POOR KIDS NEED HEALTH CARE, TOO

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, February 23, 1992                   TAG: 9202240192
SECTION: EDITORIAL                    PAGE: D-3   EDITION: METRO 
SOURCE: LYNDA JOHNSON ROBB
DATELINE:                                 LENGTH: Medium
POOR KIDS NEED HEALTH CARE, TOO
WHEN A woman - I'll call her Jolene - first discovered she was pregnant, she went to the community women's center for prenatal care, only to be told to return in two weeks for an eligibility determination appointment. When she did, she was referred to the central clinic downtown to apply for services under the Women, Infants and Children (WIC) program and to the university hospital to establish hospitalization eligibility. She was finally given a prenatal care appointment for three weeks later at the women's center, and was told to go back to the downtown central clinic for an HIV test.
After giving birth, Jolene returned for family-planning services, but found that they were only provided two days per week - during work hours - and immunization services for her baby were offered on yet a different day. All told, Jolene made nine trips in six weeks to begin prenatal care and receive Medicaid eligibility. Unfortunately, this scenario is familiar to all too many pregnant women and their families.
Every day our health care "system" in the United States fails pregnant women - women like Jolene who cannot afford private doctors and insurance plans with high deductibles; women who do not understand the care they need to have a healthy baby or where to get this care; women who must endure long waits in crowded public clinics or lack the transportation to reach these clinics.
These barriers to health care are reflected in the terrible U.S. infant-mortality rate compared to other developed nations. Nearly 40,000 babies die each year before their first birthday in the United States, and many of these deaths are preventable.
I'm proud to report that, with the help of "resource mothers," many states and communities have made strides in reducing infant mortality by enhancing access to care for pregnant women and children. Using the proven, cost-effective concept of home visiting, such resource mothers' programs send trained community workers to the homes of pregnant women or mothers of newborn babies. These resource mothers provide a vital link to the community's health and social services, help with parenting skills and home safety, provide assistance in obtaining other related services such as job training, or simply give emotional support.
Home visiting has had remarkable success. A General Accounting Office report on home visiting concluded that home-visited families had fewer low-birth weight babies, fewer reported cases of child abuse, higher rates of childhood immunizations and better child development. Home visiting is cost effective as well - the cost of a "resource mother" can be as low as $100 per pregnancy, compared with at least $30,000 to care for a baby born prematurely and more than $500,000 for that child's long-term custodial care.
So why isn't home visiting part of a national response to our infant mortality crisis?
The small gains the United States has made in recent years in reducing infant deaths have been due to technology - medical breakthroughs that made it possible to save smaller and smaller babies. It seems to me a cruel and nonsensical policy that focuses on saving children after they are born sick or premature rather than before, when investment in good prenatal care and other preventive health services can promote a healthy birth.
As a member of the National Commission to Prevent Infant Mortality, I am working to spread the wisdom of resource mothers and make home visiting a reality for all communities. The commission is currently working, through support from Nestle USA, to develop "resource mothers" training materials and program-implementation strategies to encourage and assist communities nationwide to organize home-visiting programs.
Efforts to reduce infant mortality and improve maternal and child health must become a priority, for we can no longer afford the social and economic costs of inadequate health care. For health care to be effective, it must be available and accessible. As a nation, we should look to Jolene's experience as the impetus for change and to "resource mothers" as a guiding hand.

Lynda Johnson Robb is a member of the National Commission to Prevent Infant Mortality.

by Bhavesh Jinadra by CNB