Using the Fetal Infant Mortality Review Methodology to Identify Gaps in the Prevention of Perinatal HIV Transmission in Philadelphia

The Fetal and Infant Mortality Review (FIMR) program was established to examine fetal and infant mortality rates across the U.S. The FIMR methodology was created collaboratively by the National FIMR program, the Centers for Disease Control and Prevention, CityMatCH, and the American College of Obstetricians and Gynecologists to be used at the local level and improve service systems for mothers and infants. The methodology includes three steps: tracking, review, and action. Tracking involves gathering data from specific cases via chart abstraction and maternal interviews. In the review stage, a case review team (CRT) reviews the cases, identify gaps in care, and recommend actions to prevent the observed gaps. In the action stage, a community action team (CAT) is assembled to take action specific to the gaps that were presented in the cases. The FIMR/HIV project is specific toward reviewing cases that involve perinatal transmission of HIV. Philadelphia is one of the eight sites that have taken a part of the FIMR/HIV project nationally to address their current issues with perinatal exposures and transmissions of HIV. The CRT meetings found significant gaps in the areas of preconception, prenatal, labor and delivery, postpartum, and infant care. According to these gaps, the CAT assembled themselves in four subcommittees, in which they thought the areas needed the most and immediate improvement: case management, contraception counseling, HIV testing, and emergency room pregnancy protocol. These four subcommittees are diligently working to improve these prospective areas in care to help eliminate perinatal transmission of HIV in Philadelphia.M.P.H., Public Health -- Drexel University, 201