Machala M, Miner M W
Management Department, University of Utah Graduate School of Business, Salt Lake City.
Public Health Rep. 1991 Jul-Aug;106(4):353-60.
The failure to provide adequate prenatal care for low-income pregnant women in the United States and the effects of this failure on infant mortality are well known. Many studies have identified institutional barriers against access to care as a major cause. To overcome these barriers, Public Health District V, South Central Idaho, has created a comprehensive prenatal health care model that has almost tripled participation in its program during the first year of implementation and increased it again significantly during the second year. This decentralized pregnancy program has succeeded in getting all of the physicians offering obstetrical care in the district to serve low-income pregnant clients on a rotating basis. The new program provides pregnancy testing as well as financial screening services. Also, it has combined support services into one-stop-shopping clinics that include an innovative expansion of the Women, Infants and Children (WIC) Program of the U. S. Department of Agriculture. WIC food vouchers help attract clients into the prenatal care system and keep them coming. Enrichment of the duties of the public health nurse provides case coordination that pulls together the patchwork of medical and support services for the pregnant client.
在美国，未能为低收入孕妇提供充分的产前护理及其对婴儿死亡率的影响是众所周知的。许多研究已确定获得护理的制度障碍是一个主要原因。为克服这些障碍，爱达荷州中南部的第五公共卫生区创建了一个全面的产前保健模式，在实施的第一年，该项目的参与率几乎增长了两倍，并在第二年再次显著提高。这个分散式的孕期项目成功地让该地区所有提供产科护理的医生轮流为低收入孕妇服务。新计划提供妊娠测试以及财务筛查服务。此外，它还将支持服务整合到一站式诊所中，其中包括对美国农业部妇女、婴儿和儿童（WIC）项目的创新性扩展。WIC食品券有助于吸引客户进入产前护理系统并持续前来。公共卫生护士职责的充实提供了病例协调，将为孕妇提供的医疗和支持服务拼凑在一起。
