In 2007, the North Carolina Preconception Health Coalition leadership team engaged a statewide coalition to work together to develop the NC Preconception Health Strategic Plan which was released in September 2008. The initial priority areas for the NC Preconception Health Strategic Plan are promotion of intended pregnancies and healthy weight. This coalition continues to meet annually, with four workgroups meeting on a more frequent basis The four workgroups concentrate on moving from strategy to action in the following areas: 1) increase consumer and community awareness about preconception health, 2) ensure quality preconception care and practice among health care providers and community health workers, 3) expand access and affordability of preconception care and 4) advocate for environmental and policy changes that support preconception health.
Process and Principles
From March 2007 – June 2008, four Think Tank meetings and several workgroups were convened to bring partners together in the development of the NC Preconception Health Strategic Plan. Over 80 representatives from the Division of Public Health, Department of Public Instruction, local health departments, public and private universities, the Department of Health and Human Services, community-based organizations, non-profit agencies and consumers were involved in this process. Through this process, the following guiding principles emerged:
- Utilize a collaborative planning, implementation and evaluation process that includes a large and diverse group of partners across North Carolina.
- Infuse community development and consumer leadership into each step of the plan.
- Prioritize programs with the potential to address health disparities.
- Consider women’s health needs and related wellness recommendations within the context of their family and communities.
- Focus on the whole woman, not only on her reproductive capacity.
- Avoid messages that imply that certain women should or should not become mothers.
- Address the gap between “knowing” and “doing” by bridging the transition from information to behavior change.
Outlined below are the vision, goals, and priority areas of the North Carolina Preconception Health Strategic Plan which was released in September 2008.
Vision
This effort seeks to improve the health of women of childbearing age in North Carolina. Through a collaborative focus on women’s wellness, North Carolina will improve the quality of life for women as well as the health of infants.
Goals
- Develop partnerships and work collaboratively to integrate preconception health into existing programs and services, as well as to collectively design new interventions.
- Advocate for change at programmatic and policy levels to create an environment that promotes the health and well-being of women of reproductive age.
- Promote and support preconception health related research, surveillance and evaluation to monitor progress and build a strong evidence base for interventions.
- Focus resources on partnerships, programs and services that address disparities in women’s health.
Priority Areas
- Pregnancy Intendedness
- Obesity and Related Conditions
- Substance Abuse
- Mental Health
- Collaborative Research on Preconception-focused Topics
- Policy Development and Access to Care
The coalition chose two initial priority areas for the 2009 – 2013 strategic plan: 1) Pregnancy Intendedness and 2) Obesity, Overweight and Related Conditions. These two areas were selected based on the current resources available and the interest of the initiative participants. As the Strategic Plan work continues and more resources and partners become available, workgroups will address remaining and newly emerging priority areas.
Workgroup Updates – April 2011
1) Increase consumer and community awareness about preconception health
- Developed a reproductive life planning booklet to help consumers and providers to start the conversation
- Developing toolkit of resources for providers on various topics to be available in different formats
2) Ensure quality preconception care and practice among health care providers and community health workers
- Surveyed 50 health care providers to gather information on preferred topics, tools and learning opportunities in preconception health
- Researched and compiled recommended resources for health care providers and posted on Women’s Health Branch website
3) Expand access and affordability of preconception care
- Initially involved in process with NC DMA to developing a package of core benefits for a waiver that would provide care for women with a previous high risk birth
- Affordable Care Act policies offer the opportunity for expanding coverage for women of childbearing age with SPA and increased Medicaid eligibility
- NC now participating in Peer2Peer learning collaborative to examine how to implement expanded coverage for women of childbearing age
4) Advocate for environmental and policy changes that support preconception health
- Maternity Leave Checklist and Benefits List created for state employees – covers benefit and health tips for women prior to pregnancy, during each trimester and postpartum.
- Healthy Babies Healthy Business, a free intranet- based tool from March of Dimes now posted on the state health plan website.
- Promote BMI assessment and healthy weight guidance in the family planning and maternity clinics
- Promoting appropriate gestational weight gain through trainings and/or web materials for public and private providers
- Emphasizes raising awareness about adverse maternal and birth outcomes related to overweight/obesity
- Participating in local and state coalitions promoting breastfeeding, community and school gardens, and access to local produce
- Women’s Health Breastfeeding group established and promotes breastfeeding awareness and policies