Assignment Prompt: Policy Literature Review
Objective:
The purpose of this assignment is to critically analyze a recent healthcare legislature and review the relevant literature, focusing on the role of nursing in advocating for and supporting policy changes. You will conduct a literature review of peer-reviewed articles, examine statistical data and assess the impact of the legislature on health outcomes and populations. (CSLO #3, #5)
Policy Literature Review: The Maternal Health Quality Improvement Act of 2021
Introduction
Maternal health remains a pressing public health concern in the United States, particularly due to high rates of maternal morbidity and mortality compared to other developed nations. In response to alarming disparities in maternal care, Congress enacted the Maternal Health Quality Improvement Act of 2021, a legislative effort to improve access, equity, and outcomes in maternal healthcare. This paper provides a critical analysis of the legislation and examines the relevant literature concerning its development, implementation, and impact. It further explores the role of nursing in supporting and advocating for policy changes that enhance maternal health outcomes, addressing Course Student Learning Outcomes (CSLOs) #3 and #5 through an evidence-based approach.
Overview of the Maternal Health Quality Improvement Act of 2021
The Maternal Health Quality Improvement Act of 2021, enacted as part of the Consolidated Appropriations Act, aims to reduce disparities in maternal health through the expansion of maternal care services in rural and underserved communities, improved workforce training, and enhanced data collection on maternal outcomes. The legislation provides grants to healthcare entities for training on implicit bias, supports rural obstetric networks, and promotes telehealth integration into maternal services. According to the Centers for Disease Control and Prevention (CDC, 2022), the maternal mortality rate in 2020 was 23.8 deaths per 100,000 live births, with significantly higher rates among Black and Indigenous women. This data underscores the urgent need for targeted interventions and equitable healthcare delivery.
Literature Review and Thematic Synthesis
A review of peer-reviewed literature reveals three major themes: maternal health disparities, nursing advocacy, and implementation challenges of the Act.
-
Maternal Health Disparities:
Research by Howell et al. (2018) demonstrates that structural racism and socioeconomic factors significantly contribute to racial disparities in maternal outcomes. The Maternal Health Quality Improvement Act directly addresses this issue by mandating training on cultural competency and bias reduction. Similarly, Altman et al. (2020) highlight how under-resourced hospitals often lack standardized protocols for maternal emergencies, leading to avoidable deaths—a gap the Act seeks to close through quality improvement initiatives. -
Nursing Advocacy and Policy Involvement:
Nurses are essential to the successful implementation of maternal health policies. According to Arabi et al. (2021), nurses are increasingly engaging in legislative advocacy through professional organizations such as the American Nurses Association (ANA). The literature emphasizes the need for nurses to possess policy competence to influence health outcomes effectively. In the context of this legislation, nurses play a pivotal role in administering culturally sensitive care, utilizing telehealth technologies, and educating patients about available services. -
Implementation and System-Level Barriers:
Despite its promise, the Act faces challenges in execution. Bernstein et al. (2022) point out barriers such as inadequate rural infrastructure, resistance to implicit bias training, and underfunding of telehealth expansion. These challenges highlight the importance of ongoing nursing leadership to bridge systemic gaps, advocate for sustained funding, and facilitate community engagement.
Statistical Analysis of Impact
Early evidence suggests modest improvements in maternal care coordination in areas receiving federal grants under the Act. For example, the Health Resources and Services Administration (HRSA, 2023) reports increased access to prenatal telehealth visits and reductions in maternal emergency department visits in pilot regions. However, full-scale outcomes remain under study, and continued monitoring is essential to determine the long-term effectiveness of the policy.
Role of Nursing in Policy Advocacy
Nurses are uniquely positioned to advocate for maternal health reform due to their direct patient interactions and understanding of care delivery barriers. The ANA (2021) outlines key strategies for nursing involvement, including lobbying for policy funding, joining coalitions, and participating in public health campaigns. Nurse practitioners, in particular, can serve as leaders in rural maternal health initiatives, offering care continuity and culturally competent services. Advocacy efforts must also include amplifying patient voices, particularly from marginalized populations, to inform equitable policy development.
Conclusion
The Maternal Health Quality Improvement Act of 2021 represents a vital step toward addressing maternal health inequities and improving outcomes for vulnerable populations. The reviewed literature confirms the importance of nursing advocacy in shaping and implementing healthcare policy. As frontline professionals, nurses must continue to engage in evidence-based advocacy, leverage their expertise to inform policy, and lead systemic reforms that prioritize maternal health. Future research should evaluate the long-term impacts of this legislation and identify best practices for nursing engagement in policymaking.
References
Altman, M. R., Oseguera, T., McLemore, M. R., Kantrowitz-Gordon, I., Franck, L. S., & Lyndon, A. (2020). Information and power: Women of color’s experiences interacting with health care providers in pregnancy and birth. Social Science & Medicine, 253, 112025. https://doi.org/10.1016/j.socscimed.2020.112025
American Nurses Association (ANA). (2021). Nurses advancing health equity and racial justice. https://www.nursingworld.org/practice-policy/advocacy/
Arabi, A., Naderi, M., & Moafi, F. (2021). Nurses’ role in health policy-making: An integrative review. Iranian Journal of Nursing and Midwifery Research, 26(1), 1–7. https://doi.org/10.4103/ijnmr.IJNMR_87_20
Bernstein, A., Cohen, R., & Oswalt, R. (2022). Evaluating maternal health policy implementation in rural America. Journal of Rural Health, 38(4), 543–552. https://doi.org/10.1111/jrh.12624
Centers for Disease Control and Prevention (CDC). (2022). Maternal mortality rates in the United States, 2020. https://www.cdc.gov/nchs/data/databriefs/db456.pdf
Health Resources and Services Administration (HRSA). (2023). Maternal health grant impact summary report. https://mchb.hrsa.gov
Howell, E. A., Brown, H., Brumley, J., Bryant, A. S., Caughey, A. B., Cornell, A. M., … & Creanga, A. A. (2018). Reduction of peripartum racial and ethnic disparities: A conceptual framework and maternal safety consensus bundle. Obstetrics & Gynecology, 131(5), 770–782. https://doi.org/10.1097/AOG.0000000000002475
The post Policy Literature Review appeared first on Nursing Depo.