MMMS and FIMR Aligned Recommendations to Improve Maternal and Infant Health – Michigan Health & Hospital Association

Report on Collaborative Efforts to Improve Maternal and Infant Health Outcomes in Michigan

Introduction and Alignment with Sustainable Development Goals (SDGs)

A report has been released detailing aligned recommendations from the Michigan Maternal Mortality Surveillance (MMMS) and the Fetal Infant Mortality Review (FIMR) programs. This initiative, a component of the 2020-2023 Mother Infant Health Equity Improvement plan, aims to improve outcomes across the maternal and infant health continuum. The collaborative effort directly supports the achievement of several United Nations Sustainable Development Goals (SDGs), most notably SDG 3 (Good Health and Well-being), SDG 10 (Reduced Inequalities), and SDG 17 (Partnerships for the Goals).

Programmatic Framework for Advancing SDG 3: Good Health and Well-being

The two programs provide a comprehensive framework for addressing maternal and infant mortality, directly contributing to SDG Target 3.1 (reduce maternal mortality) and Target 3.2 (end preventable deaths of newborns and infants).

• Michigan Maternal Mortality Surveillance (MMMS): This program conducts systematic reviews of maternal deaths occurring during pregnancy or within one year postpartum. By determining causality and identifying systemic failures, the MMMS committee formulates policy recommendations aimed at preventing future deaths.
• Fetal Infant Mortality Review (FIMR): FIMR utilizes an evidence-based, community-oriented process to analyze factors contributing to fetal and infant deaths. This framework engages local health providers, consumers, and leaders to identify areas for improvement, thereby strengthening local systems of care and informing policy in line with SDG 17.

Core Recommendations for Systemic Improvement and Health Equity (SDG 10)

The joint brief highlights shared themes and calls to action designed to foster systemic improvements and address health disparities. These recommendations are crucial for advancing SDG 10 by targeting the social determinants of health and ensuring equitable access to care.

Key Areas for Action

• Policy and Systems of Care: Reforming policies related to care systems, prevention initiatives, screening protocols, and treatment programs.
• Training and Education: Enhancing the knowledge and skills of healthcare providers and community stakeholders.
• Access to Quality Care: Eliminating barriers to ensure all individuals can access high-quality maternal and infant healthcare.
• Communication: Improving communication between providers and patients to foster trust and shared decision-making.
• Social Determinants of Health: Systematically addressing underlying social and economic factors that contribute to poor health outcomes.
• Care Coordination: Strengthening communication and collaboration between different healthcare providers and systems.
• Safety: Proactively addressing and mitigating safety concerns throughout the care continuum.

Implementation and Stakeholder Engagement

The report outlines a clear call to action for stakeholders to translate these recommendations into practice, fostering a multi-sectoral approach consistent with SDG 17.

1. Review and Analysis: Stakeholders are advised to review the detailed brief to understand the data and findings.
2. Local Implementation: Identify and implement relevant recommendations at the community level.
3. Strategic Planning: Utilize the information to strengthen community health improvement plans.
4. Advocacy and Policy Influence: Raise awareness among decision-makers and policymakers to drive systemic change.

Sustainable Development Goals (SDGs) Addressed

1. SDG 3: Good Health and Well-being

   • The article’s central theme is the improvement of maternal and infant health outcomes and the prevention of deaths. This directly aligns with SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. The work of the Michigan Maternal Mortality Surveillance (MMMS) and Fetal Infant Mortality Review (FIMR) programs, which review and recommend actions to prevent maternal and infant deaths, is a core component of achieving this goal.

2. SDG 10: Reduced Inequalities

   • The article explicitly mentions the “2020-2023 Mother Infant Health Equity Improvement plan.” The focus on “equity” and the call to action for “addressing social determinants of health” indicate a clear connection to SDG 10. This goal seeks to reduce inequality within and among countries, and in this context, it applies to reducing disparities in health outcomes for mothers and infants from different socioeconomic or demographic backgrounds.

Specific Targets and Indicators

SDG 3: Good Health and Well-being

Targets

• Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
  • The article directly addresses this target through the work of the MMMS program, which “reviews cases of maternal deaths that occur during pregnancy, at delivery or within one year of pregnancy” with the goal of making “recommendations to prevent future deaths.”
• Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age.
  • The FIMR program is explicitly designed to “identify and analyze factors that contribute to fetal and infant deaths.” Its purpose is to inform policies and strengthen systems to prevent these deaths, directly contributing to this target.
• Target 3.8: Achieve universal health coverage, including access to quality essential health-care services.
  • The article highlights several calls to action that support this target, including improving “Access to quality care,” strengthening “systems of care,” and enhancing “Care coordination and provider-to-provider communication.”

Indicators

• Indicator 3.1.1: Maternal mortality ratio.
  • This indicator is implicitly central to the article. The MMMS program’s function is to review maternal deaths, which requires the collection and analysis of data that constitutes the maternal mortality ratio for the region.
• Indicators 3.2.1 (Under-5 mortality rate) and 3.2.2 (Neonatal mortality rate).
  • The FIMR program’s focus on fetal and infant deaths implies the measurement and analysis of these specific mortality rates to identify trends and areas for improvement.

SDG 10: Reduced Inequalities

Targets

• Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
  • The article’s reference to the “Mother Infant Health Equity Improvement plan” and the need to address “social determinants of health” directly relates to this target. The goal is to ensure that all mothers and infants, regardless of their background, have an equal opportunity for good health outcomes, thereby reducing health inequalities.

Indicators

• Implied Indicator: Disaggregated health data.
  • While no specific indicator number is mentioned, the focus on a “Health Equity Improvement plan” implies a need to measure and track maternal and infant health outcomes disaggregated by various factors (such as race, socioeconomic status, or geographic location) to identify and address disparities. This is essential for measuring progress toward Target 10.2 in the context of health.

Summary Table of SDGs, Targets, and Indicators

Source: mha.org