Specific Aims New Mexico Pregnancy Risk Assessment Monitoring System, Category A. Core surveillance Introduction ♦ New Mexico has participated in the CDC Pregnancy Risk Assessment Monitoring System (PRAMS) project since 1997. This long-term data collection and dissemination effort has allowed for timely assessment of maternal and child health status and health behaviors, as well as monitoring of trends unavailable anywhere else. ♦ New Mexico is a rural state with substantial Health Professional Shortage Areas (HPSA), NM has historical challenges related to teen births, poverty, high school graduation rates, and access to/use of recommended preconception and prenatal health care. ♦ NM PRAMS is used to describe the health status and needs of the population served by the Medicaid Managed Care Organizations (MCOs) (over 63% of NM deliveries are paid by Medicaid), the NM WIC Program, the Navajo WIC program and the statewide Families FIRST Perinatal Case Management Program. NM PRAMS works closely with the federal Healthy Start sites in Dona Ana County and Luna County to address a broad range of indicators related to the reduction of infant mortality, maternal morbidity and increased social support for pregnant and postpartum women. PRAMS is a crucial surveillance system for monitoring maternal and infant health in NM. Specific Aims, 2021-2026 Objective 1. Improve the health of New Mexico mothers, infants and families by producing data and information for use in policy making, program decisions, and public and provider education Objective 2. Promote and maintain a 65% response rate among all strata and ethnic subpopulations of NM PRAMS Objective 3. Assure Effective Program Management including maintenance of partnerships to sustain NM PRAMS surveillance as an institutional activity Objective 4. Increase capacity for data analysis and data sharing within the state Tribal Epidemiology Centers, universities and professional health organizations Objective 5. Improve PRAMS responsiveness to birth equity and reproductive justice Innovation or unique approach NM provides a unique environment requiring innovative approaches to increase survey response rates. Several initiatives for this application are innovative: a. web-based survey module b. oversample to assure representation of women of color, especially Black and Indigenous women in New Mexico.