PUBLIC-HEALTH APPROACHES TO COMMUNITY-BASED NEEDS - BOSTON INFANT-MORTALITY CRISIS AS A CASE-STUDY

In light of a 10-year infant mortality crisis in Boston, a comprehensi ve public health approach was undertaken in which an extensive communi ty-based needs assessment was used to develop a citywide maternal and child health improvement agenda. On the basis of the needs assessment, recommendations were made calling for community-based perinatal initi atives and midwifery services as critical elements in care for underse rved communities and enhancement of perinatal services. A case descrip tion of one perinatal initiative illustrates the challenges of public health practice and describes a practice setting in which midwives pro vided leadership and guidance by using an interdisciplinary team appro ach in the implementation of a community empowerment project. (C) 1997 by the American College of Nurse-Midwives.