kilometer racial composition was 86% for the white people, 5.5 % Native Americans, 3.1% African- American, 1.4% Asian, 1.8% from other races and 2.2% Pacific Islanders. The number of total births per 300 people in Doyle community is 124 per year while the number of live births for is 112 births. The Doyle maternal mortality stands at 4% for every 100 women, and the infant mortality is 7% for every 100 live births. The Low Birth Weight is 17% infants for every 100 live births and 2% Very Low Birth Weight for every 100 live born. The rate of premature births is 12% according to the statistics (Short, Frank & Conrey, 2012). Majority of women prefer to give birth under the care of a physician, as indicated by the number of women who visit maternity hospitals and birth centers during birth. 82% of the births take place under the care of a physician, 8% under the CNMs, 7% under CMs and 3% under the other types of midwives in homes.  The government pays maternity fees for 75% of the total births while the Medicaid pays the 25% of the maternity fees (Short, Frank &Conrey, 2012). There are many policies on the role of midwives to encourage then to attend to many births, and the state offers a number of maternal services such as immunizations, antenatal and postnatal care.

Maternal Child Health indicators in Doyle

during pregnancy, during birth or immediately after birth due to maternal causes. Maternal mortality rate=Number of maternal deaths/number of 100,000 live births in a year.  That is MMR =total deaths/100000 live births per year (Zoti, Williams & Wako, 2014). The figures on Maternal Mortality Rate are useful to the health departments of the US. they help to plan on the causes of maternal deaths, how to reduce the death rates, and the amount of funding for achieving the low maternal death rates.

Infant Mortality refers to the death of a child less than one year of age due to various causes, such as infant diseases. Infant Mortality Rate is the number of deaths of infants under one year for every 1000 live births. Infant Mortality Rate =number of infants under 1 year /1000  (Zoti, Williams &Wako, 2014) live births in the same year. The statistics on Infant Mortality Rates are very vital to help in the countries work on the ways to curb infant deaths by indentifying the causes and laying down the necessary strategies.

Prematurity is a case of the delivery of neonates that are less than 37 weeks of the gestation period. Premature infants of with a weight, which is less than 1000g die due to congenital malformation, respiratory failure, and infections. Prematurity rate is the number of premature babies for every 10 live births. Prematurity rate = number of premature infants /1000 live births per year (Zoti, Williams & Wako, 2014). The data on the prematurity rates assists the health planners to come up with strategies, which can help to reduce the number of premature infants in the US. The strategies can include education, funding, and counseling.

Low Birth Weight (LBW) is the weight of a live infant, which is less than 2500 g regardless of the age of the gestation. The normal weight for a healthy infant is 2500g to 4200g at delivery. LBW can result from preterm birth or the low prenatal growth rate. Other cases are young age, poor nutrition, multiple pregnancies, heart diseases, and drug abuse. The LBW rate is the number of life infants born with low birth weight for every 1000 live births in a year LBWR =number of low birth weight infants/ 1000 live births in a year (Zoti, Williams & Wako, 2014). The data on LBW helps the health ministry to come up with solutions to the causes of low birth weight infants and teach mothers on the best diets during the pregnancy period.

Very Low Birth Weight (VLBW) is the birth weight of an infant, which is less than 1500g. The causes may be due to drug abuse, preterm birth, multiple pregnancies, and poor nutrition. Very Low Birth Weight Rate is the number of infants with less than 1500g for every 1000 births. That is, VLBWR= number of infants less than 1500g/ 1000 live births in a year. Similar to the case of low birth weight infants, the information on very low birth weight infants assists the health sector to plan on how to reduce the cases and save the VLBW infants (Zoti, Williams & Wako, 2014).

Local outcome Disparities in Doyle community

There are a number of disparities in the outcomes of the indicators in terms of ethnic community, married and unmarried mothers, underage, educated, and overage mothers.  Maternal and infant mortality rates are higher in the African- American origin than in the pure Americans. Low birth weight and very low birth weight is very common in underage, overage mothers and the less educated mothers. The unmarried mothers also contribute to the higher rate in the low birth weight and the premature infants, in the community (Short, Oza, Frank & Conrey, 2012).

Maternal-Child Data for Doyle community Lassen County (US Department of Health and Human Services Office of the Disease Prevention and Health promotion. Health People 2020 Washington, DC. Retrieved from http://www.healthypeople.gov.)

Comparison of Doyle Community to the State and the National Data

In Doyle, Lassen County the percentage of the total maternal mortality rate is 4%, which is higher than the state at 3.7% and lower than the national figure at 12.5. Comparing it with the HP2020, the mortality rate in Doyle is lower than the base line of 12.7% but it is lower than the national figure at 12.5%. The mortality rate in Doyle is quite low when compared to the above statistics, though there is a need to lower it below the state level.

Infant mortality rate in Doyle, Lassen County is at 7%, which is higher than the state or county value at 4.7%, though lower than the national level at a value of 10.1%.  The infant mortality rate is higher than the HP20 baseline by 0.3%, which deviates from the HP2020 goal of reducing the rate of infant mortality in the US. In Doyle, prematurity rate stands at 12%, a value that is higher than both the state and the national figures, which stand at 5.4 and 9.5 respectively.  He figure is quite high in comparison to the national and the county values, but is lower than the HP2020 baseline level at 12.7%. The HP2020 of lowering the rate of premature births is achievable, according to the statistics. Achievement of low premature births will ensure that infants grow healthy and do not suffer from childhood ailments, such as respiratory diseases.

The cases of low birth weight in Doyle are very high in comparison to the county and the national statistics, which stands at 6.8% and 5.6% respectively. The Doyle low birth weight rate is 10.2%, which is higher than the HP2020 base line of 8.2%. This means that the goal of achieving a lower level of prematurity is a bit difficult for the Doyle community. Prematurity can cause health challenges to infants as they grow up since they have low immunity to various kinds of diseases.

In Doyle, the rate of the Very Low Birth Weight is at 2%, which is lower than the state’s value at 4.9% and the national value at 4.8%. The value in Doyle is higher that the HP2020 base line value at 1.2%, which means the goals of lowering the rate of very low birth rate, was not achievable. Very low birth weight increases the infant mortality rate in Doyle and the nation as a whole.

The analysis table shows a trend in which the rates of, infant mortality, low birth weight, and very low birth weight are higher than the HP2020 baselines and the goals. The aim of the HP 2020 goals is to reduce the mentioned rates but their values are higher in Doyle compared to the values on the base line.  However, the rates of maternal mortality and the prematurity are lower than the values set on the HP2020 base line.

The health indicator that needs improvement is the low birth rate. The rationale for the need to improve on measures to reduce low birth rates in Doyle is due to the health risks experienced by the low birth weight infants.  Reduction of low birth weight in infants will help the infant to develop immunity that helps to fight the childhood ailments. The reduction of the low birth weight will reduce the cost in terms of the incubation fees in the hospital and any further cost related to low birth weight complications (Frioux, Wood, Fakeye, Luan, Localio & Rubin, 2014).

There are a number of programs to address the LBW and the other indicators in Doyle and other states in the US. Some of the programs are Maternal and Child Health Program, the Epidemiology Program, Research on the Preterm Birth Program, and improving the National Reporting of the Sunken Infant Syndromes (SIDs) (Thompson, Black, Esernio-Jennsen, Hardt, Das & Roth, 2012).

Conclusion

There are very many maternal child indicators in Lassen especially in Doyle community, such as maternal mortality rates.  The rates are higher in many cases compared to the HP2020 baselines and goals, though it is possible to reduce them to manageable levels. There are also some disparities in the maternal child health indicators based on the community or the race of origin. There is the need to improve on the low birth weight indicator to assist the infants live a healthy life.  There are programs to help lower the levels of the indicators, which help to reduce the percentage levels on the indicators in the community and the state.

References

Frioux, S., Wood, J., Fakeye, O., Luan, X., Localio, R., & Rubin, D. (2014). Longitudinal Association of County-Level Economic Indicators and Child Maltreatment Incidents. Matern Child Health J, 18(9), 2202-2208. doi:10.1007/s10995-014-1469-0

Thompson, E., Thompson, L., Black, E., Esernio-Jenssen, D., Hardt, N., Das, R., & Roth, J. (2012). Identifying Indicators During Pregnancy for Child Maltreatment. Matern Child Health J, 17(10), 1817-1824.

Short, V., Oza-Frank, R., & Conrey, E. (2012). Preconception Health Indicators: A Comparison Between Non-Appalachian and Appalachian Women. Matern Child Health J, 16(S2), 238-249. doi:10.1007/s10995-012-1129-1

U.S. Department of Health and Human Services.Office of Disease Prevention and Health Promotion.Healthy People 2020. Washington, DC. Retrieved from http://www.healthypeople.gov

Zotti, M., Williams, A., & Wako, E. (2014). Post-disaster Health Indicators for Pregnant and Postpartum Women and Infants. Matern Child Health J. doi:10.1007/s10995-014-1643-4

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