Unique among all health outcomes, the death of an infant has always been viewed as a sentinel event that serves as a measure of a community’s overall social and economic well-being as well as its health. It is also a measure of the organization and abilities of its local health and human services and the robustness of community resources. Often the causes of infant deaths leave families and communities with few answers and asking: “Can anything be done to make a difference in the future?”

Fetal and Infant Mortality Review Can Make a Difference.

Fetal and Infant Mortality Review (FIMR) is a community-owned, action-oriented process that results in improved service systems and resources for women, infants and families.

The FIMR process brings a community team together to examine confidential, de-identified cases of infant deaths. The purpose of these reviews is to understand how a wide array of local social, economic, public health, educational, environmental and safety issues relate to the tragedy of infant loss.

Having gained a comprehensive understanding of these issues from the case reviews, a broad forum of interested community members- leaders, elected officials, providers, agencies, advocates and consumers- are able to reason together and act to improve services and resources.

The project is headed by Healthy Mothers, Healthy Babies of Broward and is generously funded by the Children’s Service Council as well as the Broward Healthy Start Coalition. The Fetal and Infant Mortality Review Project is a true community collaboration. The Broward County Health Department and Broward County Medical Association have collaborated with the FIMR project since its inception. All Broward delivery hospitals have facilitated the review process through access to records. The Case Review Team devotes many in kind hours annually and represents both private and public medical institutions as well as local universities. The Community Action Group (CAG) translates the Case Review Team recommendations into action and participates in implementing interventions designed to address the identified problems.

Together, this collaboration serves to promote the health of women, infants and families in our community.

Based on the success of the Broward FIMR program, HMHB of Broward will also lead the FIMR/HIV Prevention Methodology project in 2010 which is a national collaborative project by Centers for Disease Control and Prevention (CDC), CityMatCH, American College of Obstetricians and Gynecologists (ACOG) and the National Fetal and Infant Mortality Review Program (NFIMR). Partnering with Children’s Diagnostic and Treatment Center and Broward County Health Department, this program will examine HIV exposed infant/fetus ≥ 24 weeks gestation and < 24 months of age using the FIMR methodology. The review of existing perinatal HIV and disease surveillance programs will identify missed cases and opportunities for system change and also coordinate efforts for sustainability. As service systems and resources continue to improve through all FIMR, the future for Broward County’s women, infants and families will be healthier.

“FIMR is the most fulfilling, interesting, satisfying, frustrating and important work that I have engaged in. Beyond selfish self growth, I firmly believe and have seen the changes in... systems that have been directly influenced by our team.”

- John E. Wright, MD Pediatrician and FIMR Case Review Team Leader Broward County, Florida