The purpose of this study was to identify unique practices underway in communities that have been empirically identified as having achieved exceptional maternal and child health (MCH) outcomes compared with their peers.
We used a qualitative, positive deviance approach to identify practices implemented by local health department (LHD) jurisdictions in Florida, Washington, and New York that achieved better MCH outcomes than expected compared with their in-state peer jurisdictions. We identified a total of 50 LHDs in jurisdictions that had better than expected MCH outcomes compared with their peers, and we conducted 39 hour-long semistructured interviews with LHD staff. We conducted inductive thematic analysis to identify key themes and subthemes across all LHD cases in the sample.
Partnerships with providers, partnerships for data collection/assessment, and partnerships with community-based organizations were associated with exceptional MCH outcomes based on our interviews.
This study offers specific examples of practices LHDs can implement to improve MCH outcomes, even with limited resources, based on the practices of high-performing local health jurisdictions.
This study identifies the unique, and otherwise poorly understood, practices underway in communities that have been empirically identified as having achieved particularly exceptional maternal and child health outcomes.
Mayes College of Healthcare Business and Policy, Department of Health Policy and Public Health (Dr Klaiman and Ms Chainani), University of the Sciences in Philadelphia, Philadelphia, Pennsylvania; and School of Public Health and School of Nursing, University of Washington, Seattle, Washington (Dr Bekemeier).
Correspondence: Tamar Klaiman, PhD, MPH, Department of Health Policy and Public Health, University of the Sciences in Philadelphia, 600 S. 43rd St, Box 22, Philadelphia, PA 19104 (firstname.lastname@example.org).
Support for this publication was provided by the Robert Wood Johnson Foundation through the National Coordinating Center for Public Health Services and Systems Research (#71595).
The authors declare no conflicts of interest.