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PUBLIC HEALTH APPROACHES TO COMMUNITY-BASED NEEDS: Boston's Infant Mortality Crisis as a Case Study

Authors

  • Jo-Anna L. Rorie cnm, msn, mph, Assistant Professor,

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    • Jo-Anna L. Rorie is an assistant professor and a member of the Nurse-Midwifery Education Program faculty of the Department of Maternal and Child Health at the Boston University School of Public Health. She received her master of science degree in nursing and nurse-midwifery education from Yale University and her master of public health degree from Harvard University School of Public Health. Ms. Rorie has extensive experience in providing primary care for women in a variety of community-based settings, including the Beth Israel Deaconess Hospital in Boston and the Dimock Community Health Center in Roxbury, where she was a key participant in the development and implementation of their Perinatal Initiative. During the past decade, Ms. Rorie has been instrumental in raising the awareness of public health officials and policymakers about the magnitude of Boston's infant mortality problem.

  • Kerry A. Richardson bsn, rnc,

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    • Kerry Richardson is a registered nurse in Fall River, Massachusetts, where she provides home care to prenatal and postpartum women and their families. Ms. Richardson received her undergraduate degree in nursing from American International College and is certified by the National Certification Corporation in inpatient obstetrics. She has extensive nursing experience in family-centered primary care settings for both high- and low-risk obstetric clients. She served as perinatal nurse coordinator at Dimock Community Health Center for 3 years.

  • Roxane Gardner md, mph

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    • Roxane Gardner is an obstetrician/gynecologist and member of the adjunct faculty of the Department of Maternal and Child Health at the Boston University School of Public Health. She received her medical education from Boston University in 1982 and her master of public health education from Harvard University in 1992. Dr. Gardner is the medical director of nurse-midwifery services and director of the Division of Community Medicine at Beth Israel Hospital in Boston, Massachusetts. She is the former director of ob/gyn services at the Dimock Community Health Center.


Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118–2326.

ABSTRACT

In light of a 10-year infant mortality crisis in Boston, a comprehensive public health approach was undertaken in which an extensive community-based needs assessment was used to develop a citywide maternal and child health improvement agenda. On the basis of the needs assessment, recommendations were made calling for community-based perinatal initiatives and midwifery services as critical elements in care for underserved communities and enhancement of perinatal services. A case description of one perinatal initiative illustrates the challenges of public health practice and describes a practice setting in which midwives provided leadership and guidance by using an interdisciplinary team approach in the implementation of a community empowerment project.

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