Application Year: October 1, 2023 – September 30, 2024 

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: 

1.1a Collaborate with Breast and Cervical Cancer Program (BCCP) providers (i.e., district and contracted providers) to improve preventative care for women by meeting or exceeding the CDC Guidelines for breast and cervical cancer prevention services annually.

1.1b BCCP implement at least two evidence-based interventions (EBIs) in each public health system (e.g., patient reminders, community-based group education, patient navigation, provider education, extended hours, reduction of structural barriers, provider assessment and feedback, one-on-one education, and small media).  

1.2 Increase participation in the Levels of Maternal Care designation program by outreaching to hospitals and providing technical support in completing the application.

Preventive Medical Visit 

In the upcoming year, Women’s Health will support activities to meet or exceed the CDC’s service goals and core indicators for breast and cervical screenings and increase opportunities to provide well-woman or preconception visits. The BCCP will continue to provide breast and cervical cancer screening and diagnostic services to low income, uninsured, and underinsured women to reduce health disparities for priority population groups, including Black women who have higher rates of breast and cervical cancer incidence and mortality, Hispanic or Asian women at risk for cultural/language barriers, women aged 40 to 64 for breast cancer screening, women aged 21 to 64 for cervical cancer screening, and those who have never or rarely been screened.  

The BCCP will continue to maintain and nurture its collaborative network of partners to ensure Georgia women at risk for health disparities and unequitable cancer outcomes receive breast and cervical cancer screening services, diagnostic follow-up, and linkage to care. The BCCP aims to increase its services among populations of focus and reduce screening and care disparities by continuing to leverage existing partnerships. The program will also provide districts with educational opportunities regarding the utilization of evidence-based interventions to increase reduce barriers to care and improve service delivery.   

The BCCP plans to install its new, electronic case management module in another 7 health districts to improve the quality of electronic records associated with breast and cervical services and to help streamline the management of care.  

Maternal Mortality Review Committee 

In the application year, the MMRC will review 2022 deaths and ensure all pregnancy-associated deaths are reviewed within two years of the date of death. The MMRC will also continue to identify deaths on a monthly basis and confirm pregnancy within three months of identification.  

The MMRC will develop an annual report and continue to disseminate data to stakeholders, including communities most affected by pregnancy-related deaths. Women’s Health will work with Emory University on a qualitative analysis of how COVID impacted pregnancy-related deaths.  

Women’s Health will also establish a new contract with the Center for Black Women’s Wellness, which coordinates the AIM Community Care Initiative (AIM CCI) in Atlanta, a community-led effort which seeks to create a more responsive, respectful, and high-quality maternity care system. This effort will include facilitating community meetings to gather insights and solutions from community members on maternal mortality, collaborating with local community members to ensure MMRC recommendations align with community needs and priorities, and completing a test of feasibility on AIM CCI Community Care for the Management of Chronic Conditions maternal safety bundle. 

Levels of Maternal Care 

Women’s Health will continue to implement the levels of maternal care verification program by outreaching to hospitals to facilitate participation, providing technical assistance during the application process and with any deficiencies noted, and providing funding to reduce the cost of the survey for hospitals. 

Other Women/Maternal Health Programs 

Georgia Perinatal Quality Collaborative (GaPQC) Maternal Initiatives 

GaPQC plans to evaluate Cardiac Conditions in Obstetrical Care (CCOC) data to assess shifts and trends in process, structure and outcome measures, as well identify other data sets to measure quality of maternal cardiac care.   

Additional learning events will be created to align with the identified needs of hospital teams and the Maternal Health ECHO program. GaPQC will focus on Patient Engagement in partnership with MoMMA’s Voices and other patient empowerment organizations to continue GaPQC’s focus on respectful care and equitable care.  

GaPQC will continue recruiting birthing facilities to participate in the CCOC initiative and provide technical assistance to hospital teams. The Wave 1 CCOC facilities will be encouraged to serve as mentors to ongoing cohorts and to spread best practices in maternal cardiac care throughout the state including with rural hospitals.     

Minding the Gap (MTG) Advisory Group 

The MTG Advisory Group will be in the last year of the study in the upcoming year and the Women’s Health Director and the Women’s Health Medical Epidemiologist will continue to participate in the group. The analyses on racial disparities in severe maternal morbidity and the Planning for Healthy Babies program will be published and shared with the state’s Care Management Organizations. The postpartum intervention randomized clinical trial will be complete and results will be published. 

Maternal Mental Health 

In the application year, Women’s Health will continue to work with PEACE for Moms to provide consultations, provider education, and Mothers and Babies skills groups to prevent perinatal depression. PEACE for Moms will become Mothers and Babies trainers and begin to train providers throughout the state to implement the Mothers and Babies program.  

Women’s Health will also continue to work with HMHBGA to provide community support around maternal mental health. HMHBGA will continue to offer peer support groups and community education on mental health and substance use disorders. In partnership with the Georgia Chapter of Postpartum Support International (PSI GA), obstetric providers and other maternal health workers will receive training on perinatal mood and anxiety disorders.  

Maternal Health ECHO 

The Maternal Health ECHO will continue to hold regular sessions on topics aligned with findings from the Maternal Mortality Review Committee. Maternal Health ECHO sessions currently planned for the application year include: Response to Severe Hypertensive Crisis (October 2023) and Contraceptive Access (November 2023). The next curriculum meeting for the Maternal Health ECHO project will occur in Fall 2023. 

Family Planning  

Women’s Health will continue to promote and increase access to family planning services through promoting awareness, education and training, expanding the family planning workforce, and increasing options for contraceptive methods with a goal of increasing the number of unduplicated women served in family planning. Women’s Health will conduct site visits with a minimum of seven public health districts. A marketing campaign to increase awareness of family planning services in health departments will be launched. Women’s Health will provide education and shared learning opportunities as part of the quarterly Women’s Health Coordinator meetings and provide trainings to family planning staff regarding available contraceptive methods in the DPH formulary. Women’s Health will also collaborate with the Formulary Committee and other stakeholders to assess new and emerging contraception to expand options for contraception methods. The program will maintain regional family planning preceptor programs in public health districts and work to increase the number of staff who provide family planning services.  The program will continue to train RNs on contraceptive implant insertion and removal and evaluate the impact of this national initiative late in calendar year 2023.

Perinatal Case Management (PCM) 

In the application year, the PCM program will focus on strengthening the provision services in 115 county health departments. This will include synergy with home visiting pilot program and incorporating breastfeeding education. The Office of Women’s Health PCM program will continue to collaborate with internal and external partners to improve communication and PCM workflow. Virtual trainings and technical assistance will be provided on the Visual Health Net PCM Module process for districts. During the trainings, districts that excel in service delivery will be recognized and best practices will be shared across all districts. Virtual meetings will be conducted with Care Management Organizations and the Department of Community Health representatives to resolve issues with data files. Women’s Health will complete annual site visits focusing on performance improvement.  

An internal evaluation of the PCM and breastfeeding service integration will be conducted with the goal of improving service delivery and increasing staff knowledge of breastfeeding and perinatal mental health during PCM training. Results will guide program structure and process improvement. 

In the application year, DPH plans to implement a home visiting pilot program. As part of this pilot, it’s valuable to assess the role PCM services and the added benefit of involving Public Health Nurses in the pilot for PCM and breastfeeding education. 

Maternal and Child Health Information and Resource Center 

DPH 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.  

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 

13.1a 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 in Georgia.  

13.1b Partner with Georgia OBGYN Society (GOGS), Healthy Mothers Healthy Babies Coalition of Georgia (HMHBGA), and Georgia Academy of Family Physicians (GAFP) to coordinate trainings on oral health and the medical provider role.  

13.1c Partner with the state Home Visiting program to provide resources and trainings on oral health and pregnant women.  

13.1d  Create a multi-tiered 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.  

13.1e Provide trainings to local water plant operators on the value of community water fluoridation and technical assistance to improve monthly reporting from local community water systems.   

Oral Health 

Oral Health will continue to promote oral health among all populations, with a special emphasis on promoting oral health care services among pregnant women. Oral Health staff will also continue to serve on advisory boards and partner with stakeholders to create a more robust state oral health surveillance system by identifying and addressing gaps in data, with a goal of expanding its reach to promote oral health among pregnant women and low-income children. 

Oral Health plans to continue to collaborate with both internal and external partners to provide oral health resources to pregnant women and caregivers of young children. 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.  

Oral Health 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. Resource bags will be distributed through district oral health program staff, district public health nurses, perinatal coordinators, and external partners such as HMHBGA.   

District program staff and MCH organizations staff will be provided with resources to help sustain preventive dental activities, including free continuing education opportunities, toolkits, guidelines, best practices for developing cross sector partnerships, social media tools, and recommendations from national oral health and MCH organizations.