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July 17, 2009
The Kansas Blue Ribbon Panel on Infant Mortality held its first meeting Friday.
The panel of child care providers, medical professionals and public health officials was convened by the Governor's Office to review the causes of infant deaths in the state and find ways to reduce the number of babies that die each year.
There were 303 infant deaths in Kansas in 2008, according to the Kansas Department of Health and Environment.
The panel’s first meeting was designed to provide its members state and national information about infant mortality, said Dr. Dennis Cooley, a Topeka pediatrician who is leading the panel.
"We're getting data and information today," he said. "The second meeting, we'll look at statewide efforts to reduce infant mortality. The third meeting, we'll put it all together and see where we want to go from there."
The panel heard a presentation from Rosemary Fournier, the coordinator of the Fetal Infant Mortality Review program in Michigan, which helps determine how and why babies die.
The program functions similarly to a child death review board, in that it investigates infant deaths. But it goes further; conducting interviews with mothers about their families and home environments at the time of the baby's death and is less punitive in nature.
Child death review boards, including those in Kansas, review deaths of all children to see if there have been criminal causes or neglect. Michigan’s FIMR program uses community-based teams of public health and social service workers seeking to better understand the root causes and social determinants of an infant’s death.
The program's staff members use the information they glean to determine what services the mothers used and what systems could have potentially prevented the deaths.
The data gathered by the program has helped define underlying causes of infant death that differed from what local providers previously thought, Fournier said.
In one community, providers thought that a lack of transportation to health clinics for pregnant women was playing a significant role in contributing to infant deaths. The panel learned that many mothers had access to transportation but were dealing with unplanned pregnancies and were not seeking necessary prenatal care.
"This gives us insight into the mothers’ experience before and during their pregnancies and conveys the mothers' stories of their encounters with their local service systems," she said. "In our community, we found we should be putting our resources into family planning."
Dr. Gianfranco Pezzino, a senior analyst at the Kansas Health Institute, said more information was needed about the profiles of at-risk mothers in Kansas.
Implementing better pregnancy risk assessment programs along with a child death review program such as the Michigan model could go a long way toward preventing deaths, he said.
"Once those babies are born too small or too early, it's too late," Pezzino said.
The programs can save lives and can save money by keeping babies out of intensive care units.
"The costs (of intensive care) are astronomical," Fournier said. "I could fund FIMRs in every county in my state for what I could spend on two babies in the (Neonatal Intensive Care Unit.)”
Panel members also discussed preparing recommendations for the 2010 Legislature. Among the possible recommendations: Support for community-based programs that address risk factors for expectant mothers and changing state laws that restrict access to vital records and create a barrier to implementing a FIMR-type program in Kansas.
The panel is scheduled to next meet Aug. 28.
-Sarah Green is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. She can be reached at email@example.com or at 785-233-5443, ext. 118.