Effects of the US HealthCare System

Problem Statement

The US hospitals and the healthcare system have increased their efforts toward enduring that women have pregnancies that are safe and positive health outcomes through a care continuum. While the healthcare system strives to ensure that patient-centered care is achieved at the highest level, women in rural areas still experience unique challenges. For women living in rural areas, accessing comprehensive obstetric and maternal care services is a challenge. In 2014, studies showed that 54 percent of rural counties did not have hospital-based obstetric services. This was a 9 percent increase over ten years. Additionally, the closure of rural hospitals was disproportionate compared to urban hospitals, impacting maternal health services, especially Black women.

Project Description

The proposed change is the introduction of a voluntary program that will reduce infant mortality rate, reduce the incidences of babies born with low birth weight, and improve babies’ developmental and health outcomes. A screening tool will be used in identifying infants and pregnant women in rural Florida, who are at risk of adverse health outcomes. The services will be offered free of charge to babies aged three years and below and pregnant women. The services offered will include women’s health support and education. Counseling services for pregnant women and mothers to toddlers, drugs and tobacco-free support and education, parenting support and education, breastfeeding support and education, and childbirth education.

The staff at the agency will need to be trained on the importance of having such a program. The Kurt Levin’s change model will be used to implement the change. The first week of the project will be dedicated to the unfreezing stage of the process, two weeks for introducing the change, and one week for the re-freezing stage.

The nursing staff will be taught the basics of maternal and baby care. The team will be equipped to handle patient’s issues regarding childbirth education, breastfeeding, support, parenting, tobacco, and drug use education, counseling, and women’s health education. The nursing staff will be taught by nutritional experts, the chief midwife at the healthcare facility, and senior staff from the finance department. The finance staff will focus on enlightening the trainees on the cost of maternal and child death associated with lack of healthcare access and how these costs impact the community and healthcare system in general and the healthcare facility in particular.

The post-implementation evaluation will be done four weeks after the conclusion of the project. Trained staff will be asked to fill a questionnaire to determine compliance with the new changes. Any team that needs re-training will also get an opportunity to request the same. Patient feedback will also be collected. With every maternal and child visit, the patient will be asked to give feedback k on their experience and give any recommendations.

Supporting Evidence

In the years between 210 and 2016, the population of those living in the rural areas decreased by 200,000. The exodus resulted in increased financial pressure on hospitals in rural areas, which began to fail at a record rate. The National Rural Hospital Association pointed out that, forever three hospitals in the rural areas, one was facing a financial crisis. The association also projected that by 2026, more than 25 percent of the rural hospitals would have closed business. Small hospitals have small profit margins and fixed operational costs, and hence when the population declines, it dramatically impacts business to the point of the financial crisis and even closure.

In the US, most healthcare deliveries take place in hospital settings. The accelerated rate of obstetric closures in rural areas and the patient’s low volume and challenges with staffing have been cited as the reasons behind these closures. These factors and the result have placed a significant burden on reproductive-age women who live in these areas. The loss of obstetric services in hospitals has been linked with a decline in prenatal care, an increase in pre-term births and out-of-hospital births, high infant mortality, and low birth weight.


This project’s stakeholders are the pregnant women living in rural Florida and children aged three years and below. Pregnant women will receive education concerning their health and that of the baby during and after birth. The Federal government will also be involved as funding will be sourced from the department of health.

According to Bolin (2015), the authors pointed out that the rural health priorities had changed over the last decade. According to Healthy People 2020s (HP2020), accessing healthcare has remained a priority regarding rural health. Additionally, maternal infant and child health was cited among the top ten rural health priorities.

In their research, Douthit et al., (2015) note that barriers to access to healthcare services in rural areas impact the health outcomes of the rural populace. The authors added that improvement needs to be made and specific for the individual needs of rural people. For a rural reform to be effective, it calls for local communities to collaborate. The researchers concluded a need for the rural communities’ needs to be represented effectively at the national and state levels.

Lastly, Kruk et al., (2016) stated that close to 66 percent of the global population would, by 2050, be living in urban areas, according to the UN. By 2030, the projected numbers would increase by 52 percent. Pregnant women tend to benefit from urbanization, including reducing the time they spend traveling to the healthcare facility and a higher patient to provider ratio. However, the gap between the rich and the poor can increase in urban areas. Farther most families that move to urban areas move to the slums or low-grade housing where the health status and healthcare quality is poor. Hence, rural healthcare facilities need to be equipped and financed sufficiently enough to discourage urban migration.


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