Sustainability of a comprehensive women's health initiative after Federal funding ends

Background

From 1996 to 2007, the Office on Women's Health funded a set of innovative Multidisciplinary Health Models for Women (MHMW) programs. MHMW was comprised of 48 projects located in urban, rural, and frontier areas and housed in academic medical centers, community health centers, area health education centers, community-based organizations, hospitals, and community health center look-alikes. Each site was designated as a National Center of Excellence and was charged with integrating a multidisciplinary model consisting of five core components: • Clinical • Research • Public Education and Outreach • Training • Leadership Development

Methods

In 2010, surveys were completed by 40 of the 48 projects. In-depth telephone interviews were completed by 22 projects and site visits were conducted to 10 of them.

Results

Over 2/3 of the sites have been able to sustain their work in developing a coordinated system of clinical care for women and expansion of public education and outreach programs. The sites have struggled most in sustaining training and leadership development components with only about 1/3 sustaining many of the features of those components. Significant differences exist between academic medical centers and community sites and between rural and urban sites. These differences are reduced but not eliminated if years of funding are controlled.

Conclusions

Institutions are able to use Federal funding to make sustainable changes in how they approach women's health and deliver care. Efforts to understand the factors that enhance their ability to sustain these approaches may help support such efforts in the future.