MCHB ALL GRANTEE MEETING

Divisions and Offices (continued)

October 4-7, 2004

MARIBETH BADURA: Hi, I’m Marybeth Badura and I’m director of the division of Healthy Start and Perinatal Systems. Now, contrary to what you heard earlier, we do not pronounce the initials of this division. And, that’s real easy for me to say because I’m from Milwaukee , Wisconsin and if you’re really from Milwaukee , Wisconsin you say it as one syllable, Milwaukee , and so just like not pronouncing the name of the division, we say very fast Healthy Start Perinatal Systems. So, it isn’t pronounceable. This was also not quite--well, never mind, I won’t go into that. I want to go through with you just real briefly some of the focus of our program activities. Peter started out earlier talking about how in 1912 women activists started working on the issues of health, of women and infants. And, that really is what our division’s about, healthy women, healthy infants for a healthy nation.

And, our activities throughout the division focus on risk prevention and reduction, health promotion, infrastructure and systems building, and actually involving women, their families, and communities in designing the programs at the local level. I’m going to briefly just highlight some of the things that we’ve been working on. We’ve had a series of grants and contracts over several years now looking at different high-risk conditions for women, particularly those having an impact on perinatal outcome. And, we’ve looked at both screening and systems development in these areas: alcohol, substance abuse, smoking, family violence, perinatal depression, and now what we’re trying to do in our last activity is to pull together what are the key questions that we may--if we could ask five questions that might let us know whether there’s a problem. Is there one key question in alcohol screening? Is there one key question in substance abuse that would be the trigger, so that we could shorten our screens and then go more into depth with women who need it, and that’s the focus of our last activity.

In infrastructure, we have integrated women’s health state infrastructure programs. We have state morbidity, mortality, review support programs. We have a new woman’s behavioral health systems building program that at the community level is trying to bring in some of the players who have not been involved family coalitions, for example, in mental health issues and weave that in to a sound system for primary care and mental health. At ACOG we have our National Fetal Infant Mortality Review Resource Center and we funded in this past year the Healthy Start Association and some leadership training activities. In Health Promotions we’ve got a very exciting program that we’ve just launched and that’s innovative approaches to promoting a healthy weight gain in women that’s a new program this past year, we’ve just announced six awards in that area and we’re really excited about that. We also have work in breast feeding, folic acids, and then Chris talked about Bright Futures for Children, and Sabrina will go in to more detail on our Bright Futures for Women’s Health and Wellness. But our division has a special focus in that, and that is adaptation and mental wellness during the perinatal period.

And, so we have an active work group that’s pursuing the information and tools that I’ll address both women their families and providers in communities in that area. Now, this is all (inaudible) they were all very familiar with. Here’s where we want to be in 2010 and here for many of our populations across the United States is where we’re at. The division has two activities in the area of infant mortality reduction. One is a new one that was just launched this past summer, closing the health gap on infant mortality, African-American risk reduction, that’s a three-component system. The research and evidence base is under the coordination of the HHS, interagency coordinate counsel, on low birth weight and preterm births which Dr. van Dyck heads and Dwayne Alexander from the National Institute of Child Health. We have four states that were chosen because of the number of African-American births and deaths in those states to infants. And, those states are charged with finding the fastest way to take the evidence that are being developed and identified through the coordinating counsel on low birth weight and pre-term birth, and translate it in to action, these are three-year grants to the four states.

And, then to compliment that we’re working with the Bureau of Primary Healthcare on a perinatal disparities collaborative to work with our community health centers to make sure we’ve got the highest quality perinatal care there. That’s just in the initial planning stages and their initial pilot areas will be in a couple of the states that are part of the state initiative at this point. We compliment a second group that’s dealing with infant mortality and that is our Native American population. And, that particular part of the initiative is under the Indian Health Service. And, then, of course, we have the healthy start program, which has been in existence since 1991. We have some core services and core systems building that all our programs are required to have. And, we have Healthy Start Projects in 36 states, Puerto Rico , Virgin Islands and along the border and in Hawaii . And, this is a map of where our Healthy Start Projects are. But we also have some very interesting activity occurring.

This year 71 of our grantees in the eliminating disparity and perinatal health will be up for re-competition. It is an open competition, and this Wednesday in Ballroom E from 1:00 to 5:00 we will be having a pre-application technical assistance meeting that is open to anyone. It’s been announced in the Federal Register and it’s been in the HRSA preview. And, that’s to help people get ready for that competition. Our guidance is out on the street, it’s about $73 million dollars that we will have available there. We have 12 grants that will end January 31 st, 2006 . And, those grantees--their competition has also been announced, because they’ll have to have their application in by September of 2005 for February 1 st funding. We sort of tease now that it takes almost as long as it does to give birth to a child as it does to have a grant go through the system in HRSA right now. And, Larry Pool will talk more about that when he speaks. And, then we did have a competition this past summer. We funded at that point six grants. We have four grants also that focus along the border, Alaska and Native Hawaiian communities.

We have two grants in that area that will be ending next year, and we have two grants that we just funded in that area this year. We also have some programs that are ending, a program in screening and treatment for perinatal depression, high-risk interconceptional care doing that in reach sort of activity to those women who have had a high-risk pregnancy, haven’t had prenatal care and we need to get both them and their infant into a care system. And, then family violence. And, what we will be doing with all of our grants that end is the materials that are developed, the work products, the brochures, the health education, the curriculums, the protocols, as the project ends we scoop them all up and they are available to you through a search engine capacity at our MCH library, and I would urge you to use that, it’s wonderful resources. There’s no reason for anyone to repeat what some of our projects have already learned, just excellent. And, then, of course, for women and their families, cultural competence, family involvement, we have responsibility for Healthy Mothers Healthy Babies National Coalition.

And, finally, nationally, we provide staff for the Advisory Committee on Infant Mortality, the Interagency Coordinating Counsel, a Federal Interagency Committee on Safe Motherhood that’s been working on maternal mortality and perinatal depression, a federal interagency committee on FAS and responsibility for the National Hispanic Prenatal hotline. We’ve got a variety of risk reduction activities going on and we’re very glad to be working with you, thank you.