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The Florida Department of Health works to protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts.

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Fetal and Infant Mortality Review (FIMR)

Contact the Maternal and Child Health Section

  •  850-245-4465



    Mailing Address

    4052 Bald Cypress Way, Bin A13 

    Tallahassee, FL 32399-1721 


Fetal and Infant Mortality Review (FIMR) is a community-based, action-oriented process aimed at improving services, systems, and resources for women, infants, and families. FIMR convenes experts within communities that examine confidential, de-identified cases of fetal and infant deaths to help understand root causes and factors that impact child outcomes. These findings become preventative measures, implemented at the community level, to improve birth outcomes for babies in the state.

Section 383.21625, Florida Statutes, requires the Florida Department of Health to contract with Healthy Start Coalitions (Coalitions) to implement FIMR in all regions of the state to improve fetal and infant mortality and morbidity. FIMR is an evidence-based process that reviews fetal and infant deaths, formulates programs, and influences policy that will lead to improving pregnancy and birth outcomes. The goal of FIMR is to assess, monitor, and improve service systems and resources for women, infants, and families.

The Department of Health has continued, as well as expanded, its partnership with the National Center for Fatality Review and Prevention (National Center), a program housed at the Michigan Public Health Institute. The National Center serves not only as the technical support and data center for FIMR, but also for Child Death Review (CDR) programs, education, resources, and calls throughout the United States. For program description and contact information for each of the 21 regions, go to National Center FIMR Spotlight - Florida.

FIMR Process 

FIMRs conduct the following activities:

  • Review and analyze rates, trends, causes, and other data related to fetal and infant mortality and morbidity in a geographic area.
  • Develop findings and recommendations for interventions and policy changes to reduce fetal and infant mortality and morbidity rates.
  • Engage with local communities and stakeholders to implement recommended policies and procedures to reduce fetal and infant mortality and morbidity.
  • Report the findings and recommendations developed by each FIMR to the Department annually.

FIMR Framework 

The Department adopted the national FIMR framework as the guide for implementation in Florida. The framework includes an ongoing cycle of improvement that for health providers, systems, and the community, as a whole. The Cycle of Improvement is a continuous quality improvement process compromised of Data Gathering, Case Review, Community Action and Changes in Community Systems.
  • Data Gathering
  • Case Review
  • Community Action Group (CAG)
  • Changes in Community Systems

Information is collected from a variety of sources including family/parental interview, medical records, prenatal care, home visits, Women Infants and Children (WIC), and other social services.

A multidisciplinary team, called the Case Review Team (CRT), is convened to review the deidentified case details for the purpose of identifying gaps in services, protective and contributing factors. CRT members are then challenged to develop recommendations for enhancements of services at the individual, provider, and community levels to improve fetal and infant outcomes.

The next step in the FIMR cycle is implementation of a Community Action Group (CAG). This group plans and implements local action steps, based on the CRT recommendations, to improve fetal and infant outcomes.

The final phase of the FIMR process is the enactment of solutions. FIMRs demonstrate process changes at the community level that include improvements in policies, procedures, availability of services, and reduction of barriers to access services. Through the FIMR process, the community is empowered to positively improve fetal and infant health outcomes. Examples include increased home visiting services, expansion of doula services, and increased partnerships with community and faithed-based organizations.


The Florida Department of Health presents an FIMR Annual Report to state leadership.