DHMIC
Strategic Initiatives
The DHMIC focuses on creating optimal health for women, infants, and families through a life course approach. Life course is a way of thinking and doing. It looks back across an individual’s or community’s life experiences and across generations for clues to current patterns of health. Our approach includes thinking holistically about women’s health and planning with the community. We support a continuum of services promoting health from birth throughout the lifespan, from one generation to the next.
DHMIC’s Aims & Focus Areas
The DHMIC has four aims to improve the health of women in babies in the state: reduce infant mortality, decrease preterm birth, decrease maternal mortality rate, and decrease disparity rate. Each of the aims has focus areas with strategic priorities to accomplish the aims.
Strategic Plan Aims
Reduce Infant Mortality
Delaware’s annual infant mortality rate (IMR) fell by 40% from a high of 9.0 deaths per 1,000 live births in 2015 to 5.4 deaths per 1,000 live births in 2020 and for the first time the Delaware IMR was similar to the U.S.’s IMR. While we have made strides in the overall reduction in our infant mortality rate, the racial disparity persists. Statistics reinforce the significant need in Delaware for continued and aggressive programming to mobilize communities and partners to educate and motivate underserved and high-risk populations to embrace healthier behaviors before, during, and after pregnancy.
Decrease Preterm Birth
Delaware’s preterm birth rate declined 3.7%, from 10.7% in 2019 to 10.3% in 2020, according to the CDC. However, racial and ethnic differences in preterm birth rates remain. Babies born too soon and too small are the main causes of Delaware’s infant mortality rate.
Decrease Severe Maternal Morbidity Rate
In Delaware, severe maternal morbidity (SMM) rose by 57% from 51.0 per 100,000 delivery hospitalizations in 2016 to 80.0 per 100,000 delivery hospitalizations in 2021, according to the Delaware Child Death Review Commission’s Maternal Mortality Review Report. Risk factors for pregnancy-related complications include obesity, preeclampsia, high blood pressure, and substance use disorder, all of which are on the rise among Delaware women of reproductive age. The solution is for women to be in optimal health before pregnancy. When women enter pregnancy with tobacco use, uncontrolled chronic disease, or unmanaged stress, in many cases, prenatal care has limited impact on improving their outcomes. Helping women be healthy and change behaviors is only one part of the solution.
Decrease Disparity Rate
According to Delaware Health and Social Services (DHSS), health disparities are all differences among populations in measures of health and health care from illness, injury, disability, or mortality. It can be described as differences in coverage, access, or quality of care. DHMIC works to identify and eliminate health disparities and collaborates with state, local, and private sectors.
In 2020, Delaware’s Black 5-year infant mortality rate was 11.6 infant deaths per 1,000 live births, compared to the 5-year Hispanic infant mortality rate of 6.3 infant deaths and the 5-year White infant mortality rate of 3.8 infant deaths per 1,000 live births. Delaware’s 5-year Black infant mortality rate in 2020 was 3 times that of White infant mortality rate.
Strategic Plan Focus Areas and Strategic Priorities to Reduce Infant Mortality
Well-Woman Care
- Enhance “Healthy Women, Healthy Babies (HWHB 2.0)” — Innovative payment models prioritization of Social Determinants of Health (SDOH)
- Consumer-informed and community-based participation to drive change
- Improve access to provisional vital statistics to inform change and support evaluation efforts
- Develop toolkits and train stakeholders on Life Course Approach to well-woman care initiative
Maternal Morbidity / Mortality
- Develop standardized clinical practice guidelines and standards of care to reduce the rate of obstetrical hemorrhage
- Create a centralized data repository facilitate data collection in real time
- Improve capacity to perform statewide continuous quality improvement
- Develop toolkits and train stakeholders on Life Course Approach to well-woman care initiative
Neonatal / Infant Care
- Maximize medical management of premature birth statewide (17-alpha-hydroxyprogesterone caproate [170HP], aspirin)
- Advance statewide Kick Counts, Safe Sleep & breastfeeding programs
Social Determinants of Health (SDOH)
- Build upon and enhance promising community-based approaches/interventions in addressing community perceptions and actual barriers (SDOH)
- Address impact of social determinants of health through screening & referral and linkage to services
Programs and Initiatives to Support Women, Maternal & Infant Health
My Life. My plan: Teen
My Life, My Plan Teen educates teens about key health and life planning topics to help them make personal choices. The choices that teens make will affect the course of their lives, including if and when to have a baby. The focus is on promoting women’s optimal health before pregnancy.
My Life. My Plan: Women
The DHMIC developed My Life, My Plan Women to provide a fun and interactive way to help them make healthy decisions and set goals for their future, especially when it comes to their reproductive health. It shares the opportunity to ask oneself a key question, “Do I want to have a baby, and, if so, when?”
Man Up Plan Up
Men have a vital role to play in the health of families and communities. The goal of men’s outreach is to ensure that young men of reproductive age are equipped to make healthy, positive choices about their health. It encourages men to ask a key question, if they are ready to be a dad.
Well Woman Initiative
Every Woman Every Time Delaware: The Well Woman Initiative strives to ensure women of reproductive age receive at least one annual comprehensive preventive well-woman visit. The focus is on promoting women’s optimal health before pregnancy.
DHMIC has identified key partners integral to developing strategies for developing and disseminating broad education as well as supporting necessary system change. They include 4 major stakeholder groups:
- Division of Medicaid & Medical Assistance (DMMA) and Medicaid Managed Care Organizations
- Healthy Women, Healthy Babies Programs
- Health Care Providers
- Community-Based Organizations
Black Maternal Health Awareness
By protecting the health of Black mothers and infants, DHMIC is spreading the conversation about the disparity gap for African American women and their infants.
Delaware CAN (Contraceptive Access Now)
Delaware CAN is aimed at reducing the rate of unintended pregnancy.
Kicks Count
The Kicks Count initiative focuses on counting the number of kicks (10 in 2 hours) to prevent stillbirth.
Birth Spacing
Birth Spacing is the practice of waiting between pregnancies. A woman’s body needs to rest following pregnancy. After having a baby, it is a good idea to wait at least 18 months before getting pregnant again to maintain the best health for her body and her children.
Healthy Women, Healthy Babies (HWHB) 2.0
HWHB 2.0 is a restructuring of the program invented in 2019 to shift emphasis more to the social determinants of health along with the delivery of quality health care, prevention, and treatment.
Safe Sleep
The Delaware Safe Sleep campaign provides tips, resources, and social media resources for families, health care providers, and community leaders. Save lives and help make sure that all of Delaware’s babies thrive!
Social Determinants of Health
The aim of Healthy Women, Healthy Baby Zones: Strategies to Address the Social Determinants of Health is to build state and local capacity and test small-scale innovative strategies to shift the impact of social determinants of health tied to root causes related to infant mortality.
Delaware Perinatal Quality Collaborative (DPQC)
The primary goal of DPQC is to foster collaboration to improve the quality of care for mothers and babies in Delaware.
Preconception Peer Education Program (PPE)
The PPE Program uses peer education as a teaching tool to educate fellow college students about healthy behaviors and the social determinants of health that impact health disparities.