Maternal and Child Health
Section Newsletter
Fall 2009


Dear fellow Section Members,


I have kept my promise to do something every week until health reform is passed! 


·         I spoke at a Move On-organized Vigil for Health Reform, where I shared stories about pregnant women who could not get insurance coverage because of their pre-existing condition.  

·         I was featured on Fox News holding a baby onesie that was decorated with hand lettered saying, “Honor Ted Kennedy – Vote for Health Reform Now.”  I sent a petition to support Health Reform Now through Facebook and encouraged my staff and board to watch the President’s speech. 

·         I invited a local Health Care for America Now (HCAN) organizer to educate our Board and Public Policy Committee.  I have joined in Webchats and kept myself knowledgeable about the work of congressional committees.

·          I am scheduled to visit with my Congressional representative next week.


What have you done?  What are you planning to do?  I am hoping that we can share our experiences on the APHA MCH Web site. Please send your responses to me at  I would like to highlight some of the work of our members at the Annual Meeting here in Philadelphia in November -- you need not be there to be recognized! 


But if you are at the Annual Meeting, please come to the MCH Membership Meeting, Sunday, Nov. 8, 2009, from 4-5:30 (see the program for location).  We want to meet you and talk to you about how you can help the MCH Section grow and thrive.


JoAnne Fischer, Chair

MCH Section


The Annual Meeting is coming up in Philadelphia on Nov. 7, 2009.  Join the MCH Section for the following exciting activities:


·         SECTION SCHEDULE:  For a complete schedule of MCH sessions, committee meetings, and other activities on the MCH Section Web site, go to

·         TOWN MEETING:  Join us for a town meeting on New Technologies and MCH.  Learn about Text4Baby, Technology Innovations for Improving Children’s Health, and E-communities. Help us identify policy implications for MCH professionals and APHA. Session will be held on Sunday, Nov. 8, 2009, 10:00 – 11:30.  See the program for location.

·         MCH DINNER:   The Maternal and Child Health Section Dinner will be held on Saturday, Nov. 7, 2009, 7:00 p.m. The price for dinner is $38.50 per person, which includes tax and gratuity.  For reservations, contact JoAnne Fischer at

·         MEMBERSHIP MEETING:  If you are coming to the Annual Meeting, please plan to attend the MCH Membership Meeting, Sunday, Nov. 8, 2009, from 4-5:30 (see the program for location).  We want to meet you and talk to you about how you can help the MCH Section grow and thrive.

·         BREAST-FEEDING FORUM:  The first business meeting of this exciting new group will be held on Sunday, Nov. 8 at 6:00 p.m. (location in program).  The Forum will also hold a social dinner at Portofino’s Restaurant on Monday, Nov. 9 at 6:30 p.m.  Please RSVP to Melissa Bartick.   Join us to meet and work with others interested in breast-feeding and public health.


·         PUBLICATIONS BOARD SEEKS BOOK IDEAS:  The APHA Publications Board welcomes queries and proposals from MCH Section members for new books.  If you have an idea, please contact Director of Publications Nina Tristani at  You can also visit the "Publish with APHA" session at the November meeting on Monday morning at 8:30 in the Philly Convention Center.

·         Career Guidance Center:  Don't miss this opportunity! Sign up now for a one-on-one or a group session with a professional career coach at the APHA Annual Meeting and Exposition. These coaches can guide you in strategizing the next phase of your career and help you define your goals. Select a 45-minute individual session or a 90-minute group session. The group sessions are designed according to your career needs. To see which session best fits you, please read about the experience and education of each coach before setting an appointment. If you have never experienced coaching before, this is a wonderful introduction to what may become a useful service for your career!  Click here for a link to more information. 


The Martha May Eliot Forum will be held on Tuesday, Nov. 10, 2009 from 2:30 to 4:00 p.m., immediately following the Marth Mae Eliot Awards Luncheon.  Access to safe, clean water is an important development issue which also has substantial impact on the health of women and children. Reaching the Millennium Development Goals 3 (Gender equity), 4 (Child health) and 5 (Maternal health) will require improvements in water, sanitation and basic health services. This session will focus on current perspectives on the intersection between water and the health of women and children. Panelist s will include:


·         Dr. Mickey Chopra, new Chief of Health for UNICEF. Dr. Chopra will speak about 'Water and Child Health: Current Priorities at UNICEF'. Diarrhea is a leading cause of child death worldwide and represents the most direct link between water and poor child health outcomes. Dr. Chopra will speak about UNICEF worldwide efforts to address diarrhea morbidity and mortality in children and development projects to improve child health. 



·         Janine Schooley, Senior Vice-President for Programs, Project Concern International. Ms. Schooley will speak about 'Water and Women: Strategies for Engagement and Empowerment'. She will draw from Project Concern International’s water and sanitation work in Latin America, Africa and Asia. She will provide a brief overview of the benefits of water and sanitation programming for women/girls and then focus on key strategies for engaging and empowering women and girls.




Two discussants will lead the discussion:  Professor Judy Lewis, Director of Global Health Education, University of Connecticut School of Medicine, and Chair of the Maternal and Child Health Section International Health Committee, and Dr. Padmini Murthy from New York Medical College, Section Councilor of the International Health Section of APHA, and member of Committee on Women’s Rights of APHA.  She is also the NGO representative of the Medical Women’s International to the United Nations Women’s Health Committee.  Representatives of the Women and Health Task Force of The Network Towards Unity For Health will also participate in the discussion. The Martha Mae Eliot Forum will address equity and development in the context of the health of women and children, with a particular focus on water, the theme of the 2009 APHA Annual Meeting.   The program will be chaired by Debra Jackson, Professor of MCH at the University of the Western Cape, Capetown, South Africa, and Chair-Elect of the Maternal and Child Health Section.  Join us for a lively and informative session!


“Facebook© is one of the largest social networking sites in the world; Facebook© helps you connect and share with the people in your life.”   What better way to show people your passion for Maternal and Child Health than posting it on your wall?  The APHA MCH Section group will not only serve to connect students with prominent MCH practitioners, researchers and leaders, but it will also help us extend a friendly hand to those interested in our field.


To join the group:

1.     You must have a Facebook© account. 

(If you do not have an account, simply go to and register.  It only takes a minute or two, and you’ll be hooked before you know it.)

2.    Log-in to your Facebook© account, and type ‘APHA Maternal & Child Health Section’ into the search bar in the upper right hand corner of the screen.

3.    Click ‘Join Group.’

4.    You are now free to navigate MCH links, write on our wall or add to the discussion board.  Feel free to add your own (appropriate) MCH-related pictures, blogs, or Web sites.

5.    You may also link to our group from the APHA MCH Section Web site ( 

Note: You must be logged on to your own Facebook© account in order to for the link on our Overview page to work properly.



The Maternal and Child Health Competencies, Version 3.0 is now available at Please help disseminate the new version of this valuable tool.  This streamlined version decreases the number of competencies from 94 to 72.  The competencies most important to MCH professionals were identified through a modified Delphi Technique, a method of expert consensus. The competencies represented in this version continue to be the result of an iterative and inclusive work-in-progress.  Based on feedback from the field, the PDF of version 3.0 also includes a clickable table of contents by which you can navigate the document.


Many thanks to Dr. Virginia Reed, from the Center for Educational Outcomes, who conducted the validation process and analysis.  Thanks also to the many MCH experts who participated in the validation process, including George Jesien, Mark Law, and Crystal Pariseau, who participated in the work group to design and implement the validation process.  Thanks also to Robert Peck, who updated the Web site and PDF to make them more user friendly.


The full report of the validation process will also be posted at  The citation is Reed, Virginia A. (May 1, 2009). Assessment in MCH Training Programs: Working Towards Data-driven Standards of Excellence in Leadership Education. Phase IV:  Validating the MCH Leadership Competencies: Results of a Modified Delphi Procedure. Silver Spring, MD:  Association of University Centers on Disabilities.


Leaders in maternal and child health need to be created, nurtured and sustained. Toward that end, the MCH Section Enrichment Fund was created in 2008 to help create a stable and consistent funding source to help support the Section’s Student Leadership Program and other special projects approved by the Section leadership. The Program, which consists of the MCH Student Fellows and the MCH Outstanding Student Papers Session, is designed to promote student leadership in maternal and child health and engage students in the work of the MCH Section.


Each year, the Section selects 10-12 Student Fellows and five Student Authors to participate in this highly successful program. The Section supports these outstanding students with financial assistance, which varies depending on funding availability, to offset the costs of attending the APHA Annual Meeting.  In 2009, the Section also will provide partial support to Student Fellows for attendance at the MCH Section Mid-Year Meeting.


Last year the Section raised over $3,000 thanks to the generous contributions of its members. Longtime Section Member Glen Bartlett matched member contributions, and the Section is seeking similar Challenge Grants to the fund in 2009. This year the Section hopes to raise even more. All contributions are tax deductible.


To donate, please send a check or money order payable to “APHA - MCH Enrichment Account #328072” to MCH Section Secretary Karen VanLandeghem at:  537 S. Mitchell Avenue, Arlington Heights, IL  60005. Funds will be recorded and forwarded to APHA for deposit into the MCH Enrichment Account.  Additional information about the Fund can be found on the MCH Section’s Web site at:


The MCH Section is pleased to welcome the 2009-2010 MCH Section Student Fellows!  Please look out for the new Fellows at the upcoming APHA Annual Meeting and say hello! 


·         Ndidi Amutah, Senior Fellow
Doctoral student, University of Maryland

·         Katie Baker, Senior Fellow
Doctoral student, East Tennessee State University

·         Elizabeth Brownell

          Doctoral student, University of Rochester

·         Adriane Casalotti

          Masters student, University of North Carolina

·         Cara de la Cruz
Doctoral student, University of South Florida

·         Elizabeth Jensen
Masters student, University of North Carolina

·         Ashley Martin
Masters student, Tulane University

·         Melissa C. Mercado-Crespo
Doctoral student, University of South Florida

·         Danica Orsino
Masters student, University of Iowa

·         Malini Persad
Medical student, SUNY Downstate

·         Melissa Romaire

          Doctoral student, University of Washington

·         Melissa Romaire

          Doctoral student, University of Washington

·         Marissa Rousselle

          Masters student, University of Illinois at Chicago

·         Barbara Singer

          Doctoral student, University of Maryland



The International Health Committee is proud to host several members of the Women’s Health Task Force at the APHA Annual Meeting.  They will be participating in MCH sessions including the Martha May Eliot Forum, and we encourage you to get to know them.  These visitors are leaders in women’s health from around the globe who have been working together to improve health care and community support.  The group includes:


  • Dr. Chet Raj Pant, Associate Dean, Kathmandu University School of Medical Sciences, Nepal 
  • Dr. Godwin Aja, Associate Professor, Health Promotion and Education, Babcock University, Nigeria
  • Dr. Todd Mamutle Mavis Maja, Dean, School of Nursing, Tshwane University of Technology, South Africa
  • Dr. Amany Refaat, Professor of Community Medicine, Suez Canal University, Egypt
  • Nighat Jahan Huda, Director, Center for Educational Development, Jinnah Medical and Dental College, Pakistan
  • Kamayani Bali Mahabal, Consultant in Research, Training, Advocacy Gender, Health and Human Rights, India
  • Dr. Mohamed Moukhyer, Assistant Dean for Academic Affairs and Administration, Ahfad University for Women, Sudan
  • Dr. Shakuntala Chhabra, Dean, Mahatma Gandhi Institute of Medical Sciences, India


The Women's Health Task Force has been an active and growing forum for the exchange of ideas and development of strategies and resources for women’s health. Its vision addresses the complex issues including social and gender inequalities. The main objectives of the Task Force are to teach health profession students and providers the necessary knowledge and skills to address women’s health and to encourage universities to partner with communities, include women’s rights in curricula and cultivate leadership among young women in the health professions. 


The Task Force created the Women’s Health Learning Package (WHLP), consisting of 14 modules that address major women’s health topics. Each module has an introductory section containing a brief description about its underlying educational philosophy; the rationale for teaching about the social determinants of health; an overview of recommended learning methods and illustrative case studies; and formats for collecting feedback from both students and tutors.  The WHLP is being revised for a 3rd edition.  Over 17 pilot projects have funded its adaptation and implementation in university and community settings.  For more information about the implementation and results, see a recently published article in Education for Health,   The WHLP, modules and other information may be found at


It has been an honor to work with this diverse and talented group of professionals.  Please come to the MCH International Health Committee meeting on Sunday, Nov. 8 at 2 p.m. to meet the group, and look for them at our sessions.  Welcome, Women and Health Task Force!


The Association of Maternal & Child Health Programs (AMCHP) supports state maternal and child health programs and provides national leadership on issues affecting women and children. As Congress works on appropriations for fiscal year 2010 and health reform legislation, our attention is turned toward ensuring increased investment in maternal and child health.


Now is a critical window of opportunity to advocate for increased funding for the Title V Maternal and Child Health Services Block Grant.  The President’s 2010 budget proposed level funding for the MCH Block Grant.  Members of Congress need to hear directly from state and local constituents now on why increased funding is needed.


If in accordance with your state’s advocacy rules, please contact your elected officials now and urge other MCH advocates in your state to contact Members of Congress about full funding for the MCH Block Grant.


To stay up to date on health reform and other critical MCH issues, please sign up to receive AMCHP legislative alerts and Pulse, AMCHP’s e-newsletter, by contacting Tania Carroll,, or call (202) 775-0436.




Legendary health activist Kay Johnson reminds us that everyone needs to get a positive and supportive message to their Congressional delegation saying WE NEED HEALTH REFORM.    


“I strongly believe that members of Congress need the positive messages, even if they are already supportive of reform,” she said. 


For a fact sheet about the importance of the passage of health reform for women’s health and preconception health, contact Kay at


The newly launched   is a Web-based initiative to help policy-makers govern more effectively by providing the up-to-the-minute, high quality research and evidence they need to enact policies that measurably improve the lives of children and families. 


Tough economic times call for policies that keep all children healthy and on track to succeed in school, support the economic success of families, and pay special attention to the most vulnerable young people and families, such as those in contact with the child welfare and juvenile justice systems.  The Web site gives governors, state legislators, agency administrators, and those who advise them clear examples of why a certain policy direction is important for children and families (based on evidence of effectiveness); what policies are succeeding in other states; and how to tailor policy to their own state’s conditions. also connects policy-makers to “two-generation” approaches that lift up children and their parents at the same time, with an emphasis on policies that close gaps and achieve equitable outcomes for all families.


·         LACTATE ON YOUR OWN TIME, LADY:  In August 2009, the Ohio Supreme Court ruled that Totes/Isotoner had the right to fire a breast-feeding mother for taking breaks to pump milk.  The employer argued that the dismissed mother took breaks that were unauthorized, regardless of her gender or condition.  The court ruled that lactation was not a condition related to pregnancy, but a condition related to breast-feeding and therefore did not constitute gender discrimination!!!  Click here to read the full story.  

·         AND NOW FOR SOMETHING COMPLETELY DIFFERENT -- A FACEBOOK CAROL: Charles Dickens never imagined anything like this! The Ghost of Facebook Past, Present, and Future confront CEO Eben Scrooge, as his response to the health care crisis is “Bah!  Humbug!” And the end has not yet been written. . . Click here to read “A Facebook Carol.”

·         STUDY HIGHLIGHTS NEW DRUG RISK IN PREGNANCY:  Reuters reported in June that pregnant women who use cocaine or heroin while taking methadone to beat their addiction may weaken their placentas, opening the door to dangerous infections that could further harm an unborn baby.  The new agency was reporting on a lab study that found that exposure to either of the drugs in the presence of methadone, used to wean people off narcotics, harmed the placenta and allowed other dangerous substances through that protective barrier.

·         STUDY SHOWS BREAST-FEEDING MAY LOWER RISK OF MS RELAPSE:  Reuters also reported in June that breastfeeding may protect women with multiple sclerosis against relapses of their disease, possibly by delaying a return to normal monthly cycles.  The study published in the Archives of Neurology found that MS patients who nursed their babies exclusively, using no bottled formula for at least two months appeared less likely to have a relapse within a year of the child's birth than women who did not breastfeed.  The researchers noted that women who breastfed exclusively delayed the return of normal menstruation, and those whose monthly cycles stayed repressed, a normal effect of breastfeeding, were those whose MS symptoms did not return.  "Studies of immunity and breastfeeding, while plentiful, are predominantly focused on breast milk content and health benefits to the infant. Little is known about maternal immunity during breastfeeding," the researchers wrote.

·         BREAST-FEEDING LINKED TO HIGH GRADES, COLLEGE:  Breast-fed babies seem more likely to do well in high school and to go on to attend college than infants raised on a bottle.   According to a study published in June 2009 in the Journal of Human Capital, an additional month of breast-feeding was associated with increases both in high school grade point averages and increases in the probability of college attendance.


Chanda Nicole Holsey, DrPH, MPH, AE-C was the recipient of the inaugural  Association of Asthma Educators Humanitarian and Outstanding Asthma Community Service Award at the annual conference this July 2009, in New Orleans.  The Humanitarian and Outstanding Asthma Community Service Award honors the Association of Asthma Educators member with a longstanding commitment to addressing community needs related to asthma. The award recognizes exceptional programs that go well beyond the traditional role of medicine, and recognizes outreaching of communities who needs are not being met through the traditional health delivery system.


Dr. Holsey is a certified asthma educator and has served in the capacity of Director of Community Service and Pediatric Asthma Camp Programs at the American Lung Association of Georgia for much of her professional career and has dedicated her time and talents to helping children with asthma and their families learn to better manage the condition.  She is now an Adjunct Assistant Professor in the Graduate School of Public Health at San Diego State University in San Diego.


‘…fiercely progressive and thoughtful…very rare…but tremendously important.’


Join us in Chicago in July 2010 for the 3rd annual University of Illinois at Chicago School of Public Health Maternal and Child Health leadership retreat:  Leadership, Legacy, and Community:  A Retreat to Advance MCH Scholarship and Practice. 


This national professional development program is designed for intergenerational, interdisciplinary, academic/practice MCH professionals who are committed to social justice, equity-based interventions, and out-of-the-box thinking to improve the health of our women, children and families. 


Retreat participants will expand upon existing leadership strengths and develop new leadership skills through unique experiential leadership development sessions.  An exploration of equity-based interventions will have participants thinking outside of the box to explore innovative methods to improve the health and well-being of those we serve in our communities.  Participants will engage in community-development activities to develop and enhance their MCH network. 


Individually, participants will have an opportunity to discuss their leadership challenges, next steps, work/life balance, etc. with a professional leadership/executive coach.  Participants will also have time to step back from the grind of their day-to-day work/personal lives to reflect on what is important and what is next for them and their communities.  Participants will leave the retreat rejuvenated, motivated, and excited to return to their work/communities and their personal lives. 


Registration is limited to 100 participants.  If this program feels exciting and full of possibilities for you, we would love for you to participate!  Additionally, we encourage you to invite your intergenerational, interdisciplinary colleagues to attend! 


For more information please check in with our Web site in December 2009 ( or contact Kris Risley, DrPH, at (312) 996-2875 or 




According to the Office of Minority Health & Health Disparities within the Center for Disease Control and Prevention, African Americans are more likely to experience a mental illness, yet less likely to seek treatment, when compared to their white counterparts. It is estimated that between 20 million and 44 million adults in this country suffer from a diagnosable mental disorder.  Exact numbers vary, as many people do not seek treatment. Studies within the CDC have shown that minorities have less access to and availability of mental health services in their communites. Furthermore, African Americans in treatment often receive a poorer quality of mental health care and are grossly underrepresented in terms of clinical research for mental health programs, medications and services.


Historically, African American women have served as the matriarchs and backbones to their families. With that heavy responsibility also comes tremendous mental and emotional burdens, with these women often complaining about being sad, lonely, weary and empty. However, due to a lack of communication as well as a lack of cultural competency on the part of their health care providers, depression in black women is frequently misdiagnosed, and the women are dismissed as being hypertensive, worn out, tense or anxious. Rarely do African Americans display or discuss depression, nor are they comfortable with labeling their experiences as being that of depression.


Depression and anxiety disorders are two major causes of illness and death in the United States. These conditions can contribute to limited social functioning, excess disability, and reduced quality of life. Therefore, in what has been a decade in the making, the Black Infant Mortality Reduction Resource Center (BIMRRC) hosted its 10th Annual Perinatal Health Disparities Conference to bring attention to mental health, in order to make the connection of how mental disorders can affect infant mortality in the black community. The event, Improving Mental Health among Black Women, Children & Families, was held in the Oral Health Pavilion at the University of Medicine and Dentistry of New Jersey (UMDNJ) in Newark, on Tuesday, Sept. 22, 2009.


Each year, the conference takes on a different focus, as the topic of infant mortality is multi-faceted. This year, in partnership with the six Maternal/Child Health consortia of New Jersey, the Department of Health & Senior Services, the Healthcare Foundation and the University of Medicine and Dentistry - School of Nursing, a holistic approach was reviewed in order to address the mental health needs of African Americans.  For the first time, we also analyzed the role of the African American father and how mental health disorders can negatively impact their ability to live up to that role.


The Black Infant Mortality Reduction Resource Center, which is an affiliate of the Northern New Jersey Maternal/Child Health Consortium, is a clearinghouse on topics related to black infant mortality. As a community education resource, BIMRRC is committed to eliminating health disparities, promoting research on the topic of black infant mortality and implementing strategies to decrease the frequency of low birth weight and pre-term infants.


For more information about the Black Infant Mortality Reduction Resource Center and the annual conference, please call (866) 665-6242 or visit our Web site at


OpenForum, a blog supported by the journal Health and Human Rights, is currently hosting a discussion on how a human rights framework informs decisions on formula versus exclusive breast-feeding by HIV-positive mothers. We invite readers to contribute their thoughts and opinions on this matter.


Dialogue on this issue began with an article in Health and Human Rights by pediatrician Dr. Agnès Binagwaho, the Permanent Secretary of the Ministry of Health in Rwanda, on the merits of formula feeding for mothers in resource-limited settings (  Dr. Claudio Schuftan, a public health physician and one of the founders of the People’s Health Movement, responded in a Perspectives piece that highlighted the limitations of bottle feeding in sub-Saharan Africa



Continuing the exchange, Dr. Binagwaho responded to Dr. Schuftan on OpenForum, where she compared the reasoning used in support of exclusive breast-feeding to past arguments against using ART in Africa (   Dr. Schuftan, joined by public health nutritionist Dr. Ted Greiner, in turn offered a final response, also posted on OpenForum (  


We welcome further discussion and comments on this lively exchange from our readers (


Health and Human Rights: An International Journal ( is dedicated to scholarship and praxis that advance health as an issue of fundamental human rights and social justice. The journal seeks to provide a forum for academics, practitioners, and activists from public health, human rights and related fields to explore how rights-based approaches to health can be implemented in practice.  OpenForum is a blog hosted by the Health and Human Rights community and shares the journal’s dedication to action-oriented dialogue about health and human rights. Visit OpenForum at for unique commentaries by professionals writing from the field, as well as provocative summaries, opinions, and reviews of news articles, other blogs and journal articles.


A new bone health campaign, Best Bones Forever!, launched in September by the U.S. Department of Health and Human Services Office on Women’s Health, encourages girls ages 9-14 to get the calcium, vitamin D, and physical activity they need to build strong bones and decrease the risk for osteoporosis later in life.


Osteoporosis is often called a “pediatric disease with geriatric consequences.” Childhood and adolescence are the key windows of opportunity for building strong bones and warding off the disease. In girls, close to 90 percent of bone mass is built by age 18. Girls, in particular, are at greatest risk for bone problems. Osteoporosis is four times more common in women than men, and adolescent girls consume calcium and participate in physical activity at lower rates than boys. 


The new campaign is focused on fun and friendship and empowers girls to “grow strong together, stay strong forever.”  The message for parents is one of urgency. Campaign materials and a Web site for parents empower them to “Act now to help her build her best bones forever!”


The Best Bones Forever! Campaign also features a community pilot program at three sites: North Las Vegas, Nev.; Ulster County, N.Y.; and Pinal County, Ariz.  Coalitions in each site will bring the campaign to their communities through a range of activities, including a bone health behavior change program for parents and girls called BodyWorks. 


For more information, go to the campaign Web site for girls at or for parents at


Partners In Health, the University of Maryland School of Nursing Office of Global Health, Regis College School of Nursing and Health Professions, and the MGH Institute of Health Professions School of Nursing invite you to join an online community for Global Health Nursing and Midwifery at GHD Online,  This community was created to serve the growing network of midwives and nurses involved and interested in the field of global health.


This online community and discussion group will serve as a platform for both online conversation and content sharing. Members can join and post questions, engage in conversation, search content and freely access materials. We hope it will lead to further collaboration and information sharing among nurses and midwives working in global health projects.  It can be publicly accessed, so we encourage you to circulate it to other nurses and midwives interested in the field of global health.


Thank you in advance for joining the Global Health Nursing and Midwifery Community at GHD Online by clicking here. We hope it provides a resource for sharing and experience and that it serves to strengthen your work and interest in the field of global health nursing and midwifery.


The Indiana Perinatal Network (IPN) has produced a unique training DVD to educate health care providers on proper screening and treatment for pregnant women using tobacco, alcohol and other drugs.  Integrating Screening and Treatment of Substance Use into Routine Prenatal Care incorporates practical role-play scenarios with clinical and research-based materials and interventions. It also emphasizes the importance of taking a supportive/empathetic approach with pregnant women as opposed to a shame-based approach. Recent research indicates that only 5-10 percent of pregnant women are identified and receive appropriate treatment for their substance use disorder.


The DVD features the work of Dr. James Nocon, Clinical Associate Professor, IU School of Medicine and Director of the Prenatal Recovery Clinic at Wishard Memorial Hospital.  This first of its kind educational product was produced in cooperation with the IU School of Medicine, the Indiana Chapter of AAP, the Indiana Section of ACOG, the Indiana Department of Health, Indianapolis Healthy Start and the Indiana March of Dimes.  The DVD has been approved for CMEs, nursing contact hours and social work CEUs. 


For more information and to order copies, go or contact IPN at (866) 338-0825.


The New York City Department of Health and Mental Hygiene (, a local public health agency recognized for being at the forefront of many cutting-edge public health initiatives, seeks a Maternal Health Specialist to identify, examine and develop strategies to prevent maternal mortality.


The work will focus on two substantive areas: maternal mortality, with review of all maternal deaths each year; and teen pregnancy prevention including promotion of state-of-the-art reproductive health practices at school and community-based clinics.  The successful candidate will:


·         Oversee maternal mortality surveillance.

·         Collaborate with the Research and Evaluation Unit to design data collection instruments and perform appropriate statistical analyses.

·         Prepare reports, presentations and manuscripts.

·         Review and advise the BMIRH and Teen Pregnancy Prevention Program on issues related to maternal morbidity and mortality.

·         Serve as Chair of the DOHMH Maternal Mortality Review Committee.

·         Supervise the Maternal Mortality Review Project Assistant, maternal mortality chart review consultants, prepare grant proposals, and maintain quality improvement standards

·         Position hours to be determined (21-37 hrs/wk).


We seek a NYS licensed physician with a minimum of five years experience working in the field of Obstetrics and Gynecology and public health. Interested applicants should apply online with a cover letter via this link:, or go to --  in the JVN search bar, enter 131299.


For more information, contact Debbie Lew, Human Resources, NYC Department of Health and Mental Hygiene,



Hospital admissions of Americans from the poorest communities for asthma and diabetes were 87 percent and 77 percent higher than respectively, than admissions for patients from wealthier areas for the same diseases, according to a recent report from the the Agency for Healthcare Research and Quality.


Asthma and diabetes are potentially preventable conditions

because good outpatient care can help to prevent the need for hospitalization. Despite national efforts to eliminate health care disparities, low-income Americans continue to have higher hospital admission rates for asthma and many other conditions.


AHRQ's analysis found that compared to Americans from wealthier areas:


·         Patients from the poorest communities were more likely to be hospitalized for chronic obstructive pulmonary disease (69 percent higher); congestive heart failure (51 percent higher); skin infections (49 percent higher); and dehydration (38 percent higher).


·         In addition, patients from the poorest communities were more likely to be admitted for severe blood infection, stroke and depression.


·         Furthermore, hospitalized Americans from the poorest communities were 80 percent more likely to receive hemodialysis for kidney failure, and they were more likely to undergo procedures often done on an outpatient basis, such as eye and ear procedures (81 percent more likely). 


The findings are based on data from Hospital Stays among People Living in the Poorest Communities, 2006 (HCUP Statistical Brief #73). The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.


More than 40 percent of the 120 million visits that Americans made to hospital emergency departments in 2006 were billed to public insurance, according to a recent report from the Agency for Healthcare Research and Quality. 


The analysis by the federal agencyfound that about 50 million emergency department visits were billed to Medicaid and Medicare. The uninsured accounted for another 18 percent of visits for emergency care, while 34 percent of the visits were billed to private insurance companies and the rest were billed to workers' compensation, military health plan administrator Tricare, and other payers.


The Agency's study of hospital emergency department use in 2006 also found that:

·         About 38 percent of the 24.2 million visits billed to Medicare ended with the patients being admitted, compared with 11 percent of the 41.5 million visits billed to private insurers, 9.5 percent of the 26 million visits billed to Medicaid, and 7 percent of the 21.2 million visits by the uninsured.

·         The uninsured were the most frequent users of hospital emergency departments. Their rate was 1.2 times greater than that of people with public or private insurance — 452 visits per 1,000 population vs. 367 visits per 1,000 population, respectively.

·         The uninsured were also the most likely to be treated and released — a possible indication of their use of hospital emergency departments as their usual source of care. Their "treat-and-release" rate was 421 visits per 1,000 population vs. 301 per 1,000 population for the insured.


These findings are based on data described in Payers of Emergency Department Care, 2006 (HCUP Statistical Brief #77). The report uses statistics from the 2006 Nationwide Emergency Department Sample, a new AHRQ database that is nationally representative of emergency department visits in all non-federal hospitals. The Nationwide Emergency Department Sample contains 26 million records from emergency department visits from approximately 1,000 community hospitals nationwide. This represents 20 percent of all U.S. hospital emergency departments.


The number of hospital stays that ended with patients leaving against the advice of medical staff increased from 264,000 cases to 368,000 — about 39 percent — between 1997 and 2007 according to a report from the Agency for Healthcare Research and Quality.


For cases in which patients left against medical advice in 2007, the Federal agency also found that:

·         The top five reasons were chest pain with no determined cause (25,600); alcohol-related disorders (25,300); substance-related disorders (21,000); depression or other mood disorders (13,900); and diabetes with complications (12,500).

·         Medicaid and Medicare patients each accounted for about 27 percent and privately insured patients accounted for 19 percent. About 22 percent of the cases in 2007 involved uninsured patients.

·         Men were roughly 1.5 times more likely to leave against medical advice than women.

·         In the Northeast, patients left hospitals against medical advice at twice the rate of that of the rest of the country—2 per 1,000 population versus an average of 1 per 1,000 population in all other regions.


These findings are based on data described in Hospitalizations in which Patients Leave the Hospital against Medical Advice (AMA) (HCUP Statistical Brief #78). The report uses statistics from the 2007 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.


The Agency for Healthcare Research and Quality is pleased to announce the release of the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) featuring 2007 data.  The NIS is the largest all-payer inpatient care database in the United States and is updated annually.  It is available from 1988 to 2007, allowing analysis of trends over time.


The NIS is nationally representative of all short-term, non-federal hospitals in the United States.  It approximates a 20 percent stratified sample of hospitals in the U.S. and is drawn from the HCUP State Inpatient Databases (SID) which includes 90 percent of all discharges in the United States. The NIS includes all patients from each sampled hospital, regardless of payer — including persons covered by Medicare, Medicaid, private insurance and the uninsured.


Researchers and policy-makers to use the NIS to identify, track and analyze national trends in health care utilization, access, charges, quality and outcomes.  The vast size of the NIS enables analyses of infrequent conditions, such as rare cancers; uncommon treatments, such as organ transplantation; and special patient populations, like the uninsured.  Its size also allows for the study of topics at both national and regional levels.  In addition, NIS data are standardized across years to facilitate ease of use.


As part of the HCUP database family, the NIS is considered by health services researchers to be one of the most reliable and affordable databases for studying important health care topics. More information about the NIS and other HCUP products can be found on the HCUP-US Web site.  If you have questions, please contact HCUP user support at  



The Agency for Healthcare Research and Quality is pleased to announce the release of its newest Healthcare Cost and Utilization Project (HCUP) database, the 2006 Nationwide Emergency Department Sample (NEDS). The NEDS is the largest all-payer emergency department (ED) database in the United States.  The NEDS was created to enable analyses of ED utilization patterns and to support public health professionals, administrators, policymakers, and clinicians in their understanding and decision-making regarding this critical source of health care. 


The NEDS has many research applications as it contains information on hospital characteristics, patient characteristics, geographic region and the nature of the ED visits (e.g., common reasons for ED visits, including injuries).  The database includes information on all visits to the ED, regardless of payer — including persons covered by Medicare, Medicaid, private insurance and the uninsured. 


The 2006 NEDS contains data from 26 million ED visits, and encompasses all encounter data from nearly 1,000 hospital-based EDs in 24 states.  The NEDS approximates a 20-percent stratified sample of EDs from community hospitals.  Weights are provided to calculate national estimates pertaining to the 120 million ED visits that took place in 2006.  The database was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID).  The NEDS provides information on “treat-and-release” ED visits, as well as ED visits in which the patient was admitted to the same hospital for further care.


The 2006 NEDS can be purchased through the HCUP Central Distributor. Some 2006 NEDS data are available in HCUPnet, a free online query system.  More information about the NEDS and other HCUP products can be found on the HCUP-US Web site.  If you have questions, please contact HCUP user support at