DEPARTMENT: Epidemiology
COURSE NUMBER:
EPI 596
BSHE 596, HPM 596, GH 596)
SECTION NUMBER:
SEMESTER: Spring
N/A (also
CREDIT HOURS: 3 (2 hours in-class & 1 hour lab period (TBA))
COURSE TITLE: Foundations of Maternal and Child Health
INSTRUCTOR: Carol J Hogue
Co-instructors: Walter Burnett, Aimee Webb Girard, Jessica Sales
INSTRUCTOR CONTACT INFORMATION
EMAIL: chogue@emory.edu
PHONE: 404-727-8095
SCHOOL ADDRESS OR MAILBOX LOCATION: 3005 CNR
OFFICE HOURS on request
Teaching Assistant: Cassie Gibbs (cmgibbs@emory.edu)
BRIEF COURSE DESCRIPTION
This is the foundational course for the Maternal and Child Health Certificate. Lectures and readings
cover historical and theoretical underpinnings of maternal and child health problems and programs aimed
to reduce morbidity, mortality, and health disparities. Laboratory utilizes a multi-disciplinary team
approach, supervised weekly by a combination of course faculty, field-based faculty, and teaching
assistant. The laboratory reinforces MCH concepts through practical application in program planning
and evaluation in local, state, federal, and non-governmental agencies. Maternal and child health
programs are unique to reproduction and life course development; more common in women, infants,
children, or adolescents; more serious in women, infants, children, or adolescents; or have
manifestations, risk factors, or interventions that are different in women or during life course
development.
ACADEMIC HONOR CODE
The RSPH requires that all material submitted by a student in fulfilling his or her academic course of study must be
the original work of the student.
RSPH COMPETENCIES
This course contributes to the achievement of the RSPH competencies as they related to maternal
and child health. By the end of this course students will be able to
1. Describe environmental conditions, including biological, physical and chemical factors, which affect
the health of individuals, communities and populations
2. Discuss how health policy and finance affects the delivery, quality, access and costs of health care for
individuals, communities and populations
3. Apply skills and knowledge in public health setting(s) through planned and supervised experience(s)
related to professional career objectives
4. Describe behavioral, social and cultural factors that contribute to the health and well being of
individuals, communities and populations
MCH CERTIFICATE COMPETENCIES
Additionally, upon completion of this course, students will have gained the following MCH related skills
and perspectives.
1. Describe in depth the major domestic and international causes of mortality and morbidity within
MCH populations (defined as women and children along a life course trajectory) including
differences between the United States and other countries.
2. Apply methodological and analytical skills in the interpretation of data on the health of MCH
populations in order to detect meaningful findings and translate them into information for program
planning and evaluation.
3. Determine the appropriate use of networking, team building, small group process, advocacy,
negotiation and conflict resolution towards the solution of maternal and child health issues and
problems.
4. Assign a maternal and child health program within the historical and current context of related
programs.
5. Write a clear and concise policy statement, position paper, and/or testimony appropriate for a specific
audience.
6. Conduct ethical practice and research within MCH populations with sensitivity to confidentiality of
information and in culturally appropriate contexts.
LIST LEARNING OBJECTIVES ASSOCIATED WITH THE COMPETENCIES
Learning objectives for this course are keyed to the Association of Teachers of Maternal and Child Health
(ATMCH)Competencies (http://www.atmch.org/documents/mchcomps.PDF)
1. Learn the scientific and historical basis for MCH programs (ATMCH competencies: A1, A2, A9, D1,
D2, D5, D9)
2. Develop key management and communication skills (ATMCH competencies: C4, C5, C6, C10, C11)
3. Develop key policy and advocacy skills (ATMCH competencies D10, D11, D12, D13, D14)
4. Learn and practice skills through ethical public health practice (ATMCH competencies: E1, E2, E3,
E4, E5, E6)
EPI596 Foundations in Maternal and Child Health
Spring 2013 Schedule (subject to change)
In-class schedule
Friday, 8 – 9:50am
Date
1/18
Topic
Introduction &
Ethics
Guest Speaker / Class Activity
Hr1: Introductions, Syllabus
review, Assignments review
Hr2: Gibbs: Ethics case study and
discussion
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
1/25
Project
Introductions
2/1
Intro to MCH -Domestic Policy
HR1: Organization 1 and 2
HR2: Organization 3 and 4
HR 1 and 2: C. Hogue: History of
MCH in the US; Scavenger Hunt
Discussion
Readings
Three Vexing Cases in Healthcare Ethics: Case 8.
From: Capper, et al.
Mann, Johnathan M. Medicine and public health
ethics and human rights. Hastings Center Report.
May-June 1997, pages 6-13.
Dickens & Cook. Reproductive health and public
health ethics. Int J Gyn Obstet. 2007;99(1): 75-79
Walker M. International breastfeeding initiatives and
their relevance to the current state of breastfeeding
in the United States. J Midwifery Womens Health.
2007 Nov-Dec;52(6):549-55.
WHO/UNAIDS/UNICEF breastfeeding guidelines (see
Blackboard [BB] for link)
Please read one of the following (your choice)—see
BB for links:
a) Global strategy for infant and young child feeding
b) the Innocenti Declaration
c)Code for marketing breastmilk substitute
d) Baby Friendly Health Initiative –US website
Organization assigned readings / websites – field faculty
introductions (see Blackboard for links to the
organizations’ websites)
 Hogue C. Maternal and child health. Chapter 26 In:
Principles of Public Health Practice
 Peoples-Sheps MD, Alexander GR. Introduction to
the Delta Omega Public Health Classic entitled
“Landmark Federal MCH Legislation.” 3 pages (or
Assignments / Notes
Preclass Asst: Pretend you are a
member of the Institutional Ethics
Committee of the hospital and
that you are tasked with
reviewing these 3 cases. What
would be your recommendations
regarding the "morally justifiable
course of action" to Mr. Blackwell
and the hospital managers?
Assignment 1 Handed out and
Reviewed
Preclass Activity: Complete
scavenger hunt ahead of class
(due at 8 am on Friday, Feb. 1)
Preclass assignment: Describe a



2/8
2/15
Intro to MCH –
global MCH
Intro to MCH –
global MCH
HR 1: Webb Girard: Global MCH:
priorities and progress
HR 2: GH case studies – students
will be randomly selected to give a
5 minute summary report on one
of the four countries.
HR1-2: Team presentations and
discussion of GH case studies




2/22
Team projects
HR1: Team 1 and 2
HR2: Team 3 and 4
Team order will be randomly
selected
3/1
MCH theory to
practice
Sales: MCH theory
Sales: Logic models / Activity –
students work on logic model
entire landmark legislation?)
Alexander GR. Our legacy for leadership in MCH.
MCH Journal 2003;7:145-150.
Explore the website
http://mchb.hrsa.gov/timeline/resources.htm
Additional individual reading corresponding to preclass assignment: to be announced
specific, small portion of the
landmark legislation that is
assigned to you (post on BB at 8
am on Friday, Feb. 1). Each
student will do this individually.
See rubric.
Hulme, D. (2009) The Millennium Development
Goals (MDGs): A Short History of the World’s Biggest
Promise.
“World Health Organization and UNICEF (2012)
Countdown to 2015. Building a Future for Women
and Children: The 2012 Report.”
“World Health Organization and UNICEF (2012)
Countdown to 2015. Building a Future for Women
and Children: The 2012 Report.”
The Partnership for Maternal, Newborn & Child
Health (PMNCH). Analysing commitments to
advance the global strategy for women’s and
children’s health. The PMNCH report. 2011 (pg 147)
Pre-class activity: Using the
countdown document and
methodology described within,
conduct a MCH situational
assessment for Haiti, Guatemala,
Nigeria and India.
Preclass activity: student teams
prepare case study presentation
(additional details will be given
during the 2/8 class)
Feb 18th 5pm -- Asst 1 posted on
BB
Feb 20th noon – Critiques due
Feb 22nd –presentations
Assignment 2: Handed out and
Reviewed in class


Fraser MR. Bringing it All Together: Effective
Maternal and Child Health Practice as a Means to
Improve Public Health. Matern Child Health J. 2012
Jun 22.
Grason H and Misra D. 2006. Application of a
Lifecourse and Multiple Determinants Framework to

3/8
MCH theory to
practice
Aubel or Webb Girard:
Intergenerational models for MCH
Sales: Gender and Empowerment

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

Improve Maternal Health. Baltimore, MD
Thurston, WE.; Vissandjée, B. An ecological model
for understanding culture as a determinant of
women's health. Critical Public Health. Sep. 2005,
Vol. 15 Issue 3, p229-242.
Wingood GM, DiClemente RJ. Application of the
theory of gender and power to examine HIV-related
exposures, risk factors, and effective interventions
for women. Health Educ Behav. 2000 Oct;27(5):53965. Review.
Aubel J. The role and influence of grandmothers on
child nutrition: culturally designated advisors and
caregivers. Matern Child Nutr. 2012 Jan;8(1):19-35.
Our Whole Lives (OWL) website
Grandmother project website (GMP website)
Please read one of the below readings (your choice):
a) Wingood GM, DiClemente RJ. The effects of an
abusive fprimary partner on the condom use and
sexual negotiation practices of African-American
women. Am J Public Health. 1997 Jun;87(6):1016-8.
b) DePadilla L, Windle M, Wingood G, Cooper H,
DiClemente R. Condom use among young women:
modeling the theory of gender and power. Health
Psychol. 2011 May;30(3):310-9.
c) Aubel J, Touré I, Diagne M. Senegalese
grandmothers promote improved maternal and
child nutrition practices: the guardians of tradition
are not averse to change. Soc Sci Med. 2004
Sep;59(5):945-59.
d) Musoko AS, Scoppa C, Manoncourt E. Girls and
Grandmothers Hand-in-Hand: Dialogue between
Generations for Community Change. The
Preclass Activity: Choose one of
the four “recommended” articles
provided; read and come
prepared with questions for the
guest speakers.
Review the OWL (Our Whole
Lives) website or the GMP
(Grandmother Project) website.
See Blackboard for links.
Grandmother Project. 2012. Rome, Italy. Pages 1-68.

3/15
3/22
3/29
SPRING BREAK
Team Presentations
HR 1 and 2: Team presentations of
logic model
Data for decision
making: Application
HR1: Hogue: Intro to surveillance
systems, international data and
electronic records
HR2: Theresa Chapple-McGruder: Uses
of data for decision making for Title V
Assignment 2 Due to BB at 8am
Assignment 3: Handed out and
discussed
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



4/5
Quality
Improvement and
Evidence Based
Policy Making
HR1: Burnett: Quality from a policy
perspective
HR2: Discuss Ehernthal and
Youngleson studies (Students will be
randomly selected to present their
responses in class.)


Wilkins K, et al. The data for decision making
project: assessment of surveillance systems in
developing countries to improve access to public
health information. Public Health 2008;122:914922.
McGraw D, et al. A policy framework for public
health uses of electronic health data.
Pharmacoepidemiology and Drug Safety
2012;21(S1):18-22.
Maternal and Child Health Services Title V Block
Grant. State Narrative for Georgia. Application for
2013, Annual Report for 2011. Optional reading
(see pages 45-59).
Commission on Information and Accountability for
Women's and Children's Health. Keeping
promises, measuring results. World Health
Organization. 2011. Required to read the
Executive Summary (pp. 3-5).
Chapple-McGruder T, Zhou Y, Freymann G, et al.
From preconception to infant protection. Georgia
Department of Public Health, Maternal and Child
Health Program, Office of Epidemiology. Atlanta,
GA: March 2012.
Chassin, Mark R. and Jerod Loeb. "The Ongoing
Quality Improvement Journey: Next Stop. High
Reliability" HEALTH AFFAIRS. April 2011. pp. 559568.
Donabedian, A. "Evaluating the Quality of Medical
Care." The Milbank Quarterly, Vol. 83, No. 4, 2005
Pre class activity: Students will
read Ehernthal and Youngleson
studies and answer the
following questions for each
study
(pp. 691-729).
Ehrenthal DB, et al. Neonatal outcomes after
implementation of guidelines limiting elective
delivery before 39 weeks of gestation. Obstet
Gynecol 2011;118:1047-1055.
 Youngleson MS, et al. Improving a mother to child
HIV transmission programme through health
system redesign: quality improvement, protocol
adjustment and resource addition. PLoS One
23010 5(11): e13891. Doi:10.1371
None

4/12
Team Presentations
HR1: Group 1 and 2
HR2: Group 3 and 4
4/19
Policy and Advocacy
Guest speakers


4/26
TBD -- OPEN
Final
Exam
Day
(TBD)
Team Presentations
1. How solid is the research?
2. What strategies would you
see as most effective for
translating the conclusions into
best practices?
Assignment 3 Due to BB at 8am
Assignment 4: Handed out and
discussed
Shiffman & Smith. 2007. Generation of political
priority for global health initiatives: a framework
and case study of maternal mortality. Lancet
370:1370-1379
Sardwell, 1990. Child Health Policy in the US: The
paradox of consensus. J Health Politics, Policy, and
Law. 15(2): 271-304
OPEN
Last 20 minutes: In class completion of
evaluation
HR1: Group 1 and 2
HR2: Group 3 and 4
Lunch with partners
Assignment 4 Due to BB at 8am
on presentation day
Laboratory Schedule (Times TBD with each group)
Projects are community-based, with extensive contact outside class in the community and with the designated agencies for whom
the project teams are working. The four teams, comprised of students from each discipline (i.e., Epidemiology, Behavioral Sciences,
Health Policy, Global Health, Environmental Health) will meet weekly with their in-house faculty advisory, the teaching assistant,
and/or their field faculty advisor. Community hours will vary from week to week, with a minimum number of 30 expected
community-based hours outside of laboratory hours. Teams will track both laboratory and community-based effort.
Note that 10% of your final grade will be from peer evaluations of your contribution to the semester-long project. We will average
the scores provided about you by each peer in your group. This peer evaluation can have a large effect on your final letter grade—in
fact, it did for some students this past semester.
Spring 2013 projects are as follows: 1) Needs assessment for distance-based reproductive health services in 3 rural counties of
Western North Carolina (Dr. Burnett, faculty; Dr. Lynn Hogue, field-based faculty). 2) Planning for “Askable Adults” for child
nutrition promotion in the HEALing Community, Northwest Atlanta (Dr. Webb Girard, faculty; Dr. Charles Moore, field-based
faculty). 3) Evaluation of the Baby LUV prenatal support program in Lowndes County, Georgia (Dr. Carol Hogue, faculty; Dr. Theresa
Chapple-McGruder, field-based faculty). 4) Needs assessment for the Baby Friendly (breastfeeding promotion in hospitals) Program
(Dr. Sales, faculty; Dr. Theresa Chapple-McGruder, field-based faculty).
Evaluation
Grades for the course will be assigned as follows:
Assignment
Class Participation
Stating the problem presentation (Assignment 1)
Study design/ logic model assignment (Assignment
2)
Analysis / metrics assignment (Assignment 3)
Final written report (Assignment 4, Part 1)
Final Presentation (Assignment 4, Part 2)
Group’s average grade for you (that is, how your
group evaluates your contribution)
Points
10
15
15
15
25
10
10
TOTAL
POINTS
= 100
Individual (I) or
Group (G)
I*
G
G
G
G
G
I
Grade Distribution
95.0-100% = A
90.0-94.9% = A87.0-89.9% = B+
83-86.9% = B
80.0-82.9% = B77.0-79.9% = C+
74.0-76.9% = C
70.0-73.9%= C*Individual participation grades will be determined as follows:
2 of 10 points: Executive summary of landmark legislation (due 2/1)
1 of 10 points: Scavenger hunt (due 2/1)
2 of 10 points: Group presentation on WHO/UNICEF (due 2/15)
5 of 10 points: participation in class discussions about readings