St. Louis Children’s Hospital executive studies birth outcomes in Kenya, Sweden
Posted By: St. Louis Children's Hospital 
Date Posted: January 9th, 2012 Category: Health Care
SLCH Rick Majzun traveled to Sweden to learn more about health care outcomes relating to births — then his wife, Bonnee, gave birth.
Tucker Majzun came four weeks early in St. Louis, and Majzun watched it live on a Skype video call. Tucker was the Majzuns’ fifth child and first boy.
Majzun, vice president for strategic operations and planning at St. Louis Children’s Hospital, recently completed five weeks of international travel for an Eisenhower Fellowship focusing on how medical communities in Sweden and Kenya are working to reduce the incidence of premature birth and infant mortality.
After meeting with about 90 health care and community leaders in 15 different cities across the two countries, he confirmed what some may find as a startling conclusion: Depending on where children are born in the United States, their health care outcomes are either on par with Sweden’s, which ranks among the best in the world, or comparable to Kenya’s, among the world’s worst. Using his research to find ways of narrowing the gap between these two extremes in St. Louis is Majzun’s ultimate goal.
“If you stand at St. Louis Children’s Hospital and throw a baseball one ZIP code to the north, you hit health care outcomes not altogether different than Sub-Saharan Africa’s. If you throw it to the west, you hit outcome rates like Scandinavia’s,” says Majzun.
Mama Ana, a traditional birth attendant in Kenya, with Rick Majzun. | Courtesy photo
“In St. Louis we have areas in which the incidence for African-American babies dying before their first birthday is four to five times higher than the average Caucasian baby,” Majzun says. “Only a few of the causes for these outcomes are explained medically. Most are driven by a whole litany of social and economic issues.”
Majzun was invited to apply for an Eisenhower Fellowship by John McDonnell, a BJC board member. The Eisenhower Fellowships is a nonpartisan, nonprofit organization that brings 40 to 50 mid-career professionals ages 32 to 45 to the United States annually and sends eight to 12 U.S. citizens or permanent legal residents overseas as Eisenhower USA Fellows. The program provides professional enrichment, leadership development and network expansion.
Fellows have an opportunity to take time out from their occupations to meet leaders and senior experts in their field, enhance their leadership skills, and become part of a global network of Eisenhower Fellows.
“It was truly an honor to be selected for this fellowship. The experience is one that I will never forget and that will be of value to me, and hopefully Children’s Hospital and the St. Louis community, for years to come,” says Majzun.
While completing his research in Sweden, Majzun found a driving force in the country’s high-quality health care benefits for its children was the willingness of Swedish citizens to pay additional taxes into the country’s social insurance schemes.
“Society basically serves as an extra parent in Sweden, where children are followed by nurses from the day they are born,” he says.
“As a result, something like childhood obesity is 1 to 2 percent there, compared to 30 percent in the United States. And, for us, that 30 percent is going to manifest itself in a torrent of adult diseases the Swedish won’t have to deal with. There is no question as to why Sweden’s health care costs are half of ours.”
He adds, “The officials I met with basically wagged their fingers at the United States for our uninsured problem. Our system of having the uninsured receive treatment in the emergency room setting was beyond their understanding.”
Kenya also offers national health care for all children under the age of 5, but issues of access to medical care are extraordinarily difficult, Majzun says.
“In Nairobi, Kenya’s largest city, 60 percent of the population lives in slums. Most babies are delivered at home,” he says.
“In smaller towns, government hospitals receive $7,000 each quarter for their operating budgets, and then they must depend on whatever they can collect from the public and donations from nongovernmental organizations. It’s amazing to me that they are even able to stay open, but I’ve never seen stronger or harder-working people than those I encountered in Kenya Ñ they are hustling to get by in a country with literally no resources,” Majzun says.
Majzun concludes that the United States falls squarely between Sweden and Kenya, with health care access depending on where people live and their income levels. He plans to use the knowledge he has gained to develop community partnerships that will make an impact on improving maternal and child health in St. Louis.
“Interventions like the Healthy Start Program and CenteringPregnancy have a significant impact on improving outcomes for infants and mothers,” says Majzun. “As a board member of the Maternal Children and Family Health Coalition, I hope to help advance these and similar initiatives in the months ahead. I also plan to share the knowledge I gained through my research. I already have presented my research findings to the Coalition, the Washington University Institute of Public Health’s annual meeting, and the Washington University’s Brown School of Social Work. In the future, I will make presentations internally at Children’s Hospital, and I hope to address a national conference or publish my findings.”