What is the Future of Maternal and Child Health Policy and Systems?

Maternal and child health policy and systems need to be re-examined and transformed to meet the challenges facing children, youth and families in the 2lst century. Although there was a strong commitment to this population in the past via White House Conferences, the passage of Title V of the Social Security Act in 1935 and major investments in maternal and youth programs during the War on Poverty of the 1960's and early 1970's, there was little attention paid to this population during the closing decades of the 20th century. Given the growing number of children and youth with chronic conditions and/or challenges in their living conditions associated with poverty and the expanded evidence base about critical conditions needed for healthy child development, major investments are needed in all sectors (e.g., health, education, social services, etc.) to assure that children grow into productive healthy adults. A major transformation of the maternal and child health system is needed to assure that children's healthy development is achieved for all children. Several options for the MCH system of the 21st century will be presented for discussion and comment. Key issues to be discussed are the role and future of Title V, the relationship of an MCH public health system to health insurance expansions, the inclusion of women's and family health issues, the relationship of health to other programs and legislation, and the social strategies needed to develop and maintain the political will to assure that all children and youth thrive.