Power in Numbers: Accountability and Monitoring of Preterm Birth in the United States

Photo: March of Dimes

Five years ago, it was difficult to get elected officials and policy leaders to pay attention to the growing crisis of preterm birth, in the U.S. as a whole and in each state.  Today, that situation has reversed itself.   Much of the credit goes to a very simple tool:  a Report Card. 

It is one thing to have a goal, and quite another to mobilize a wide range of stakeholders to rally around that goal. Yet, the Report Cards have done just that.

The March of Dimes has issued Premature Birth Report Cards every November since 2008.   After five years, I am happy to report that policymakers are not just paying attention, they are also taking action:  pledging to reduce preterm birth at the state level, devoting funding to model interventions at the federal level and spreading the word through publicity and joint advertising efforts.

Report Cards are one key tool in a decade-long effort to elevate the issue of prematurity among thought leaders, civil society, policymakers, researchers and the public.   Report Cards make their contribution by providing a straightforward way to monitor progress and the motivation to do better (after all, who doesn’t want a better grade?).   

Over the past five years, the difficult news of an “F” or “D” grade* became a rallying point for many, culminating in a forthright challenge by the Association of State and Territorial Health Officials and the March of Dimes. Together, our two organizations asked all states to pledge to reduce the rates of preterm birth by 8% by 2014. We knew we were asking for a lot, but a public, signed pledge brings accountability, which is what was needed.  After the “ask” letters were sent, we crossed our fingers, hoping for a few “yes” responses. 

Within five months of issuing the challenge, we had far more states saying “yes.”  Top health officials in 48 of the 50 states (as well as Puerto Rico and the District of Columbia) signed the pledge to reduce preterm birth in their state or territory. 

Our U.S. events for Prematurity Awareness Month (including World Prematurity Day on November 17) are now more powerful than they have ever been.  States are mobilizing to respond to the availability of new funding opportunities, and developing initiatives to follow through on their pledges to reduce preterm birth.  Ads are airing prominently in many states and nationwide.  And state officials are joining with the March of Dimes and other stakeholders to bring attention to all of this activity as they announce their 2012 Report Card grades today, November 13.

There is some good news in the Report Cards this year, because preterm birth rates have declined in many individual states and in the nation as a whole.  But if you pay close attention to the news coverage, as I will, you will see that no one is satisfied, at least not yet.  The rates are still too high to be acceptable to any of us.   The United States remains a “C.”   There are states that have been working hard and still get an “F,” because change takes time. 

Too many families are suffering.  For them, we want every Report Card grade to be “A”.

For more on the report cards, visit marchofdimes.com/reportcard.

* In the American grading system, an “A” is the highest grade and an “F” is the lowest grade, representing a fail.

 > Click to view the US national Report Card

This blog is part of a series on HNN that will lead to World Prematuriy Day, November 17, discussing preterm birth and highlighting the actions needed to prevent and reduce preterm birth, the leading cause of newborn deaths. Join us as we discover that everyone has a role to play. To get involved and learn more, please visit www.facebook.com/WorldPrematurityDay.


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