“ Infant mortality is not a health problem.
Infant mortality is a social problem
with health consequences.”
– Marsden Wagner JPHP,1988

The Healthy Start Coalition of Miami-Dade Fetal and Infant Mortality Review (FIMR) Project is a countywide effort to better understand the issues associated with fetal and infant mortality and morbidity and to develop strategies that improve perinatal systems of care, locally and statewide.

FIMR began in 1990 as a collaborative effort between the American College of Obstetricians and Gynecologists (ACOG) and the Federal Maternal and Child Health Bureau (MCHB). Since it was first introduced in the late 1980's, FIMR has been a dynamic, community process. FIMR has enjoyed continued growth and refinement as more communities have used it. Today, there are over two hundred FIMR programs.  While the basic methodology is the same in most programs, the specific recipe for actual operation is local. Funding sources vary from community to community. Different types of agencies sponsor the FIMR program including city and county health departments, local hospitals, regional perinatal centers and community based maternal and child health coalitions.

Florida adopted the FIMR model in 1992. The Healthy Start Coalition of Miami-Dade has been contracted by the State of Florida to implement FIMR locally. FIMR of Dade County is one of 12 FIMR projects statewide organized under Florida Statute 766.101 and funded by the State of Florida.

What is FIMR?

FIMR is:

• a strategy to close the gap in health disparities at the community level;
• a timely and valuable source of information about changing health care systems and how they affect real families trying to access them;
• a community coalition that promotes volunteerism and good citizenship and will translate into local accountability;
• a community coalition that can represent all ethnic and cultural views in the community;
• a strategy that improves communication among health and human service providers;
• a form of continuous quality improvement that allows communities to assess the performance of systems and the impact of changes in those systems;
• a voice for local families who have lost their baby;
• a tool that helps local health officials implement policies to safeguard families; and,
• a program endorsed by the American College of Obstetricians and Gynecologists, the March of Dimes Birth Defects Foundation and the federal Maternal and Child Health Bureau.

Who if part of FIMR?

Potential members come from the entire community and include individuals and agency representatives who:

• live in the community and use its resources;
• provide health and human services;
• set policy; and/or,
• rely on the community as a source for workers and a good place to do business.

FIMR is composed of two groups, the Case Review Team (CRT) and the Community Action Group (CAG). A multi-disciplinary team of professionals, the CRT uses unidentified/patient blinded abstracted information from vital records (death and birth certificates), hospitals, clinics, physicians, police, Medical Examiner records and family/maternal interviews. The CAG is comprised of community leaders representing government, consumers, key institutions, health and human services organizations. The members of the CAG work collaboratively with the CRT to implement strategies that will improve fetal and infant outcomes within our community.