This report presents findings of a study tour organized by the French-American Foundation, for 13 United States' health care professionals to examine and interpret the nearly 50-year-old French maternal and child health care system, Protection maternelle et infantile (PMI). Chapter 1 describes the operation of PMI and the possibility of similar achievements in the United States. Chapter 2 discusses how maternal and child health are accorded national priority through the creation of four universal partnerships between society and families: health insurance, family allowances, paid maternity leaves, and child care and education. Chapter 3 illustrates the operation of the PMI in two regions in France which, although contrasting in local cultures and politics, are dedicated to the national mission. Chapter 4 describes the responsibility of French employers as partners in ensuring the health and well-being of mothers. It also describes the development of the PMI and the changes in its philosophy over the years. Chapter 5 discusses how PMI agencies identify and assess conditions that pose risks to maternal and child health. Chapter 6 explores home visits offered by PMI agencies to families living with social and medical risks that may endanger a woman's pregnancy or the health of a newborn or young child. Chapter 7 discusses the diverse services and activities offered by a PMI center, ranging from free preventive health care and advice and counseling for parents, to nutrition classes for mothers, and play sessions and summer programs for children. Chapter 8 describes one of PMI's newest responsibilities, to help integrate children with special needs into child care settings. The final chapter examines the strategies employed by the PMI in the four arenas of health promotion--clinic, community, work place, and home--to encourage and ensure private responsibility. (BAC)
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