Our legacy for leadership in MCH

The history of Maternal and Child Health (MCH) in the United States provides some important lessons for us today. Emerging from the child labor abolition and progressive reform movements of the late 1800s, the basis of MCH in the United States can be traced to fundamental concerns regarding how our society should protect children from a host of threats, including abuse, the adverse practices of childhood labor, disease, and the ill effects of unclean milk and water, poor sanitation, and an unsafe environment. These and additional concerns about how to assure that children and families have access to adequate healthcare and to health and social systems that understand the special developmental needs of children persist to this day. A review of the history of MCH fosters an appreciation of the many accomplishments made by early MCH leaders during some very difficult times in this country. Today, with the advent of war and an unclear economic forecast, to say nothing of continuing health care reforms and the reinvention of the roles and purposes of public health, it may offer modest comfort to know that our predecessors faced grim circumstances too and prevailed. As MCH continues to evolve in response to the major social events of the times, there is an ongoing need to revisit and reflect upon the role and purpose of MCH in the society. Our inherited legacy of leadership in MCH both inspires and challenges us as we strive to responsibly advocate, align constituencies, build and use data capacities for need assessment and evaluation, question our premises, identify and courageously confront pressing health and social issues, and continue our efforts to formulate and articulate a vision for the future of MCH.