over 50 years of age.

1.1.b Meet or exceed the CDC guideline of providing ≥20% of initial pap tests to individuals who have never or rarely been screened for cervical cancer.

1.2.a Increase the percent of women of reproductive age (15-44) served in Georgia Family Planning Program who use LARCs.

Preventive Medical Visit

The Women’s Health program will continue to support activities to meet or exceed the CDC guideline for the percent of initial cervical screening tests that are conducted among women who have never been screened or not screened within the last 10 years. A well-woman or preconception visit provides a critical opportunity to receive recommended clinical preventive services, including screening, counseling, and immunizations, which can lead to appropriate identification, treatment, and prevention of diseases to optimize the health of women before, between, and beyond potential pregnancies. A key component of a well-woman visit for a reproductive-aged woman is the development and discussion of her reproductive life plan to align with her current and future. Prevention, screening, and management of chronic conditions, such as diabetes, counseling to achieve a healthy weight, and smoking cessation, can be advanced with a well-woman visit to promote women’s health prior to and between pregnancies and improve subsequent maternal and perinatal outcomes.

Family Planning
Women’s Health will continue to promote and increase access to family planning service, particularly LARCs. The Family Planning Program plans to launch Phase III of the marketing campaign. Site visits will be conducted with public health districts to garner insight on district level implementation of family planning. Staff will also provide an eight-week series of women’s health courses for new nurses. DPH will partner with Bixby to provide the standard LARC CME course and in-depth special courses to train family planning staff on best practice in increasing access to family planning.

Maternal Mortality Review Committee

Women’s Health will continue to work with the MMRC to complete case reviews and will continue to work towards the goal of reviewing cases within two years of the date of death, to provide information to the GaPQC and other groups working to impact maternal mortality.

Alliance for Innovation on Maternal Health Bundles (AIM)

GaPQC will continue to support the AIM Patient Safety Bundles by providing support for birthing hospitals across the state to implement the Obstetric Hemorrhage and Severe Hypertension in Pregnancy Initiatives. Outreach efforts will continue to recruit new hospitals to join the 55 of the 73 birthing hospitals participating in one or both initiatives. To support hospital teams, monthly webinars will be hosted to provide expertise related to implementing the specific bundle interventions and provide one on one hospital support and technical assistance. Focus will be placed on incorporating elements of the Reduction of Peripartum Racial/Ethnic Disparities into each AIM bundle. Women’s Health will continue to build capacity and create a culture of equity including systems for reporting, response, and learning. Partnerships with organizations will support improving population level outcomes for mothers and infants, including March of Dimes in the health equity work and HMHB as partners on the policy and clinical implementation workgroups. Building on the foundational work of AIM, we will participate in AIM Clinical Community Integration to address preventable maternal mortality and severe maternal morbidity among pregnant and postpartum women outside of hospital and birthing facility settings.

Priority Need: Promote Oral Health Among All Populations

NPM 13: Preventive Dental Visit

Percent of women who had a preventive dental visit during pregnancy

NPM 13.1 Strategies:

13.1.1 Support state supplemental PRAMS questions regarding pregnancy and oral health to create a more comprehensive understanding of oral health status and access to care in pregnant women

13.1.2 Partner with Georgia OBGYN Society, Healthy Mothers Healthy Babies, and Georgia Academy of Family Physicians to coordinate trainings on oral health and the medical provider role.

13.1.3 Partner with the state Home Visiting program to provide resources and trainings on oral health and pregnant women.

13.1.4 Create a multi-tiered varied platform approach by developing a campaign that uses radio ads, physical resource bags, videos, and social media clips to increase oral health literacy in pregnant women.

13.1.5 Provide trainings to local water plant operators on the value to community water fluoridation and technical assistance to improve monthly reporting from local community water systems.

The Oral Health program will continue to promote oral health among all populations, with a special emphasis on promoting oral health care services among pregnant women. The Oral Health Program staff will continue to serve on advisory boards and work groups for external partners including HMHB, Georgia Department of Early Care and Learning (DECAL), Georgia Cancer Control Consortium Human Papilloma Virus (HPV) workgroup, and the Georgia Bureau of Investigations (GBI), among other stakeholders. The Oral Health Director plans on continuing to provide two presentations to family physician residents as well as two presentations to OBGYN residents in the upcoming year through the support of oral health partners. The Georgia Academy of Family Physicians and the Georgia OBYGN Society Oral Health program will continue to create a more robust state oral health surveillance system by identifying gaps in data, researching data sources to fill gaps, and dedicating resources to incorporating sources.

The Oral Health Program plans to continue to collaborate with both internal and external partners to provide oral health resources to pregnant women and caregivers of young children. The Oral Health Annex contract with the health districts in FY2020 included a recommendation to have perinatal oral health services for WIC and other public health patients. A newly developed and simplified oral health reporting tool will also reduce administrative burden on districts and allow for more time for patient care, education, and prevention services. With this tool, districts will provide monthly tracking of total clinical visits broken down by age categories, total number of prevention services (dental sealants, fluoride varnish applications, oral health screenings, and oral health education), as well as total number of pregnant women seen by district oral health program staff (either for services, screenings, or referrals). District program staff are continuously provided updates and resources that help empower them to provide care, services, and education for MCH populations, including but not limited to, free continuing education opportunities, toolkits, guidelines, best practices, and recommendations from national oral health and MCH organizations.

The Oral Health program will continue to promote an oral health awareness campaign and provide Pregnancy Oral Health Resource Bags that contain an adult toothbrush, two types of infant toothbrushes, floss, toothpaste, intraoral wipes for cleaning after nursing or bottle feeding, a brochure on health oral habits/behaviors, and a baby book on oral health will be distributed through district oral health program staff, district public health nurses, perinatal coordinators, home visitation workers, and external partners such as Healthy Mothers Healthy Babies Coalition of Georgia.

The Oral Health program will continue to fund three additional state supplemental oral health questions to the Georgia PRAMS survey, in addition to the two standard core oral health questions and one supplemental state oral health question. With a combination of six questions related to oral health in PRAMS, future data will give a more complete picture of burden of disease, specific challenges and barriers, and strategize on best solutions. Data from the additional questions is expected to be available in the upcoming year.

Other Women/Maternal Health Programs

Centering Pregnancy

The Women’s Health program will continue to support public health districts in their goal to provide Centering Pregnancy services to women in the community. The Women’s Health program will collaborate with Federally Qualified Health Centers (FQHC) and evaluate the data retrieved to improve the services provided in the Centering Pregnancy site in Albany. The Women’s Health program will work with other public health districts that desire to host a Centering Pregnancy program in their community and form an alliance between the districts for support of one another. Efforts to collaborate and build communication and relationships between internal and external partners will continue. Women’s Health will collaborate with external partners to gather information on the next Basic Facilitators training for district staff in need.

Perinatal Case Management (PCM)

Women’s Health plans to increase the number of county health departments providing PCM services from 107 to 115 by 2022. The developed post cards and brochures to promote PCM benefits will be distributed to all public health districts for use by the PCM Case Managers and the pregnant women enrolling in PCM. The PCM program will collaborate with the child occupant safety program to increase participation in the car seat program for all counties and provide education to pregnant mothers on safely transporting their child. DPH will continue providing technical assistance on the PCM module, education, training, and updates of the PCM program to all district PCM Case Managers on the health outcomes for at risk women. PCM will continue collaborating with the Oral Health program to distribute dental kits to pregnant women in the public health districts that enroll in the PCM program to promote good oral health during pregnancy.

Planning for Healthy Babies (P4HB)

MCH will continue to support P4HB by participating with community partners and provider groups toward increasing awareness of the program’s benefits for greater utilization by both participants and providers statewide. The P4HB working group will continue statewide marketing and communications plan in collaboration with the four Care Management Organizations, provider organizations, and community-based organizations that serve populations eligible for P4HB. The working group will increase providers’ understanding of P4HB services and what is covered, how and when to utilize benefits, and develop strategies for communicating with patients as well as increase patients’ awareness of P4HB, knowledge of services offered, and enrollment processes.

Maternal and Child Health Information and Resource Center

The Women’s Health program will continue to work with the existing Maternal and Child Health Information and Resource Center that operates the MCH resource hotline and website to include resources and referrals to resources that identify and treat chronic illnesses such as hypertension, heart disease, obesity, and diabetes.