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Advancing Health Equity and Fostering Collaboration through Black Maternal and Child Health Initiatives

Views from the Field
Posted September 16, 2024
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Morgan-Hynd

Loreen Chant, President and CEO, Health Foundation of South Florida

When basic social needs go unmet, they become the principal drivers of health disparities. Recognizing this, the Health Foundation of South Florida has been advancing a collaborative approach that brings together health systems and community-based organizations and paves the way for implementing promising social interventions. Through this approach, the Health Foundation seeks to drive improved health outcomes and greater coordination to address unmet health-related social needs within clinical care settings.

Acknowledging philanthropy’s role in fostering collaborations and driving innovation, in 2022, the Health Foundation invited proposals to establish health equity collaboratives to build an infrastructure that supports improving health outcomes for South Floridians with low incomes and who are racial and ethnic minorities. Ultimately, the Health Foundation provided technical assistance and funding support for four newly established health equity collaboratives, which today include 26 organizations working together to effectively address the social drivers of health and treat health-related social needs as part of effective clinical care.

In 2023, three out of four of the Foundation’s health equity collaboratives launched pilot projects to improve maternal and infant health outcomes in South Florida.

Advancing Maternal Health Care and Community Well-Being

The Health Foundation’s focus on maternal and infant health outcomes acknowledges that the state of Black maternal health in South Florida is alarming, with significant disparities in birth outcomes.

For instance, in Miami-Dade County, Black women are three times more likely to die from childbirth and related complications compared to white women (FLHealthCHARTS). In Broward County, Black and Haitian women are less likely to receive first-trimester prenatal care compared to their white and Hispanic counterparts. According to Broward Healthy Start Coalition, white (non-Hispanic, non-Haitian) women were more likely to enter prenatal care in the first trimester (75.6 percent), followed by Hispanic women (70.0 percent); Black (non-Hispanic, non-Haitian) women (63.1 percent); and Haitian women (57.3 percent).

In Monroe County, the Florida Keys are facing a shortage of health care professionals, resulting in inadequate maternity care services. The CDC estimates that four out of five pregnancy-related deaths are preventable, highlighting the urgent need to address these disparities.

Health Foundation of South Florida Establishes Two Black Maternal Health Equity Collaboratives

Informed by the region’s first Black Health Summit, the Health Foundation invested $1.8 million in its Black maternal health initiatives. Nearly $1 million of this commitment is allocated to a Miami-Dade Black Maternal Health and Infant Health Equity Collaborative led by Jackson Health System, including Southern Birth Justice Network, Metro Mommy Agency, Magnolia Birth House, and YWCA South Florida to incorporate community-based doulas into prenatal and postpartum care and to support Jackson Health System’s journey of becoming a doula-friendly hospital.

The funding helps to build the doula workforce, improves doula access and integration in Miami-Dade County, and builds the infrastructure to incorporate community-based doulas into the prenatal, birthing, and postpartum process.

The Health Foundation holds a strong commitment to investing in doula training, mentoring, educating pregnant women, and providing social support as vital strategies in the organization’s maternal health collaboratives. Additionally, the positive impacts demonstrated by including doulas in the prenatal, birthing, and postpartum process note that they significantly improve birth outcomes.

The Foundation also invested significant funding and support to increase access in a major maternity care desert in Lauderdale Lakes and surrounding cities in Broward County. With only two practicing OB-GYN doctors in this area, these communities were experiencing the worst maternal health outcomes in the county. 

In response, the Health Foundation awarded funding for the Broward Black Maternal Health Collaborative, which is comprised of Community Care Plan, Broward Health, Urban League of Broward County, and Broward Healthy Start Coalition. In collaboration with community partners, a new Maternity Care & Heart Community Resource Center opened in Lauderdale Lakes earlier this year, expanding access to services and providing much-needed resources for pregnant and postpartum people. More than $850,000 in Health Foundation grant funds established stronger community collaboration. The collaborative brought together our public safety net hospital, a health plan, and community-based organizations so that the health care needs as well as social needs of the mothers would be addressed and met holistically.

The Health Foundation also provided funding to support a third maternal health collaborative, the Florida Keys Maternal Child Health Equity Collaborative, to address previously existing gaps in maternal health care due to the limited number of practicing OBGYNs in the Florida Keys. This collaborative includes the Florida Keys Healthy Start Coalition, Womankind, Rural Health Network, and other local organizations working together to increase access to prenatal care in Monroe County.

Member organizations of the collaborative are supporting increased care coordination, enhancing access to essential prenatal care services, training doulas, and supporting a mobile health unit that brings these services to existing clinics, which were not previously offered.

The Health Foundation chose to fund doulas across each maternal health collaborative because studies indicate that doulas can be particularly beneficial for women of color, women with low incomes, and women living in underserved communities. In a 2022 NIH study, the presence of a doula during childbirth has been linked to a nearly 53 percent reduction in the likelihood of having a cesarean section and a 58 percent decrease in the chances of experiencing postpartum depression or anxiety (Falconi et al. 2022).

Despite these clear advantages, funding for doulas and birth workers remains challenging, which is why the Health Foundation funding is critical in supporting this effort.

The state of Black maternal health, particularly in South Florida, demands urgent action and systemic change. The Health Foundation’s proactive approach, investment in collaboratives, and focus on community-driven solutions are crucial to achieving more equitable maternal health care.

As stakeholders prioritize this critical issue, meaningful change can be driven to improve maternal health outcomes for pregnant people and infants in the region. The Health Foundation believes all people in Florida should access quality care, including prenatal, delivery, and postnatal services, to reduce pregnancy complications, improve birth outcomes, and set families up for health and success.


Reference

Falconi, April M., Samantha G. Bromfield, Trúc Tang, Demetria Malloy, Denae Blanco, Susan Disciglio, and Winnie Chi. “Doula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching.” EClinicalMedicine 50 (2022): 101531. doi:10.1016/j.eclinm.2022.101531.

FLHealthCHARTS. “Maternal Deaths.” Florida Department of Health.

Focus Area(s): Health Equity and Social Justice

Related Topic(s): Children and Families, Health Equity
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