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Community leaders in the Pittsburgh region have long recognized the critical importance of the health and well-being of mothers, infants, and young children and have made intensive efforts to develop effective community-based early childhood interventions and support services. Despite these efforts, in several key areas, mothers and young children in this community are not receiving the health care services they need, and the result is premature illness and preventable death. In 2002, The Heinz Endowments commissioned the RAND Corporation and the University of Pittsburgh, in partnership with the Department of Health and Department of Human Services in Allegheny County, Pennsylvania, to establish a learning collaborative of local stakeholders to (1) catalyze new thinking around the best evidence and practice for maternal and child health care; (2) assess the strengths, weaknesses, and barriers to improvement in the current system; (3) identify targets for local policy reform; and (4) develop a blueprint for action. This report provides an overview of the community-based approach through which this work was undertaken, highlights key study findings, and outlines a vision, strategy, and action plan for achieving systemwide improvements in maternal and child health care processes and outcomes.

Table of Contents

  • Chapter One


  • Chapter Two

    Mobilizing a Community Collaborative for Change

  • Chapter Three

    Barriers and Issues Faced by Families in the Community

  • Chapter Four

    Barriers and Issues Faced by Local Providers and Program Staff

  • Chapter Five

    Lessons Learned from Promising National and Local Programs

  • Chapter Six

    Potential Policy Levers for Enhancing Local Improvement Efforts

  • Chapter Seven

    A Blueprint for Community Action

  • Appendix A

    Members of the Learning Collaborative

  • Appendix B

    Local Providers and Payers Interviewed

  • Appendix C

    Model National and Local Programs Interviewed

The research described in this report was sponsored by The Heinz Endowments conducted by RAND Health.

This report is part of the RAND Corporation Monograph series. RAND monographs present major research findings that address the challenges facing the public and private sectors. All RAND monographs undergo rigorous peer review to ensure high standards for research quality and objectivity.

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