Better Management and More Resources Needed To Strengthen Federal Efforts To Improve Pregnancy Outcome

The federal government, along with state and local health agencies, has a number of health care programs directed at preventing or better timing pregnancies and improving the health and well-being of mothers and infants. However, a comprehensive national strategy for using and coordinating funds and staff involved in these numerous and fragmented programs is lacking. Federal funds have been inadequate for extending health care services to all areas and to all of those in need, while some areas have duplicate projects.

The two major federal programs targeted at improving pregnancy outcome are the Maternal and Child Health (MCH) program administered by the Department of Health, Education, and Welfare (HEW) and the Special Supplemental Food Program for Women, Infants, and Children administered by the Department of Agriculture. Family planning programs in recent years have helped to prevent unwanted or unplanned pregnancies. However, many women continue to have unwanted, unplanned, or ill-timed pregnancies and significant amounts of welfare costs can be attributed to adolescent pregnancy. The effect of the HEW programs to prevent pregnancies, especially high-risk ones, is questionable because services are not always available, accessible, or effectively used. Although progress has been made, women and infants in some locations still do not have easy access to appropriate labor and delivery services or infant care units, and many areas still do not have regionalized systems of perinatal care. Despite the problems that persist, some federal agencies and programs, such as MCH, Medicaid, National Health Service Corps (NHSC), Improved Pregnancy Outcome, and Improved Child Health, have helped to provide access to health care for many women and infants.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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