The Greater Washington Research Center's task force on local government is making three recommendations that, if adopted, would significantly reduce the rate of infant mortality in the District of Columbia. They have to do with:
* a program to lower the number of seriously underweight infants born to District residents;
* a program to direct high-risk mothers and infants to hospitals that have the specialized staff and equipment necessary to provide optimal care; and
* the need for improved data-gathering so the impact of various techniques can be more accurately assessed.
The availability of good quality medical treatment will always be necessary to care for those seriously underweight infants who are born. Specialized neonatal intensive care services -- known as tertiary services -- are extremely expensive and require significant patient volume to maintain staff skills and use personnel effectively.
Because the number of high-risk newborns delivered each year in the Washington area is quite small -- in the low hundreds -- it is impossible to attain adequate patient volume to economically maintain specialized neonatal intensive care staff and equipment in each of the 24 metropolitan Washington hospitals. Accordingly, medical services for high-risk mothers and infants must be organized as a regional network so that the high-risk cases can be referred to a few adequately equipped medical centers.
Better and more detailed records should be kept by all hospitals and made available to the public. We need to know the age, race, residence, medical history, height and weight of the mother; the duration of the pregnancy; the weight of the infant; the onset and duration of the prenatal care, and similar matters. Record-keeping has improved from earlier years, but further improvement is necessary if we are to better evaluate the causes of -- and means of -- reducing infant mortality in the District.