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Report Urges 'One-Stop Shop'For Indigent Pregnant Women

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Washington--The United States should adopt programs and policies that allow poor pregnant women to obtain health and social services at one location, a new report concludes.

By establishing a "one-stop shopping" strategy for these women, the report by the National Commission to Prevent Infant Mortality argues, the government could save money and lives.

According to the commission, about one-third of pregnant women, or 1.3 million annually, receive inadequate prenatal care because they cannot or do not weave their way through numerous government programs.

Although preliminary figures show that the infant-mortality rate fell to 9.1 per 1,000 live births last year, down from 9.7 deaths in 1989, there was no corresponding drop in the percentage of low-birthweight babies. This condition, which is largely preventable through good prenatal care, is strongly linked with infant mortality.

Currently, poor expectant mothers may have to make numerous visits to different offices and fill out similiar forms at each to become eligible for welfare payments, Medicaid, food stamps, and the Special Supplemental Food Program for Women, Infants, and Children, the report notes.

"All too often," it says, "a positive pregnancy test turns out to be the end--rather than the beginning--of a women's contact with perinatal and pediatric services."

To reduce these systemic barriers, the commission recommends that the states and the federal government simplify applications procedures for public assistance. In one such effort, the federal government is expected to complete this summer a model joint-application form covering seven aid programs for pregnant women and for children under age 6.

The report also calls for the creation of more home-visiting programs for pregnant women, as well as aggressive public-awareness and outreach programs for women who may not know about the need for good prenatal care.

According to the commission, the Congress should appropriate funds to the full authorization level for the Maternal and Child Health Block Grant to trigger the initiation of one-stop-shopping programs that were authorized, but not funded, in 1989.

In late March, as part of a supplemental-appropriations bill, the Congress allocated $25 million to combat infant mortality, an initiative proposed by President Bush and Secretary of Health and Human Services Louis W. Sullivan.

In doing so, however, the Congress prohibited the Administration from transferring funds to the initiative from community-health centers or the maternal-and-child-health program, as the Administration had proposed.--ef

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