1 / 17

Donna Strobino, PhD, Department of Population, Family & Reproductive Health

Educating the Next Generation of Public Health Leaders: Integrating Preconception Health into MCH Curricula at Schools of Public Health. Donna Strobino, PhD, Department of Population, Family & Reproductive Health. Course Opportunities at BSPH. Lifecourse Perspectives on Health

dwayne
Download Presentation

Donna Strobino, PhD, Department of Population, Family & Reproductive Health

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Educating the Next Generation of Public Health Leaders: Integrating Preconception Health into MCH Curricula at Schools of Public Health Donna Strobino, PhD, Department of Population, Family & Reproductive Health

  2. Course Opportunities at BSPH • Lifecourse Perspectives on Health • Clinical Aspects of Maternal & Newborn Health • Women’s Health • Women’s Health Policy • Preventing Infant Mortality & Promoting the Health of Women, Infants & Children

  3. Presentation Overview • Why Public Health • Importance of Lifecourse Perspective • Unique contribution of Lifecourse • Application of Lifecourse to Preconception Health • Policy and Practice Concerns using a Lifecourse Perspective • Missed Opportunities

  4. Why Public Health? • Wholistic view of health, including social determinants of health & context • Lifecourse framework • Lifecourse of the fetus? • Girl’s health? • Policy Implications • Prevention Orientation

  5. Why Lifecourse? A lifecourse approach recognizes the role of time in shaping health & incorporates time into models which explain health outcomes. Time & timing are particularly relevant with regard to pregnancy & its consequences.

  6. Time Scales • Individual time: chronological age, physical maturation, developmental & social maturation, social norms • Historical time: calendar year, year of birth, technological development, economic change, social change

  7. Clarifying Terms • Life Span: length of time species is capable of living or length of life • Life Cycle: regular, predictable series of life stages or reproductive cycle • Life Course: age graded developmental trajectories shaped by context

  8. How Time Matters • Individuals’ health changes over time • Determinants of health vary over time • Relation between determinants and health can change over time • Relation between determinants and health may depend on time

  9. Advantages of LifeCourse Approach • Recognizes complexity but provides an integrating model • Big picture, highlights connections – important to public health mission and discussion of preconception health • Thinking about pathways helps possible breaks in “chains of risk”, alter probabilities • Allows focus on positive human development

  10. Goal for pregnancy period • To produce a healthy child with minimum compromise to the health of the mother • To provide an acceptable birth process and postpartum experience

  11. Lifecourse Model of Childbearing Period Pregnancy Pregnancy Menarche Menopause

  12. Defining the Preconception Period: Concept of Reproductive Awareness Providers recognize the possibility of reproduction at all health care visits with women of childbearing age About 50% of pregnancies are unplanned About 70% of women aged 18-39 have had at least one preventive health visit in the past year

  13. Policy and Practice Concerns • Traditional view of preconception period and policy: when is care provided and when are women eligible for insurance benefits? • For what length of time prior to pregnancy should women be eligible for a preconception visit?

  14. Diabetes as a Model • Only half of women with diabetes recall being counseled about good glycemic control before pregnancy • Less than half of women with diabetes report seeking prepregnancy counseling in their last pregnancy

  15. Policy and Practice Concerns • Wise argues that we need to “recast preconception, prenatal & interconception care as part of a larger commitment to women’s health” • “focusing on the health of the newborn has not resulted in improvements in …. contraception, chronic disease management, abortion, or behavior and mental health services”

  16. Lifecourse Perspective • Reminds us that women are important, women’s health before and during pregnancy have an impact on her health postpartum and as she ages • Focus on the fetus and newborn also ignores opportunities to promote women’s health in the immediate preconception and interconception period

  17. Missed Opportunities at BSPH • Reproductive & Perinatal Epidemiology • Fetal & Infant Growth & Development • Fetal origins of disease • Intergenerational health • No attention to earlier health of mother

More Related