HEALTHY START BENCHMARKS
1. Improve Women's Health
Health Insurance (women/child) - Increase the proportion of Healthy Start women and child participants with health insurance.
Healthy Start participants should enroll in health insurance to guarantee that they qualify for and receive both preventive and essential health care services. Although uninsured rates are decreasing in the U.S., disparities persist within race, income, and age groups.
Postpartum Visit - Increase the proportion of Healthy Start women participants who receive a postpartum visit.
Since the period immediately following birth is a time of many physical and emotional adjustments, a visit for the mother with a healthcare provider approximately six weeks postpartum is important. Recovery from the delivery can be assessed, and preventive health measures such as screening for postpartum depression, providing contraception, and reinforcing the health benefits of breastfeeding can be provided.
Reproductive Life Plan - Increase the proportion of Healthy Start women participants who have a reproductive life plan.
A reproductive life plan is a set of personal goals about having (or not having) children, accompanied by family planning intended to help achieve those goals. The CDC recommends that everyone make a reproductive life plan based on personal values and resources. Reproductive life plans reduce the risk of unintended pregnancy and increase the number of women who plan their pregnancies, and engage in healthy behaviors before becoming pregnant.
Usual Source of Care (women/child) - Increase proportion of Healthy Start women and child participants who have a usual source of medical care.
“Usual source of care” refers to a place an individual or family usually goes to when sick, such as such as a doctor’s office, clinic or health center but not an emergency room. Having a usual source of medical care has been shown to increase quality of care, boost access to preventive services, improve health outcomes, and reduce overall health care costs.
Well Woman Visit - Increase proportion of Healthy Start women participants that receive a well-woman visit.
American College of Gynecologists recommends annual assessments to counsel women about preventive care and to provide recommended services such as screening and immunizations. A number of illnesses can be prevented when proper well-woman care is a priority, and even illnesses that can’t be prevented have a much better prognosis when detected early. In addition, a woman who has been receiving annual well-woman care is more likely to be in optimal health before any subsequent pregnancy.
2. Promote Quality
Birth Spacing- Reduce the proportion of Healthy Start women participants who conceive within 18 months of a previous birth.
Pregnancies should be spaced at least 18 months apart to reduce health risks for both mother and baby. Increased risks for babies conceived within 18 months of giving birth include preterm birth, low birth weight, and small size for gestational age. Additionally, in order to achieve optimal health before another pregnancy, the mother needs time to fully recover from the previous birth.
Initiation Breastfeeding- Increase proportion of Healthy Start child participants whose parent/caregiver reports they were ever breastfed or pumped breast milk to feed their baby.
Breast milk contains vitamins and nutrients babies need for good health and protection from disease. Research shows that any amount of breastfeeding is beneficial for the baby and that the skin-to-skin contact of breastfeeding has physical and emotional benefits. Prenatal counseling and education of pregnant women can correct misperceptions about breastfeeding and encourage more of them to breast feed.
Safe Sleep- Increase proportion of Healthy Start women participants who engage in safe sleep practices.
The American Academy of Pediatrics recommends that all babies be placed on their backs for every sleep time because this practice has been shown to reduce the incidence of Sudden Infant Death Syndrome (SIDS). Additional safe sleep strategies that can decrease the risk of infant death by asphyxia/suffocation include use of a firm sleep surface free of soft objects or loose bedding, room-sharing without bed-sharing, and sleeping in a smoke-free environment.
Smoking Abstinence- Increase the proportion of pregnant Healthy Start participants that abstain from cigarette smoking.
Research shows that smoking in pregnancy is directly linked to poor outcomes including preterm birth, low birthweight infants, certain birth defects such as cleft lip or cleft palate, Sudden Infant Death Syndrome (SIDS), and premature separation of the placenta from the uterus. Women who smoke may also have a harder time getting pregnant and an increased risk of miscarriage. All of these risks can be reduced if a woman quits smoking before or even during pregnancy.
Sustaining Breastfeeding- Increase proportion of Healthy Start child participants whose parent/caregiver reports they were breastfed or fed breast milk at 6 months.
The American Academy of Pediatrics recommends exclusively breastfeeding for the first six months because breastfeeding is good for both the baby’s and the mother’s health. Benefits for the baby include decreased diarrheal illness, gastroenteritis, and respiratory tract infections, fewer allergies, and reduced risk of obesity and diabetes. Benefits for the mother include decreased obesity and Type II diabetes, reduced risk of breast cancer, and decreased postpartum depression.
Well Child Visit- Increase proportion of Healthy Start child participants who receive the last age-appropriate recommended well child visit based on American Academy of Pediatrics schedule.
The American Academy of pediatrics recommends regular well-child visits to assess if the child is meeting developmental milestones on hearing, vision, nutrition, safety, sleep, diseases, and growth. These visits also provide an opportunity for additional age- and developmentally-appropriate preventive services such as immunizations and anticipatory guidance.
3. Strengthen Family Resilience
Father/Partner Parenting Involvement- Increase proportion of Healthy Start women participants that demonstrate father and/or partner involvement (e.g., attend appointments, classes, infant/child care) with their child participant.
Early male involvement in children’s lives has been shown to have a positive effect on both sons and daughters in several areas. It is associated with future academic success, reduces the chance of delinquency, and decreases the incidence of substance abuse.
Father/Partner Prenatal Involvement- Increase the proportion of HS grantees that demonstrate father and/or partner involvement (e.g., attend appointments, classes, infant/child care) during pregnancy.
Paternal involvement has an impact on both pregnancy and infant outcomes. The father or partner can, for example, participate in childbirth classes, prenatal and pediatric medical appointments, and infant care. Paternal involvement during pregnancy has been shown to reduce negative maternal health behaviors, risk of preterm birth, fetal growth restriction, and low birth weight.
Intimate Partner Violence- Increase proportion of Healthy Start women participants who receive intimate partner violence (IPV) screening.
Intimate Partner Violence, a pattern of abuse by one partner against another in a relationship such as marriage, cohabitation, or dating, is a substantial yet preventable public health problem. Every year women experience 4.8 million incidents of physical or sexual assault by an intimate partner. This violence tends to persist or even increase during pregnancy. The U.S. Department of Health and Human Services recommends that IPV screening and counseling be a core component of both prenatal and well-women healthcare visits.
Perinatal Depression Screening - Increase proportion of HS participants who receive perinatal depression screening and referral.
Perinatal depression is one of the most common medical complications of pregnancy. It is important to identify women with depression because untreated mood disorders can have adverse effects on women, infants, and families. ACOG recommends that pregnant women should be screened for depression at least once during the perinatal period.
Reading to Child Daily- Increase the proportion of Healthy Start child participants aged <24 months who are read to by a parent or family member 3 or more times per week.
Reading to a child teaches him or her about communication, introduces concepts such as numbers, letters, colors, and shapes, builds listening, memory, and vocabulary skills, and provides information about the surrounding world. It is also associated with future academic success. Because of this, a mother or father should read to the infant or young child every day.