women and children can receive multiple health and/or social services at one site" (p. 6),1

  • the integration of a well-designed, patient-carried health diary into the delivery of services, and

  • the development and integration of computer-based patient records and systems.2

The second approach appears to be relatively easy to achieve; implementation of the other two would require greater commitment and effort, but it is reasonable to expect that such efforts would result in substantial improvements in care. Although these three approaches are intended to improve many aspects of overall health care, they may be especially useful in facilitating the improved delivery of nutrition services in support of maternal and infant health.


The coordination of health care services, food assistance, and social services can promote continuity of care and improve the integration of nutrition services into the care of pregnant and postpartum women. In 1986, the U.S. Departments of Health and Human Services (DHHS) and of Agriculture jointly sponsored a study of coordination between the Maternal and Child Health (MCH) Program of DHHS and the Special Supplemental Food Program for Women, Infants, and Children (WIC). The study concluded that coordinated care has the following objectives:

  • a well developed referral system among the providers for each program

  • the transfer of needed information between providers on an anticipatory basis

  • avoidance of unnecessary duplication of functions between MCH and WIC programs, such as blood and anthropometric measurements

  • the scheduling of services and different aspects of care such that they contribute to, rather than interfere with, the services and care being delivered in another program

  • the design, content, and delivery of nutrition-related education components which do not contradict those delivered by another program serving the same patient

  • improved case management, continuity of care and follow-up of shared clients (p. ii).3

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