DESPITE THE usual number of blue-ribbon panels, campaigns and assorted gimmicks, the District's infant mortality rate has not been improved. Among cities, only Indianapolis has a higher rate of black infant deaths. Among states, D.C. ranked 49th in the number of women who received late prenatal care or none. The problem most assuredly is not that nothing can be done.
Consider the example of Mississippi. Gains have been made there in lowering what was once the nation's highest infant mortality rate. Some of the methods used could certainly be tried here. First, state health officials formed partnerships with private obstetricians. They were urged to accept "high risk" poor pregnant women as patients and given authority to perform deliveries in state and local clinics. Now, about 70 of the state's 120 obstetricians are involved in the program.
In the District, too many poor pregnant women are still unaware of their options. Women who do use city clinics and qualify for free care are still repeatedly sent bills. The wait for a prenatal care appointment is eight weeks. In Mississippi, state health officials made a financial commitment to hire enough health-care workers to provide prenatal care within two weeks of the request for it, and -- if complications arise -- within 24 hours.
Mississippi officials say that poor women, regardless of extensive campaigns in the media, need direct contact to know that help is available. If a pregnant woman misses a prenatal care appointment there, she is called the same day to set up a new one. If that doesn't work, she gets a visit from a health-care worker. If that can be done in rural Mississippi, where the distances between clinics and patients can involve many miles, it can certainly be done in the District.
These efforts have resulted in a steady decrease in the infant mortality rate in Mississippi. Of the state's newborn children last year, 10 percent had a better chance of reaching their first birthday because of the care they received. That suggests that District health-care efforts can improve with partnerships with doctors and more direct and routine contact with pregnant women.