ECU Health IMPACT Clinic: A Report on Integrated Care and Sustainable Development Goals

Introduction

ECU Health has launched the Integrated Model of Perinatal Addiction Care and Treatment (IMPACT) Clinic to address the critical intersection of maternal health and substance use disorders in eastern North Carolina. This initiative directly supports the achievement of several United Nations Sustainable Development Goals (SDGs) by providing a patient-centered, integrated care model that combines obstetric and addiction services. The clinic’s framework is designed to dismantle barriers to care, thereby advancing global health and equality targets.

Advancing SDG 3: Good Health and Well-being

The IMPACT Clinic’s core mission is fundamentally aligned with SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages.

Target 3.1 & 3.5: Improving Maternal Health and Treating Substance Abuse

The clinic makes significant contributions to the following targets:

• Target 3.1 (Reduce maternal mortality): By providing specialized, accessible obstetric care to a high-risk population, the clinic works to improve maternal health outcomes.
• Target 3.5 (Strengthen prevention and treatment of substance abuse): The model directly addresses this target by embedding evidence-based addiction treatment within routine prenatal care. This integrated approach ensures that pregnant patients receive comprehensive care for both their pregnancy and their substance use disorder in a single, supportive environment.

Target 3.4: Promoting Mental Health and Well-being

The clinic actively combats the stigma associated with substance use during pregnancy, a major barrier to seeking treatment. By creating a safe and non-judgmental space, the IMPACT Clinic promotes mental well-being. The provision of on-site mental health providers to address co-occurring conditions like depression and anxiety is a direct action toward achieving Target 3.4.

Contributions to SDG 5 (Gender Equality) and SDG 10 (Reduced Inequalities)

Empowering Women and Reducing Health Disparities

The IMPACT Clinic’s model is a powerful tool for promoting gender equality and reducing systemic inequalities in healthcare.

1. SDG 5 (Gender Equality): The program empowers pregnant individuals, overwhelmingly women, by providing them with the resources and support necessary to manage their health. This patient-centered approach ensures they are active participants in their care, fostering autonomy and well-being.
2. SDG 10 (Reduced Inequalities): By focusing on a vulnerable and often marginalized population, the clinic directly addresses health disparities. It eliminates the fragmented and stigmatizing experience many pregnant individuals with substance use disorders face, ensuring equitable access to high-quality, comprehensive care.

A Holistic Framework for Sustainable Health Outcomes

Comprehensive Support Services

The clinic’s holistic approach extends beyond medical treatment, recognizing that social determinants are critical to health. This comprehensive support system is crucial for achieving lasting, sustainable outcomes and touches upon broader SDGs, including SDG 1 (No Poverty).

• Integrated Medical Care: Obstetric and addiction services are delivered concurrently in the same visit.
• Lactation Consulting: Specialized support is available for patients navigating breastfeeding while on medication.
• Social Work Assistance: Social workers connect patients with essential resources such as housing and transportation, addressing socio-economic barriers to health.
• Mental Health Support: On-site providers treat co-occurring mental health conditions.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The article’s primary focus is on healthcare, specifically addressing maternal health, substance use disorders, and mental health for pregnant individuals, which are core components of SDG 3.
• SDG 5: Gender Equality: The initiative targets a specific group of women (pregnant patients) and aims to remove barriers like stigma, ensuring they have access to necessary health services, which aligns with empowering women and ensuring their health rights.
• SDG 10: Reduced Inequalities: The article highlights the clinic’s mission to eliminate stigma and fragmentation in care, which are significant barriers for a vulnerable population. By providing integrated and accessible services, the clinic works to reduce inequalities in healthcare access and outcomes.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article mentions that the clinic addresses co-occurring conditions like depression and anxiety and provides treatment for substance use disorders, which are key components of this target.
   • Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol. The IMPACT Clinic’s entire model is built around this target, as it was established specifically to provide “care for pregnant patients with substance use disorders” and offers “addiction services.”
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services. The clinic’s model of integrating “obstetric and addiction care in the same setting, in the same visit” and removing barriers like stigma is a direct effort to improve access to quality, essential healthcare for a specific underserved population.

2. SDG 5: Gender Equality

   • Target 5.1: End all forms of discrimination against all women and girls everywhere. The article explicitly states that the clinic is designed to “eliminate the stigma” that pregnant patients with substance use disorders face, which is a form of discrimination that prevents them from seeking help.

3. SDG 10: Reduced Inequalities

   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory policies and practices. The clinic’s approach combats the “fragmentation” and “stigma” that lead to unequal health outcomes for this group, creating a “safe, welcoming environment where patients can receive evidence-based care without judgment.”

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For Target 3.5 (Strengthen prevention and treatment of substance abuse)

   • Implied Indicator: Coverage of treatment interventions for substance use disorders. The article implies this by describing the clinic’s function: offering “evidence-based care,” “addiction services,” and a holistic approach that includes medical treatment and mental health support for patients with substance use disorders. Progress could be measured by the number of patients enrolled and receiving comprehensive treatment.

2. For Target 3.4 (Promote mental health and well-being)

   • Implied Indicator: Availability of integrated mental health services. The article states that patients have access to “mental health providers who address co-occurring conditions like depression and anxiety.” The existence and utilization of these services within the obstetrics clinic is a direct indicator of progress.

3. For Target 10.3 (Ensure equal opportunity and reduce inequalities)

   • Implied Indicator: Proportion of population reporting personally feeling discriminated against. The clinic’s stated goal is to “eliminate the stigma” and provide care “without judgment.” A potential measure of success would be patient-reported experiences of stigma and discrimination, comparing their experience at the IMPACT clinic to previous healthcare encounters.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article. In this table, list the Sustainable Development Goals (SDGs), their corresponding targets, and the specific indicators identified in the article.

Source: ecuhealth.org