The Illinois Department of Public Health (IDPH), Office of Women’s Health and Family Services requests funding through the Preventing Maternal Deaths: Supporting Maternal Mortality Review Committees program from the Centers for Disease Control and Prevention (CDC) to strengthen our existing infrastructure of our two Maternal Mortality Review Committees (MMRCs) to prevent maternal deaths in Illinois. This project will improve infrastructure, data quality, data dissemination, and implementation of recommendations, and will particularly focus on reducing disparities in maternal mortality and morbidity.
Illinois was one of the first states to implement maternal mortality review, convening the first state MMRC meeting in 2001. A second state committee, the Maternal Mortality Review Committee for Violent Deaths (MMRC-V) was formed in 2015 to review deaths of women who die within one year of pregnancy due to homicide, suicide, or drug overdose. In 2016, IDPH sought technical assistance from the CDC to strengthen our process for reviewing maternal deaths resulting in the identification of several key opportunities for improvement. Key recommendations were to increase the number of cases reviewed to include all pregnancy-related deaths and to shift from a clinical focus to a broader population health focus.
While this re-organization of maternal mortality review activities resulted in a more systemized procedure, there is still a need for increased resources and infrastructure to review all potentially pregnancy-related cases in a timely manner. Resources are also needed to address health disparities and use data to identify trends, emerging issues, and initiate action steps to prevent further pregnancy complications and maternal deaths.
We propose using this funding to sustain and improve our timeliness of identifying pregnancy-associated deaths, by abstracting clinical and non-clinical data into the CDC’s Maternal Mortality Review Information Application (MMRIA), conducting multidisciplinary reviews, entering committee decision forms into MMRIA, implementing data quality assurance processes, analyzing data, disseminating findings, prioritizing recommendations, and convening stakeholders to implement prevention strategies. The specific activities funded by the grant would add critical personnel, support case abstraction, improve timeliness of maternal mortality review, and facilitate opportunities for stakeholder engagement. Given Illinois has racial disparities in pregnancy-related deaths that are greater than disparities seen nationally, particularly for non-Hispanic black women, our work will focus especially on supporting prevention work among disproportionately affected populations, to decrease inequities and lower pregnancy-related complications in Illinois overall.
The Illinois project has five goals:
1. Infrastructure: Strengthen existing infrastructure and build staff capacity to improve organization and timeliness of the MMRC process.
2. Data Quality: Assure that timely, accurate and standardized information is available for review, organized effectively for analysis, and entered into MMRIA.
3. Data Dissemination: Assure that timely, accurate and standardized information is available to the public, partners and decision makers.
4. Data to Action: Raise awareness of the MMRC and its recommendations to drive implementation of recommendations.
5. Health Disparities: Collaborate to reduce disparities in maternal mortality.