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B'More Babies

Alicia Buelow

B'More Babies (continued)

Collaboration is Key

In 2008, then Baltimore City Health Commissioner Joshua Sharfstein (now principal deputy commissioner of the FDA) laid the groundwork for B’More for Healthy Babies with an evaluation of the services that could have the biggest impact on children and mothers—and a look at where in the city the help was most needed

The Bloomberg School’s Donna Strobino, PhD, got involved soon thereafter—in part because she had a graduate student, Meredith Matone, who was particularly interested in infant mortality. Together with a second student, they worked with staff at the city on a strategy to improve infant mortality.

“We really wanted to focus on a community population-based strategy, not an individual client strategy,” says Strobino, deputy chair of infant and child health in the Department of Population, Family and Reproductive Health. “We wanted to pull together all the [community] resources related to services for women in general, and pregnant women in particular, and their newborns.”

That meant getting disparate city agencies, health care providers, community organizations and nonprofits to work together—not an easy task. “In Baltimore, like a lot of other urban areas, there are a lot of politics and concerns about funding among community agencies, especially in a difficult economy,” says Strobino. “Who provides the services? Who collaborates with whom? We need to be able to get the community to develop its own strategy and increase cooperation between agencies for that strategy to work.”

“Baltimore has the problem of being terribly underfunded and too decentralized,” agrees Guyer. “There are too many independent agencies and nonprofits and neighborhood organizations each trying to get their cut of the resources.”

Collaboration obviously would be key to the success of B’more for Healthy Babies, says Avril Houston, MD, MPH, the Baltimore City Health Department’s assistant commissioner for maternal and child health. “What’s different about this initiative is that the resources are being aligned to provide a service to a population,” she says. “We’re trying to get all the social programs coordinated to empower the communities.”

The other critical part of the campaign involved education and getting the message out into the communities. The health department ultimately selected the School’s Center for Communication Programs (CCP), which specializes in delivering strategic health communication and knowledge management programs to populations—albeit most often in developing nations across Africa and Asia.

Though CCP would be working much closer to home than usual, its strategy would be the same, says Cathy Church-Balin, CCP’s business development director. “No matter if it’s Baltimore or Bangladesh, we can use the same framework and ideas,” she says.

“That Could be My Baby”

The program’s first efforts are focused on reducing unsafe sleep environment-related deaths like those due to sudden infant death syndrome (SIDS), which claimed the lives of 27 Baltimore infants in 2009. SIDS is used to explain the deaths of babies where no visible cause of death is found, and there’s no apparent reason for the infant to have died. Asphyxiation is suspected in many cases, caused by an infant not getting enough oxygen while sleeping.

Efforts in the U.S. over the past two decades—particularly the medical community’s advice that babies be placed on their backs to sleep—have reduced the SIDS rate nationally. But SIDS remains a problem in underserved urban communities. In Baltimore, it is the second leading cause of infant deaths, behind low birth weight.

 “Eight percent of infant deaths in the U.S. are by SIDS,” says Church-Balin. “In Baltimore, it’s 21 percent. Twenty-seven deaths [last year] were preventable because they were linked to unsafe sleeping practices—putting infants in places where they can suffocate. It’s not acceptable. It can’t be.”

 

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