MCHbest. NPM 15: Continuous and Adequate Insurance
Strategy. Expansion of Access to Prenatal Care
Approach. Expand access to prenatal care to increase coverage and improve health outcomes for immigrant women and their infants.
Overview. Research indicates that prenatal care is an important component of preventive health care with multigenerational consequences for women and their families. A structured expansion of Emergency Medicaid Plus can provide access to prenatal care for a vulnerable immigrant population.1
Evidence. Scientifically Rigorous. There is strong evidence that expansion of access to prenatal care for immigrant women can result in a significant increase in adequate prenatal care, well-child visits, and reduced incidence of infant mortality and extreme low birth weight. These strategies have been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).
Target Audience. Pregnant women and their infants.
Outcome. Increase in adequate insurance for children (increase in coverage and care for women and their infants). For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.
Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Expand access to prenatal care to increase coverage and improve health outcomes for immigrant women and their infants,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):
1 Swartz JJ, Hainmueller J, Lawrence D, Rodriguez MI. Expanding prenatal care to unauthorized immigrant women and the effects on infant health. Obstetrics and gynecology. 2017 Nov;130(5):938.