Maternal and Child Health

Abstract

THE past year has probably been the most successful for the Council on Maternal and Child Health (MCH) to date. I will mention one major activity and two publications which have contributed to increasing visibility for the Council, NAPHP, and our Health Agenda for the '90s, Universal Maternity Care (UMC). Universal Maternity Care, our name for publicly guaranteed access to comprehensive maternity and infant care, was first conceived by the Council at its inaugural meeting during the APHA's annual meeting in Montreal in I 9 8 Z. At that time, Alan Rosenfield, now Dean of the School of Public Health at Columbia University, suggested that the best strategy for a new organization would be to pick one issue to concentrate on rather than dissipate our limited energy among the many important issues facing MCH. We chose the problem of infant mortality, which we had already recognized as a disaster several years before it became popular to support efforts to reduce infant mortality because of our embarrassing record compared to other developed countries. Improving access to comprehensive maternity care services was selected as the strategy, and three years and several meetings later we were prepared with our proposal, which appeared first in the Journal of Public Health Policy in our article, "Background Paper on Universal Maternity Care" (i). We continue to look for ways of promoting UMC. Our Vice-chair, Rosemary Barber-Madden, presented a paper in I987 at Harvard's Colloquium on State Approaches to Financing Maternity Care in which she argued that universal access to existing maternity services would do little to improve pregnancy outcome. Rather, a public maternity and infant care system would have to guarantee the scope, availability, and quality of the care, not just the financing. This paper has subsequently been accepted in a form suitable for publication by the Journal of Health Politics, Policy, and Law. We expect to see it in print in the early spring. For a number of years NAPHP has been interested in sponsoring a conference among national health care advocates, but lacked either the funds or the hook to bring the many disparate groups together. I had the good fortune to recruit a medical student, Kathleen Shapley-Quinn, to work with me in the summer of I989 to develop an agenda for a meeting which would bring together for the first time national health advocates