School of Public Health

Oregon Asks Women How to Improve Health Care

July 2016

OREGON HEALTH AUTHORITY
Maternal and Child Health Section | Public Health Division

In Oregon: 40% of women, regardless of insurance coverage, did not seek preventive care, one quarter of all births were unintended, half the pregnant women did not take folic acid, and 8% were smoking in the last months of pregnancy. 1 The Maternal and Child Health (MCH) Section at the Oregon Health Authority wants to understand why this happened and assure that high quality well-woman visits are accessible throughout the state.

Well-woman health care is one of the 15 National Performance Measures (NPMs) the Maternal and Child Health Bureau (MCHB) will use to monitor health over the next 5 years.  The goal of the NPM is to “increase the number of women who have a preventive medical visit.”2 To meet this goal, Oregon MCH plans to identify and reduce barriers to primary care, raise awareness of the link between preconception health and pregnancy, and promote high quality well-woman visits throughout the state.

Identify Barriers to Primary Care

Oregon MCH staff will conduct four focus groups with women from different regions of the state. Topics will include women’s experiences with well-visits and their thoughts to improve accessibility. The results of these focus groups will help the state determine the most effective methods to address health care barriers and inform the development of the state's well-woman marketing strategy.

Well-Woman Marketing

Oregon MCH will develop a preconception education campaign to promote well-woman care based on focus group feedback. As part of this strategy, the state will build on current efforts to promote preconception care by the Health Care Coalition of Southern Oregon and incorporate Show Your Love, a successful national social media initiative.

Case Management

Oregon MCH will collaborate with home visiting programs to develop strategies to help clients understand the connection between the well-woman visit and pre- and interconception health. They will also provide support to Oregon tribes to develop and implement an incentive program for improving well-woman visit rates.

Community Trainings

To assure high-quality well-woman care, Oregon MCH will host trainings for a broad spectrum of public health professionals: family planning providers, MCH home visitors, community health workers and other community partners. In the first year, the trainings will focus on implementing pregnancy-intention screening through public health programs. The trainings will include best practices for preconception health visits based on standards developed by Oregon's Preventive Reproductive Health Advisory Committee.

While this is the first time the state has focused explicitly on the well-woman visit, some previous work on pre- and-interconception strategies and partners have already been identified through the state's Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN).

Oregon MCH began implementation in July 2016. For more information about Oregon’s strategy for the well-woman visit, contact Anna Stiefvater, Perinatal Nurse Consultant at anna.k.stiefvater@state.or.us


REFERENCES

  1. Oregon Health Authority, Maternal and Child Health Section. Title V Maternal and Child Health Issue Brief, National Priority Area: Well Woman Care. 2015.
  2. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Federally Available Data Resource Document. 2015