Probable future funding priorities in maternal and child health: a modified Delphi National Survey.

ABSTRACT

PIP: Recent enactment of program consolidation block grants proposed by the Reagan administration has left many observers of public health services wondering about the impact. This study 1st presents predictions about the future of 23 specific Maternal-Child Health (MCH) services, and then examines the implications of these predictions for future public health. The predictions were gathered in 1981-2 by means of a Delphi National Survey, a method of seeking consensus among homogeneous groups of experts by aggregating the judgments of individuals and then feeding back the results to a participating panel of experts. 5-year forecasts for 23 categorical MCH services were established through 3 Rounds of questions administered to a panel of 83 nationally recognized experts in MCH from across the US. Information was obtained regarding the survival potential of the 23 services, including expected and projected financial support from government and private sources. Given current economic and sociopolitical indications, several potential future gaps in services for parents and children were indicated. Main areas of concern include declining health care for youth, specifically school programs and adolescent health services, and the lack of commitment to preventive health in the MCH field. If born out by future events, severe gaps in preventive services to mothers and children will occur. A need for state level consideration of private funding sources in their fiscal planning of preventive programs is strongly suggested. Such planning would include close examination of the question of cost-effective primary prevention programs versus less cost-effective secondary and tertiary treatment programs in the long run.