The fetal and infant mortality review (FIMR) process is a community-oriented strategy focused on improving the health services systems for pregnant persons, infants, and their families. FIMR helps communities to understand and change systems that contribute to racial disparities in birth outcomes. FIMR equally values the medical and social services delivery records and the personal narratives of families who have suffered a fetal or infant loss when creating the de-identified case summaries to be reviewed by teams. A two-tiered process, FIMR uses a multidisciplinary Case Review Team (CRT) as the information processor and the Community Action Team (CAT) as the action arm of the process. Pediatricians are vital to both teams, helping to bring about systems change to improve maternal and child health. This paper examines how the well-established FIMR team serving Indianapolis (Marion County, IN) worked to build the capacity of its CAT to address racial disparities in birth outcomes through 5 distinct steps: focus on the primary causes of local fetal or infant mortality, focus on neighborhoods with the highest stable fetal or infant mortality rates, designation of a CAT leader, creation of a culture of regular CAT meetings inclusive of a health-equity skill building curriculum, and inclusion of Grassroots Maternal and Child Health Leaders on the CAT. This paper demonstrates how the synergy between local organizations and community members can effectively address racial disparities in birth outcomes.

中文翻译：

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利用胎儿和婴儿死亡率审查 （FIMR） 流程促进健康公平。


胎儿和婴儿死亡率审查 （FIMR） 流程是一项以社区为导向的策略，专注于改善孕妇、婴儿及其家庭的卫生服务系统。FIMR 帮助社区了解和改变导致出生结果种族差异的系统。FIMR 在创建供团队审查的去识别化病例摘要时，同样重视医疗和社会服务提供记录以及遭受胎儿或婴儿损失的家庭的个人叙述。FIMR 是一个两级流程，使用多学科案例审核小组 （CRT） 作为信息处理者，使用社区行动小组 （CAT） 作为流程的行动部门。儿科医生对这两个团队都至关重要，他们帮助实现系统变革以改善孕产妇和儿童健康。本文研究了服务于印第安纳波利斯（印第安纳州马里恩县）的成熟 FIMR 团队如何通过 5 个不同的步骤努力建设其 CAT 解决出生结果种族差异的能力：关注当地胎儿或婴儿死亡的主要原因，关注胎儿或婴儿死亡率稳定的社区，指定 CAT 领导者， 创造一种定期 CAT 会议的文化，包括健康公平技能建设课程，并将基层妇幼健康领导者纳入 CAT。本文展示了地方组织和社区成员之间的协同作用如何有效解决出生结果中的种族差异。