The Evolution of Fetal and Infant Mortality Review as a Public Health Strategy

Abstract

Infant mortality review (IMR), the forerunner of fetal and infant mortality review (FIMR), emerged at the national level in the mid-1980s as a promising method to improve understanding of local factors contributing to infant mortality and to motivate community response. Building on federal efforts to enhance data capacity and early state and local infant mortality case review studies, the federal Maternal and Child Health Bureau (MCHB) initiated its IMR Program in 1988. Key actions taken to refine and diffuse the IMR/FIMR method include forging a public-private partnership between MCHB and the American College of Obstetricians and Gynecologists in 1990 to develop the National Fetal and Infant Mortality Review Program, recruiting prominent leaders to advocate for FIMR, seeding community projects in geographically dispersed states and localities, and routinely reporting best practices information to the field. In concert with the articulation of core public health functions and a growing emphasis on accountability, attention at the national level has turned to promoting and institutionalizing FIMR in state systems. Efforts are underway in states to build on the FIMR model and coordinate multiple maternal and child health-related review programs. Increasingly, FIMR is recognized as a strategy for contributing to implementation of the core public health functions of assessment, policy development, and quality assurance. The recent national evaluation of FIMR sheds new light on the role of FIMR in community and state maternal and child health systems and marks a new phase in the evolution of FIMR.

Mineração de dados e características da mortalidade infantil

“…Os estudos sobre fatores de risco associados à mortalidade fetal e infantil no Brasil, em áreas da Região Metropolitana de São Paulo, bem como em outras localidades, com suas propostas de instrumentos preditivos e recomendações sobre assistência materno-infantil já relatavam características semelhantes aos encontrados pelo DM 4,24,25,26,27,28,29,30 .…”

Can we prevent deaths of homeless persons? Police led public health approach to prevent homeless deaths

“…Research shows FIMR is an evidence based, effective perinatal systems intervention (Koontz, Buckley, & Ruderman, 2004;McDonnell, Strobino, Baldwin, Grason, & Misra, 2004). In Indianapolis, the FIMR process provides a systematic method to obtain information about homeless deaths beyond official police and outreach records.…”

Using Fetal and Infant Mortality Reviews to Improve Birth Outcomes in an Urban Community

“…The FIMR was developed approximately 20 years ago as a combined e¡ort between the ACOG and the federal Maternal and Child Health Bureau (MCHB) (a division of the Health Resources and Services Administration of the U.S. Department of Health and Human Services). It was designed as a community-based, systematic process to collect data, review cases, refer information to a community action team, and make changes in health care, public health, and other systems that a¡ect the health of a mother and her fetus/infant (Koontz, Buckley, & Ruderman, 2004). Also included in the FIMR is an interview with families, where referrals may be made to appropriate community agencies.…”