The Healthy Start Coalition of Sarasota County has been conducting Fetal and Infant Mortality Reviews (FIMR) since 1992. The FIMR process is based on a model developed by the American College of Obstetricians and Gynecologists. There are currently 200 FIMR projects in the nation.
Florida is considered a leader among the states. Fully funded FIMR Projects positively impact infant mortality statistics. Additionally, the FIMR process fits well with the State Surgeon General’s Strategic Priority on Public Health Wellness, Access, Prevention & Protection and the focus on Improvements to Women’s Health across the Lifespan.
The FIMR Process
Data for fetal and infant deaths are gathered from sources including birth and death certificates and records from hospitals, physicians, Healthy Start, WIC, social service and law enforcement agencies, interviews with the mother, and other family members. All information is de-identified and access to records is given to Healthy Start Coalitions through public health research statutes. The de-identified cases are reviewed by the Case Review Team, an interdisciplinary team of professionals, who examine the medical record case abstractions and family interviews to answer the question, “Where did the system fail this family?” The review team prioritizes and documents all contributing factors for each case. Annually, the year’s cases and priority contributing factors are examined by the FIMR Community Action and Education Group. After determining the major issues and trends, the group makes formal recommendations for community interventions to prevent further deaths. Strict confidentiality is maintained at all steps in the process, and the cases the team reviews have no identifying information.
How is Sarasota County Doing?
Although vital statistic information coupled with current research provides a wealth of information, it is still unclear why some babies die. Many disturbing trends and issues continue to beleaguer Florida. For example, the racial disparity in fetal and infant mortality statistics is staggering. The infant mortality rate for non-white babies in Florida is almost two and a half times that of white babies and the fetal mortality rate is three to four times higher.
In Sarasota County in 2007, that discrepancy continues. Fetal death rate (>20 weeks gestation) was 8.7 for whites, versus 24.6 for blacks and 13.1 for Hispanics. Infant death rate was 3.5 for whites, versus 7.2 for blacks and 4.0 for Hispanics. An example of how the FIMR process and Coalition activities address these needs is the implementation of the “Save My Life” educational awareness campaign and program for African-American residents. It focuses on prevention and early treatment of risk factors for poor birth outcomes.
Invitation to Participate
Participation on the Case Review Team is by invitation only. If you are a local professional and work in the maternal-child health care field or a related agency, please call (941) 373-7070, ext. 301 if you are interested in participating.