E. Fitzgerald COINNThe United States has an embarrassing problem. It has one of the worst infant mortality rates among industrialized countries. Nearly six out of every 1,000 babies born in the US in 2013 died before their first birthday. And, it gets worse. Babies born to black mothers in the US die at more than twice the rate of babies born to white mothers.

As a society, we have a moral obligation to ensure all children have the right to a healthy start in life. Yes, many are ALREADY working in different ways to improve birth outcomes. But, we can do it better AND accelerate improvement by coordinating our efforts, learning from one another and engaging diverse stakeholders with different perspectives on the issue. As a country we need a more robust understanding and a collaborative, multisectoral approach to tackling this complex problem.

I believe one promising approach is the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN). This newly expanded national initiative unites federal, state, community, private and public partners to spread best practices and identify innovative ideas that can be further tested and implemented. IM CoIIN participants are coordinating their work around a common set of aims in a rapid timeframe (18-24 months) through six learning networks (see image). The networks focus on action oriented changes to reduce infant mortality and improve birth outcomes. Examples of specific aims include reducing early elective deliveries by 33 percent and increasing the rate of women who stop smoking prior to pregnancy relative to state baseline by 10 percent.

States, including Ohio, have assembled teams to participate in the learning networks, and are discovering how to maximize and align existing initiatives, scale up best practices, test new changes, and identify successful improvements before implementing statewide. Through an “all teach, all learn” approach, diverse stakeholders with multiple perspectives can share and learn collaboratively about how to accelerate improvements to the dynamic and complex systems that enable or inhibit our efforts to address infant mortality in this country.

Our hope is that the IM CoIIN approach will challenge the status quo and that we can improve the systems that directly influence birth outcomes, so that more children are reaching their first birthday and beyond. Will you join us?


Learn more about IM CoIIN and hear from IM CoIIN participants.

Elaine Fitzgerald,  DrPH, MIA is a project director at NICHQ. She currently leads the Infant Mortality Collaborative Improvement and Innovation Network (IM CoIIN).NICHQ serves as the lead quality improvement and technical assistance organization for IM CoIIN.