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.

The Florida Department of Health has continued, as well as expanded, its partnership with the National Center for Fatality Review and Prevention.

FIMR Process

  • 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.
Reports and Data

Reports

FIMR Annual Legislative Report 2024

Infant Mortality and Low Birth Weight Rates

Comparison of Expected Rates by County and Healthy Start Coalition Areasย and County

These reports compare county infant mortality rates and low birth weight percentages to the rates and percentages that would be expected for each county and Healthy Start Coalition Area. The expected statistics are calculated to account for county differences in maternal education, marital status, and race. Statistical tests are applied to identify the counties that have significantly higher or lower than expected infant death rates or low birth weight percentages.

About Florida’s FIMR

Section 383.21625, Florida Statutes, requires the Florida Department of Health to contract with Healthy Start 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.

FIMR Framework

The Florida Department of Health adopted the national FIMR framework as the guide for implementation. The framework includes an ongoing cycle of improvement that for health providers, systems, and the community, as a whole.

Data Gathering

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

Case Review

A multidisciplinary case review team (CRT), reviews the de-identified details for the purpose of identifying gaps in services, protective, and contributing factors. CRT members develop recommendations for enhancements of services at the individual, provider, and community levels to improve fetal and infant outcomes.

Community Action

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.

Community Systems

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. Examples include increased home visiting services, expansion of doula services, and increased partnerships with community and faithed-based organizations.