title: An urban perinatal health programme of strategies to improve perinatal health.
abstract: Promotion of a healthy pregnancy is a top priority of the health care policy in many European countries. Perinatal mortality is an important indicator of the success of this policy. Recently, it was shown that the Netherlands has relatively high perinatal death rates when compared to other European countries. This is in particular true for large cities where perinatal mortality rates are 20-50% higher than elsewhere. Consequently in the Netherlands, there is heated debate on how to tackle these problems. Without the introduction of measures throughout the entire perinatal health care chain, pregnancy outcomes are difficult to improve. With the support of health care professionals, the City of Rotterdam and the Erasmus University Medical Centre have taken the initiative to develop an urban perinatal health programme called 'Ready for a Baby'. The main objective of this municipal 10-year programme is to improve perinatal health and to reduce perinatal mortality in all districts to at least the current national average of l0 per 1000. Key elements are the understanding of the mechanisms of the large health differences between women living in deprived and non-deprived urban areas. Risk guided care, orientation towards shared-care and improvement of collaborations between health care professionals shapes the interventions that are being developed. Major attention is given to the development of methods to improve risk-selection before and during pregnancy and methods to reach low-educated and immigrant groups.
authors.affiliation: Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. s.denktas@erasmusmc.nl
authors.forename: S
authors.initials: S
authors.lastname: Denktaş
authors.forename: G J
authors.initials: GJ
authors.lastname: Bonsel
authors.forename: E J
authors.initials: EJ
authors.lastname: Van der Weg
authors.forename: A J J
authors.initials: AJ
authors.lastname: Voorham
authors.forename: H W
authors.initials: HW
authors.lastname: Torij
authors.forename: J P
authors.initials: JP
authors.lastname: De Graaf
authors.forename: H I J
authors.initials: HI
authors.lastname: Wildschut
authors.forename: I A
authors.initials: IA
authors.lastname: Peters
authors.forename: E
authors.initials: E
authors.lastname: Birnie
authors.forename: E A P
authors.initials: EA
authors.lastname: Steegers
mesh_terms: D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000379:methods*; D054625:Healthcare Disparities; D006801:Humans; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D018743:Perinatal Care / Q000379:methods* / Q000592:standards*; D054238:Perinatal Mortality / Q000208:ethnology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D016730:Program Development; D012307:Risk Factors; D014504:Urban Health; D014505:Urban Population