Columbia World Projects (CWP) on Thursday published a report on its recent maternal health Forum and announced three projects that are in development for potential implementation.
In January, around 35 experts came together at Columbia for a Forum to discuss key challenges in maternal health, analyze their root causes, and identify projects that CWP could implement to substantially reduce maternal mortality and morbidity.
The meeting was the fourth Forum held by Columbia World Projects. Forum meetings bring together experts with a variety of backgrounds from inside and outside the university to identify how Columbia University’s unique knowledge and expertise can be brought to bear on addressing fundamental challenges. Participants are asked to develop projects that can demonstrate measurable impact on people’s lives within five years, by partnering Columbia faculty with practitioners in government, the private sector, nongovernmental and international organizations, and other entities.
The report describes nearly 20 project proposals that participants prepared in advance of the Forum and the feedback they received at the meeting from fellow experts. In addition, the report sets out three projects that received the greatest support from participants for further development by CWP.
The first project would partner with select U.S. jurisdictions to leverage Medicaid to cover pregnancy-related complications in the year after delivery, during which 60 percent of pregnancy-related deaths occur. Nearly half of all births in the United States are paid for by Medicaid, yet the program only guarantees mothers’ coverage for 60 days after delivery, after which many new mothers go uninsured. The project’s ultimate objective is to design and test adaptations to Medicaid coverage for mothers in order to reduce pregnancy-related morbidity and mortality, improve maternal and infant outcomes, and reduce costs. The model could be adapted by other jurisdictions across the country.
The second project brings together three ideas that were proposed to address different aspects of maternal health in New York State. It would improve access to mental health care in New York during pregnancy and the postpartum period, by creating a program at Columbia University Irving Medical Center for embedding mental health care into obstetrics primary care. It would expand and improve upon the Safe Motherhood Initiative, a program that has demonstrated significant progress in reducing the main drivers of maternal mortality in the state, by tackling the problems of sepsis and cardiac events. And it would develop and deploy a set of activities designed to improve trust between health systems, providers, and women from vulnerable communities in order to address biases that contribute to enduring racial disparities in maternal health outcomes.
The third project would implement a multi-pronged, evidence-based set of interventions aimed at improving maternal health among adolescents in Mozambique, which has one of the highest maternal mortality rates in the world, and perhaps a second country. The project would bring together an interdisciplinary team to design, implement, and evaluate a package of adolescent-focused antenatal and postnatal services. Those services would include mental health screenings, family planning and contraception, income-generating skills, and literacy and numeracy training. This project would use a group care approach, relying on adolescents to assist one another.
Columbia World Projects staff are currently working with the respective project leads to further develop the projects, taking into account the recommendations from Forum participants and the CWP Advisory Committee. This includes defining major deliverables, a precise timeline for implementation, a funding plan, a set of performance indicators for monitoring and evaluation, and the key implementing partners – all of which will be synthesized in a project design report. Based on these reports, a final decision will be made on which projects CWP will implement.