Leading Maternal and Child Health (MCH): Past, Present and Future

Objectives The maternal and child health (MCH) community, partnering with women and their families, has the potential to play a critical role in advancing a new multi-sector social movement focused on creating a women’s reproductive and economic justice agenda. Since the turn of the twenty-first century, the MCH field has been planting seeds for change. The time has come for this work to bear fruit as many states are facing stagnant or slow progress in reducing infant mortality, increasing maternal death rates, and growing health inequities. Methods This paper synthesizes three current, interrelated approaches to addressing MCH challenges—life course theory, preconception health, and social justice/reproductive equity. Conclusion Based on these core constructs, the authors offer four directions for advancing efforts to improve MCH outcomes. The first is to ensure access to quality health care for all. The second is to facilitate change through critical conversations about challenging issues such as poverty, racism, sexism, and immigration; the relevance of evidence-based practice in disenfranchised communities; and how we might be perpetuating inequities in our institutions. The third is to develop collaborative spaces in which leaders across diverse sectors can see their roles in creating equitable neighborhood conditions that ensure optimal reproductive choices and outcomes for women and their families. Last, the authors suggest that leaders engage the MCH workforce and its consumers in dialogue and action about local and national policies that address the social determinants of health and how these policies influence reproductive and early childhood outcomes.

Section: Discussionmentioning

confidence: 99%

Section: The Way Forwardmentioning

confidence: 99%

Catalyzing a Reproductive Health and Social Justice Movement

Verbiest

Malin

Drummonds³

et al. 2016

“…A skilled MCH workforce is critical for ensuring the public health system’s readiness to address persistent and emerging challenges (Grason et al, 2012 ), and to design, implement, and evaluate MCH programs and policies across system levels (Association of Schools & Programs of Public Health, 2021 ). However, one important challenge to meet the need for a competent MCH workforce is the shortage of culturally diverse MCH professionals who match the values and needs of diverse communities (Alexander et al, 2002 ; Petersen, 2015 ). Another challenge is the diminishing MCH capacity and expertise due to the loss of leaders from staff attrition or retirement (Streeter, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

MCH Leadership Training Program: An Innovative Application of an Implementation Science Framework

Vamos

Salinas-Miranda

Daley

et al. 2023

Self Cite

Introduction MCH training programs in schools of public health provide specialized training to develop culturally competent and skilled MCH leaders who will play key roles in public health infrastructure. Previous literature has reported on the effectiveness of MCH training programs (e.g., number of trainees, improvement in knowledge/skills); less attention has been devoted to understanding factors influencing program implementation during times of rapid change, while considering internal and external contexts (e.g., global pandemic, social unrest, uncertainty of funding, mental health issues, and other crises). Purpose This article describes a graduate-level MCH leadership training program and illustrates how an implementation science framework can inform the identification of determinants and lessons learned during one year of implementation of a multi-year program. Assessment Findings reveal how CFIR can be applicable to a MCH training program and highlight how constructs across domains can interact and represent determinants that serve as both a barrier and facilitator. Key lessons learned included the value of accountability, flexibility, learner-centeredness, and partnerships. Conclusion Findings may apply to other programs and settings and could advance innovative training efforts that necessitate attention to the multi-level stakeholder needs (e.g., student, program, institution, community, and local/regional/national levels). Applying CFIR could be useful when interpreting process and outcome evaluation data and transferring findings and lessons learned to other organizations and settings. Integrating implementation science specifically into MCH training programs could contribute to the rigor, adaptability, and dissemination efforts that are critical when learning and sharing best practices to expand leadership capacity efforts that aim to eliminate MCH disparities across systems.

“…A 2016 study found that MCH leaders wanted more training in building systems, managing change, and evidence-based PH (AMCHP, 2016 ). The MCH Leadership Competencies (USDHHS, 2018 ) have supported developing leaders who can strengthen systems and lead organizational change, as have other needs assessments and statements (Grason et al, 2012 ; Kavanagh, 2015 ; Petersen, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Developing State Leadership in Maternal and Child Health: Process Evaluation Findings from a Work-Based Learning Model for Leadership Development

Umble

Powis

Coffey

et al. 2022

Objectives Since 2013 the MCH Bureau has supported the National MCH Workforce Development Center to strengthen the Title V MCH workforce. This article describes the Center’s Cohort Program and lessons learned about work-based learning, instruction, and coaching. Description The Cohort Program is a leadership development program that enrolls state-level teams for skill development and work-based learning to address a self-identified challenge in their state. Teams attend a Learning Institute that teaches concepts, skills, and practical tools in systems integration; change management and adaptive leadership; and evidence-based decision-making and implementation. Teams then work back home on their challenges, aided by coaching. The Program’s goals are for teams to expand and use their skills to address their challenge, and that teams would strengthen programs, organizations, and policies, use their skills to address other challenges, and ultimately improve MCH outcomes. Methods This process evaluation is based on evaluation forms completed by attendees at the three-day Learning Institute; six-month follow-up interviews with team leaders; and a modified focus group with staff. Results Participants and staff believe the Cohort Program effectively merges a practical skill-based curriculum, work-based learning in teams, and coaching. The Learning Institute provides a foundation of skills and tools, strengthens the team’s relationship with their coach, and builds the team. The work-based learning period provides structure, accountability, and a “practice space” for teams to apply the Cohort Program’s skills and tools to address their challenge. In this period, teams deepen collaborations and often add partners. The coach provides accessible and tailored guidance in teamwork and skill application. These dimensions helped teams in develop skills and address state-level MCH challenges. Conclusions for Practice Continuing professional development programs can help leaders learn to address complex state-level MCH challenges through integrated classroom-based skills development, work-based learning on state challenges, and tailored coaching.