Strategies to Include Maternal and Child Health in Emergency Planning

October 24, 2023 | Heather Tomlinson

Midsection shot of a pregnant woman sitting across the desk from her doctor during an office visitASTHO, in partnership with CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD), interviewed former state and territorial health officials (S/THOs) to learn about the inclusion of maternal and child health (MCH) in infectious disease emergency preparedness and response in states and territories.

While respondents described experiences in different jurisdictions and emergency responses, there were striking similarities in the challenges they experienced to address the needs of MCH populations. Common factors included the need for sustainable funding to support collaboration, intentional inclusion of MCH programs and staff in emergency response, improved data quality and surveillance systems, and open communication with partners and the public.

Providing Sustainable Funding

S/THOs said the current pattern of funding public health through short-term or emergency funding makes long-term planning extremely challenging. Consistent and sustainable investment in public health infrastructure creates the strong foundation necessary for successful emergency management and preparedness. Responding to emergencies without that foundation is often more expensive than the long-term investment—every $1 invested in public health yields improved health outcomes equivalent to as much as $88 in expenditures saved by public health agencies.

“The biggest challenge we have is threadbare staffing and resources for the stuff that we do all the time. Then there's no surge capacity. Our best preparation for a public health crisis is to have robust, well-functioning public infrastructure, people who are actually able to do their work, and there's surge capacity because when you need extra staff in a crisis, you're not going to be able to hire them and train them.”

Long-term, flexible funding would allow health agencies to invest in the public health infrastructure, workforce, and cross-cutting approaches needed for prevention, including addressing social determinants of health. Experts found that $4.5 billion, or $32 per person in the United States, of permanent annual funding is needed to ensure equitable and sustainable public health services for all.

The current authorization level does not meet public health’s need to sustain readiness capability. Public health agencies must retain well-trained staff, exercise emergency operations plans, support partnerships, navigate grant administration, and modernize systems for interoperability among agencies from the local to the federal level. Sufficient baseline funding is crucial to maintaining public health readiness and bolstering our nation's ability to respond to all threats as they arise.

During past public health emergencies, jurisdictions had to wait for congressional approval and release of federal funding, which can take a long time to reach health agencies. Emergency response and preparedness needs to be able to adjust quickly to challenges; preapproved, flexible funding would allow public health agencies to be ready to respond to emergencies and allow them to adjust their approach as needed for the most efficient response.

Developing Inclusive Preparedness Plans

S/THOs emphasized the importance of establishing and maintaining partnerships prior to a crisis. As highlighted in a recent ASTHO blog post, including subject matter experts in emergency preparedness planning is critical to ensuring all populations are considered in emergency planning and response.

Incorporating emergency preparedness into all public health sectors can help every team understand their contribution to different types of emergencies. Likewise, integrating MCH into other areas of public health can facilitate cooperation and create comprehensive strategies. One way to do this is by breaking down silos within health agencies to ensure MCH needs are correctly captured and MCH teams are incorporated into planning and response. Health agencies can work with partner organizations that serve MCH populations to gain a deeper understanding of community needs and their solutions.

“Not unlike COVID, during the H1N1 pandemic we pulled people from all over the department to mobilize. The family and child section were brought in because of their expertise and their connection to a wide variety of organizations. And they played a variety of roles, helping figure out what the right policy should be, helping develop educational materials, helping to link up to partnership organizations, a wide range of different activities.”

Enhancing Data Quality and Systems

Assessing data is fundamental to understanding the impact of a disease. Creating firm case definitions and structured reporting requirements helps capture accurate numbers when collecting data. Collecting comprehensive data on race, ethnicity, age, pregnancy status, and disability status can provide a clearer picture of health disparities that is available throughout the emergency management cycle.

“Clear guidance on definitions, what to collect, how to collect it from a federal level would be very important, specifically related to populations who are most vulnerable, including maternal, mothers and children and families.”

“There needs to be a lot more federally mandated and structured reporting requirements. I think that would put in a better position than having to spend as much effort and time during a pandemic in trying to get aligned, trying to get on the same standards.”

Understanding disparities in health outcomes can help S/THOs strategize where to target resources and interventions to most effectively close gaps. Forming strong partnerships with healthcare systems and community organizations can assist comprehensive data collection, particularly for organizations serving high numbers of vulnerable populations.

Data cannot be stored without paperless vital record systems. Electronic data systems reduce the burden on staff and resources. Expanding disease surveillance systems and lab capacity can help identify emerging health threats, possibly before they become public health emergencies. Ensuring adequate staffing and flexible data tracking systems allows jurisdictions to quickly adapt to emergencies instead of having to rapidly build up staff or develop a new system during a crisis.

Building Clear Communication Channels

When engaging with external partners and providers, it is crucial that information is communicated clearly and rapidly distributed. Clinicians and health agencies on governmental support to establish best practices and to comply with requirements. Virtual platforms can provide that rapid connection.

S/THOs recommended continuing conversations with different levels of government and external partners. Maintaining communications with a wide group of partners can ensure that diverse stakeholders are involved in the conversation and health agencies receive input from many perspectives.

Staying Prepared

These recommendations can help health officials be prepared to address public health emergencies. ASTHO will continue to share best practices for including MCH considerations in emergency planning and response efforts. You can learn more strategies for MCH emergency planning and response at the following resources.