Maternal and Child Health Initiative
Georgia has one of the highest rates of maternal and infant mortality and morbidity in the nation. Data from the Georgia Maternal Mortality Review Committee (2012-2016) showed 26 pregnancy-related deaths per 100,000 live births, of which 70% were found to be preventable. A pregnancy-related death refers to a death occurring during pregnancy, within one year of the end of pregnancy due to a pregnancy complication, a death resulting from a series of events initiated by pregnancy, or the exacerbation of an unrelated condition caused by the physiological effects of pregnancy. The leading cause of pregnancy-related deaths in Georgia are due to cardiomyopathy, cardiovascular/coronary, and hemorrhage. Further, Black, Non-Hispanic women are 2.7 times more likely to die from pregnancy-related causes than White, Non-Hispanic women.
According to 2018 data from America’s Health Rankings, Georgia’s infant mortality rate increased 17 percent from 6.6 to 7.7 deaths per 1,000 live births, leading to a ranking of 46th in the nation for infant mortality. The three leading causes of infant deaths are conditions related to preterm birth and low birth weight, birth defects, and sleep-related deaths (including sudden death syndrome and accidental suffocation and strangulation in bed). Preterm birth and low birth weight accounted for 45 percent of Georgia’s infant deaths and are more common among Black infants with risk factors being maternal chronic medical conditions, inadequate prenatal care, and unintended pregnancy.
In 2021, Healthcare Georgia Foundation launched the Maternal and Child Health Initiative, a multi-year, multi-pronged equitable grantmaking strategy to address maternal and infant morbidity/mortality among Black women and infants in Georgia and to continue to provide support to women and their families throughout the perinatal/interconception periods to improve health and mental health outcomes for both women and children. This initiative was based on the Foundation’s previous investments in the Taking Care of You Initiativeand the Promising Approaches to Improved Health Demonstration Program.
The initiative intentionally targets Black women of reproductive age (approximately 15-45 years), regardless of socioeconomic status, and their children, partners, and families. Although infant mortality measures the death of an infant before his/her first birthday, the intent is not only for infants to “survive,” but to “thrive.” Therefore, the focus is on Black women of reproductive age and children up to age 3. This provides an opportunity to strengthen not just the child’s development through innovative and/or evidence-based grantmaking programs, but to also continue to support the mother and the family unit throughout the perinatal and interconception periods.
The Foundation utilized several approaches in designing its Maternal and Child Health Initiative, including researching evidence-based and best practice strategies to address maternal and infant mortality/morbidity among Black women and infants, hosting meetings with nonprofit, academic, and public health leaders throughout Georgia, participating in existing maternal and child health leadership groups in Georgia, and supporting an environmental scan of evidence-based/best practice programs that address maternal and child health across Georgia, with an emphasis on Black women and children up to age 3. Emory University partnered with the Center for Black Women’s Wellness to conduct the environmental scan, which included a literature review of best practice/evidence-based programs throughout Georgia, surveys and key informant interviews among maternal and child health leaders, and focus groups among Black women with lived experience and fathers/supportive persons to gain their perspectives on perinatal care needs and experiences, access to care, respectful and equitable care, and experiences with children and infant health. Emory and the Center for Black Women’s Wellness summarized their findings in a white paper that was submitted to the Foundation that included both policy and programmatic maternal and child health funding recommendations for consideration.
The goals of the Foundation’s Maternal and Child Health Initiative are to:
1.) Strengthen the leadership capacity and build a coordinated statewide collaborative system in Georgia working to reduce maternal and infant morbidity/mortality by utilizing the Foundation’s convening role, building organizational, leadership and fundraising capacity, and developing/strengthening partnerships.
2.) Modify, scale, and replicate new and/or existing innovative, promising, or evidence-based interventions throughout Georgia. The Foundation will prioritize listening to and investing in Black-led community solutions and community-based organizations focused on areas of highest need for Black women, birthing individuals, infants, and children.
3.) Strengthen the healthcare professional workforce in Georgia to achieve more equitable access and support improved quality and coordination of healthcare services for Black women and children.
4.) Support efforts to dismantle systemic racism, by addressing bias within the healthcare system and supporting policy efforts that address the social and political determinants of health.
5.) Improve data systems collection and reporting to ensure more accurate tracking and reporting of maternal and infant health outcomes in Georgia.
To accomplish these goals, the Foundation is utilizing a multi-pronged approach that includes investments in policy/advocacy, programs, and partnerships. The Foundation is applying an equitable lens to its approach, incorporating community voices into the design, implementation, and evaluation of the initiative, partnering with a community advisory board, and implementing a theme of RESPECT that is centered on Respecting Black Women’s Voices and Choices, supporting Evidence-Based and Innovative Programs, identifying Sustainable Solutions, leveraging Partnerships, instilling Equity-Centered approaches, and investing in Transformative strategies. The Foundation will elevate Black women’s voices by sharing women’s experiences in childbirth and navigating the healthcare system and seek to ensure women can have access to quality, culturally appropriate, and respectful healthcare.
In December 2021, the Foundation awarded a round of seed grants to five organizations that align with the Foundation’s maternal and child health policy/advocacy priorities and are seeking to expand the number of healthcare providers serving Black women and fathers in rural communities.
Atlanta Resource Foundation, Inc., fiscal agent for 4Kira4Moms to establish 4Kira4Moms as a maternal and child health policy/advocacy organization, build its organizational capacity and strengthen its infrastructure to increase its ability to collaborate with partners, build an advocacy volunteer base, and develop programming that aligns with the Foundation’s policy/legislative agenda items.
Center for Black Women’s Wellness (CBWW) to support providing community-based advocacy training and to implement strategies that will activate and amplify the voices of Black women to promote equitable maternal and child health policies. This project will allow CBWW to provide policy/advocacy training to Sisters with Voices, a group of activated Black women with lived experience that informs CBWW’s work, as well as CBWW staff to enhance their knowledge surrounding maternal and child health (MCH) policy issues and increase comfort levels talking with legislators and advocating for equitable MCH policies.
Healthy Mothers, Healthy Babies Coalition of Georgia, Inc. (HMHB) to support promoting health equity and to improve maternal health outcomes through advocacy and authentic community engagement. This project will allow HMHB to strengthen its staff capacity to deepen its relationships and better understand the needs of communities with disproportionately higher incidents of maternal mortality, support marketing efforts to spread awareness of resources and policy solutions and expand the representation of its working groups to ensure activities are responsive of the unique needs of its target population.
Morehouse School of Medicine (MSM) to support MSM’s Center for Maternal Health Equity to implement a patient navigation project to advance maternal health equity. The project will target low-income, Black women of childbearing age and fathers who reside in rural communities across Georgia. MSM will work with community partners to train patient navigators (PN) to identify and mitigate patient-level barriers to healthcare, including financial, cultural, logistical, and educational barriers. This project will lead to a more diversified perinatal workforce, and advance MSM’s advocacy activities, including supporting policies to promote healthcare providers being trained and practicing in underserved rural communities, and advocating for enhanced reimbursement for healthcare providers.
SisterSong, Inc., fiscal agent for Black Mamas Matter Alliance (BMMA) to strengthen BMMA’s staffing capacity and ability to deepen partnerships, develop advocacy and awareness materials, and promote community engagement and advocacy in Georgia. This project will allow BMMA to engage and impact members of its alliance and external movement partners in Georgia, establish BMAA as a clearinghouse of information and tools, and serve as a technical assistance provider to nonprofit organizations, healthcare and public health systems, policymakers, and other decision-makers to increase their capacity to influence state and federal policies that can impact Black maternal health and advance maternal health equity.