Online Program

Relationship between local health department organizational characteristics and changes in maternal and child health service profile

Tuesday, November 3, 2015 : 9:10 a.m. - 9:30 a.m.

Comfort Olorunsaiye, MPH, PhD(c), College of Health and Human Services Dept. of Public Health Sciences, University of North Carolina Charlotte, Charlotte, NC
L. Michele Issel, PhD, RN, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
Background: Changing health care and economic climates can affect local health department (LHD) service delivery. This study explored the relationship between LHD organizational characteristics and changes in the provision of five key maternal and child health (MCH) services.  

Methods: In 2012, using a stratified, random sample, 195 LHDs provided data via an online survey regarding their organizational characteristics and the MCH services provided/contracted out. We matched respondents to the 2008 NACCHO Profile Survey, yielding a sample of 178 LHDs. We identified changes in the provision of five MCH services as added, eliminated, or no change. Net change per service was calculated across LHDs. Chi-square analysis was used to examine the relationship between top executives’ clinical background, local board of health (LBoH) autonomy (defined as decision-making powers) and population size, and net change per service.

Results: Between 2008 and 2012, 11% of LHDs added family planning and pregnancy prevention, whereas 5% and 3% of LHDs, respectively, eliminated EPSDT and prenatal care. The percent of LHDs providing well child care was unchanged.  When we looked at changes in services by population size, several interesting patterns emerged.  Although not statistically significant, LHDs with no autonomy reported more net gains than those with low or high autonomy in all services, except well-child care. Overall, top executives’ clinical background and organization characteristics were not significantly related to changes in MCH service provision.

Conclusion:  Changes in each MCH service provision stem from a complex set of factors which deserve further exploration.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related research

Learning Objectives:
Explain changes in five key MCH service profile. Describe the relationship between local health department organizational characteristics and changes in the provision of five key MCH services.

Keyword(s): Maternal and Child Health, Public Health Infrastructure

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD Candidate in Health Services Research at UNC Charlotte, and I have collaborated on other studies assessing local health department performance and MCH service delivery.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.