Improving Maternal and Infant Health Through Multisector, Community-Driven Partnerships
The United States has the highest rate of maternal mortality among high-income nations. Maternal mortality rates in the United States exceed those of other high-income countries, and this largely preventable crisis disproportionately affects Black women. Multisector, community-driven approaches bring together health and social sectors to address disparities and advance maternal health.
Strategic Models for Advancing Health Equity
To address these challenges, the Center for Medicare and Medicaid Innovation’s Transforming Maternal Health Model, to be implemented in up to 15 states, requires the coverage of doula services in Medicaid as well as increases access to the midwifery workforce and birth centers, and also supports coverage of perinatal community health worker services. Community-based partnerships in Baltimore and Cincinnati that center the voices and experiences of expectant mothers offer lessons for advancing maternal and infant health.
The following table summarizes key components of the current landscape and maternal health models:
| Focus Area | Key Data and Requirements |
|---|---|
| Medicaid Enrollment | Roughly 55 percent of Medicaid enrollees are working full or part time. |
| Transforming Maternal Health Model | Requires the coverage of doula services and perinatal community health worker services. |
| Workforce and Access | Increases access to the midwifery workforce and birth centers in up to 15 states. |
Key Insights for Evidence-Driven Approaches
Stakeholders committed to improving maternal and infant health can draw from the following insights:
- A life-course approach to maternal health fosters early intervention and trust.
- Multisector, community-driven approaches drive individual- and systems-level impact.
- Partnership between public health and health care sectors and with mortality review committees facilitates evidence-driven approaches.
- Housing is a critical need for pregnant women.
- Rising cannabis use among pregnant women suggests the need to expand maternal behavioral health initiatives.
Policy Recommendations for Sustaining Progress
Policy changes may help sustain these efforts through the following strategies:
- Providing adequate support for the community-based perinatal workforce.
- Strengthening investments in evidence-based home visiting services.
- Facilitating continued partnership efforts through direct funding of community-based organizations and other backbone organizations.
- Offering further guidance on pooling federal funding sources.
- Prioritizing community-engaged research on the use and effects of cannabis during pregnancy.