This article presents a critical review of the available evidence on the effectiveness of
programs to improve pregnancy outcome in changing rates of infant mortality. A total of
27 secondary reviews and original evaluation articles were assessed for quality of evidence
on program outcomes. Although infant mortality rates are clearly dropping, initial review
of the studies showed that history, differential selection, and experimental mortality were
powerful alternative hypotheses to the conclusion that any particular program can claim
to have caused the drop. Thus, our knowledge of exactly which programs are effective, and
which are not, is compromised.
Get full access to this article
View all access options for this article.
References
1.
Barnes, F.E.F. [ed.] (1978) Ambulatory Maternal Health Care and Family Planning Services. Crawfordsville, IN: R. R. Donnelley and Sons.
2.
Bendick, M., Jr., T.H. Campbell, D.L. Bawden, and M. Jones (1976) Efficiency and Effectiveness in the W.I.C. Program Delivery System (Miscellaneous Publication No. 1338). Washington, DC: USDA, Food and Nutrition Service.
3.
Bergner, L. and M.W. Susser (1979) "Low birth weight and prenatal nutrition: an interpretative review." Pediatrics46: 946-966.
4.
Boruch, R.F. (1975) "On common contentions about randomized field experiments ," in R. F. Boruch andH. W. Riecken (eds.) Experimental Tests of Public Policy. Boulder, CO: Westview .
5.
---and J.S. Cecil (1979) Assuring the Confidentiality of Social Research Data. Philadelphia: Univ. of Pennsylvania Press.
6.
Budetti, P.B., J. Butler, and P. McManus (1982) "Federal health program reforms: implications for child health care." Milbank Memorial Fund Q.60, 1: 165-181.
7.
———and P. McManus (1982) "Assessing the effectiveness of neonatal care " Medical Care20, 10: 1027-1039.
8.
Campbell, D.T. and R.F. Boruch (1975) "Making the case for randomized assignment to treatments by considering the alternatives: six ways in which quasiexperimental evaluations in compensatory education tend to underestimate effects," in C. A. Bennett and A. Lumsdaine (eds.) Central Issues in Social Program Evaluation. New York: Academic.
9.
———and A. Erlebacher (1970) "How regression artifacts in quasi-experimental evaluations can mistakenly make compensatory education look harmful," in J. Hellmuth (ed.) Compensatory Education: A National Debate, Vol. 307: Disadvantaged Child. New York: Brunner/ Mozel.
10.
———and J.C. Stanley (1963) Experimental and Quasi-Experimental Designs for Research. Chicago: Rand McNally .
11.
Chenoweth, A.D. (1971) "Maternal and child health." Women Physician26: 553-556.
12.
Cook, T.D. and D.T. Campbell (1979) Quasi-Experimentation. Chicago : Rand McNally.
13.
———and W.R. Shadish, Jr. (1982) "An evaluation of the CMHS congressionally mandated evaluation system for community mental health center," in G. Stahler and W. R. Tash (eds.) Innovative Approaches to Mental Health Evaluation . New York: Academic.
14.
Cronbach, L.J., S.R. Ambron, S.M. Dornbusch, R.D. Hess, R.C. Hornick, D.C. Phillips, D.F. Walker, and S.S. Weiner (1980) Toward Reform of Program Evaluation. San Francisco: Jossey-Bass.
15.
Egan, M.C. (1969) "Combating malnutrition through maternal and child health programs." Children16: 67-71.
16.
Elliot, M.M. (1972) "The fiftieth anniversary of the maternal and child health section: some remarks on its background and origin." Amer. J. of Public Health62: 1018-1019.
17.
Field, C.A. (1974) "Perinatal mortality and maternal and infant care program at the University of Nebraska Medical Center." Nebraska Medical J.: 336-337.
18.
Foltz, A.M. (1982) "The organization and financing of health care for children and pregnant women," in U.S. Department of Health and Human Services Better Health for Our Children: A National StrategyWashington, DC: U.S. Government Printing Office.
19.
Guttmacher, A.F. (1973) "Family planning," pp. 419-460 in H. Wallace, E. Gold, and E. Lis (eds.) Maternal and Child Health Practices . Springfield, IL: Charles C. Thomas .
20.
Haggerty, R.J. and P.E. Darney (1980) "Maternal and child health service," in J. H. Last (ed.) Maxcy-Rosenau Public Health and Preventive Medicine. New YorkPrentice-Hall.
21.
Hodgman, J.E. (1971) "Perinatal Mortality in California." The Woman Physician26: 557-562.
22.
Kennedy, E.T., J.E. Austin, and C.P. Timmer (in press) "Cost/ benefit and cost effectiveness of WIC." Amer. J. of Agricultural Economics.
23.
———, S. Gershoff, R. Reed, and J.E. Austin (1982) "Evaluation of the effect of WIC supplemental feeding on birth weight." J. of Amer. Dietic Association80: 220-227.
24.
Jaffe, F.S. and P. Cutright (1977) "Short-Term benefits and costs of U.S. family planning programs, 1970-1975." Family Planning Perspectives9: 77-80.
25.
Kessner, D.M., J. Singer, C.E. Kack, and E.R. Schlesginger (1975) Infant Death: An Analysis by Maternal Risk and Health Care. Washington, DC: National Academy of Science.
26.
Komaroff, A.L. and P.J. Duffell (1976) "An evaluation of selected federal categorical health programs for the poor." Amer. J. of Public Health66: 255-261.
27.
Lane, D.S. and H.R. Kelman (1975) "Assessment of maternal health care quality: conceptual and methodologic issues." Medical Care13, 10: 791-807.
28.
Lanman, J.T., S.G. Kohl, and J.H. Bedell (1974) "Changes in pregnancy outcome after liberalization of the New York State abortion law. Amer. J. of Obstetrics and Gynecology118: 485-492.
29.
Lesser, A.J. (1972) "Progress in maternal and child health." Children Today1: 7-12.
30.
———( 1969) "The federal govenment in health care." Pediatric Clinics of North America16: 891-900.
31.
McNamara, J.J., S. Blumenthal, and C. Landers (1978) "Trends in infant mortality in New York City Health Areas served by children and youth projects. " Bull. of the New York Academy of Medicine54: 484-498.
32.
Massachusetts Department of Public Health ( 1981) 1980Massachusetts Special Food Program for Women, Infants, and Children (WIC) Evaluation Project. Final Report of the U.S. Department of Agriculture, Grant #593198974. Washington, DC: Government Printing Office.
33.
Morris, N.M., J.R. Undry, and C.L. Chase (1975) "Shifting age-parity distribution of births and the decrease in infant mortality." Amer. J. of Public Health65: 359-362.
34.
Naverman, N., B. Haskins, and G. Robinson (1978) Community Mental Health Centers: A Decade Later . Cambridge, MA: Abt Associates .
35.
Newport, J. and M.I. Roemer ( 1975) "Comparative perinatal mortality under care foundations and other delivery models." Inquiry12: 10-17.
36.
Niswander, K.R. and M. Gordon (1972) The Women and Their Pregnancies (DHE Publication No. 73-379). Washington, DC.U.S. Government Printing Office.
37.
Office of Management and Budget (1983) Budget of the United States: FY 1983. Washington, DC.Government Printing Office.
38.
Pearse, H. (1970) "Views and reviews: the maternity and infant care program." Obstetrics and Gynecology35: 114-119.
39.
Peoples, M.D. (1981) Evaluation of the Maternity and Infant Care Project, North Carolina Maternal and Child Health Branch, North Carohna Department of Human Resources.
40.
———, R.C. Grimson, and G.L. Daughtry (1984) "Evaluation of the effects of the North Carolina Improved Pregnancy Outcome Project: implications for state-level decision making." Amer. J. of Public Health74, 6. 549-554.
41.
Rush, D. (1982a) "The relationship of protein energy deprivation and supplementation in pregnancy and childhood to subsequent behavior and mental function: an epidemiological perspective," in J R. Galler (ed.) Nutrition and Behavior. New York: Plenum.
42.
———( 1982b) "Is WIC worthwhile?" Amer. J. of Public Health72: 1101-1103
43.
Sharpe, T.R. and H. Wetherbee (1980) Final Report: Evaluation of the Improved Pregnancy Outcome Program. Tupelo, MI: Three Rivers District Health Department, Mississippi State Board of Health.
44.
Sinclair, J.C., G.W. Torrance, M.H. Boyle, S.P. Horwood, S. Saigal, and D.L. Sockett (1981) "Evaluation of neonatal-intensive care programs ." The New England J. of Medicine305: 489-494.
45.
Soko, R.J., R.W. Woolf, M.G. Rosen, and K. Weingarten (1980) "Risk, antepartum care, and outcome: impact of a maternity and infant care project." Obstetrics and Gynecology56: 150-156.
46.
" Special Care for High Risks Cuts Prematurity Rate." Public Health Reports84: 235-236.
47.
Stromsdorfer, E. W. and G. Garkas [eds.] (1980) Evaluation Studies Review Annual, Vol. 5. Beverly Hills, CA: Sage.
48.
Surgeon General (1979) Healthy People: The Surgeon's Report on Health Promotion and Disease Prevention (DHEW PH Publication No. 79-55071). Washington, DC: Government Printing Office.
49.
U.S. Department of Agriculture (1981) Evaluation of the Effectiveness of WIC. Washington, DC : USDA, Food and Nutrition Service, Office of Policy, Planning and Evaluation.
50.
U.S. Department of Health, Education, and Welfare (1979) Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention. Washington, DC : U.S. Government Printing Office.
51.
U.S. Department of Health and Human Services ( 1981a) Maternal and Infant Health (PHS 81-50161). Washington, DC: Public Health Service.
52.
———( 1981b) Better Health for Our Children: A National Strategy: The Report of the Select Panel for the Promotion of Child Health. Washington, DC: U.S. Government Printing Office.
53.
U.S. General Accounting Office (1980) Better management and more resources needed to strengthen federal efforts to improve pregnancy outcome. (HRD-80-24). Washington, DC: Author, January, 1980.
54.
———( 1979) The Special Supplemental Food Program for Women, Infants and Children (WIC): How Can it Work Better? (CEO-79-55). Washington, DC: Author.
55.
Wallace, H.M., E.M. Gold, H. Goldstein, and A.C. Oglesby (1973) "A study of services and needs of teenage pregnant girls in the large cities of the United States." Amer. J. of Public Health63: 5-16.
56.
———and A.S. Medina (1982) "The organization of and legislative base for health services for mothers and children," in H. Wallace, E. M. Gold, and A. C. Ogles by (eds.) Maternal and Child Health Practices: Problems, Resources, and Methods of Delivery. New York: John Wiley.
57.
Wallach, G. and J.F. Jekel (1978) An Evaluation of a Supplementary Feeding Program for Women, Infants and Children (EPH 510-project #18). New Haven, CT: Yale University, School of Medicine, Department of Epidemiology and Public Health.
