Improving maternal and child health across the lifespan

Elevating health and wellness across the lifespan 

January 27, 2022

Ever heard the expression “Moms are the buttons that hold everything together”? In the world of public health, this is nothing short of the truth. A healthy mother means a healthy next generation. Pregnancy and early life are critical times to ensure healthy development and address health risks for women and their children. 

To learn more about the role of maternal health across the lifespan, we connected with Leanna Bird, project manager at the 1889 Jefferson Center for Population Health, from the Cambria County project team. The team has implemented the Pathways Community HUB model to improve care coordination for individuals in their 130,000-person county, including pregnant mothers. The Pathways Community HUB model creates an organized multi-agency network and uses data to provide community-based care coordination that works to improve health outcomes. 

“We chose the Pathways Community HUB model because this approach empowers communities to move toward equitable healthcare access and social determinants of health, and measure the results,” Bird said. “We are now able to support our community through the mobilization of community health workers to identify those at greatest risk, connect clients to evidence-based services and track the results in a value-based payment approach.”

Various factors impact pregnancy and nutrition is a big one. Mothers have distinct nutritional requirements throughout their life – especially before and during pregnancy and while breastfeeding. 

Leanna and her team of community health workers have been very intentional in how they approach nutrition education and support for their participants.

 “The HUB aims for a preventive, upstream approach by working with pregnant women,” Bird said. “If we can influence the nutrition of pregnant women, there is a greater chance that we can influence the nutrition of infants and children across the lifespan.”

Imbalanced maternal nutrition can also lead to a number of health conditions including anemia, high blood pressure and even gestational diabetes.

“One specific pregnant population that the Community Care HUB works with are those diagnosed with gestational diabetes,” Bird said. “We recognize the influence of nutrition on pregnant women diagnosed with GD, and we know that infants born to mothers with GD are at a greater risk of developing chronic disease, such as Type 2 diabetes, later in life.” 

Beyond nutrition, access to care heavily influences maternal health outcomes. According to Bird, some of the largest barriers mothers in the county face right now include the inability to connect with an OB/GYN provider and attend regular check-ups. Fortunately, the team’s network of skilled community health workers has been working to prioritize this connection and support women in getting to their appointments by providing them with sustainable transportation or attending appointments with them.

 “We also know that poor access to housing, food, and childcare are among some of the greatest social determinant barriers for parents and their children,” Bird explained. “Our outcomes data show that HUB community health workers are most often connecting mothers to social services like child care, medical providers, oral health providers, housing assistance programs, and substance use resources. Basic needs often need to be addressed first, and community health workers work closely with their participants to help prioritize other needs.”

The team also recognizes the major racial and ethnic disparities in maternal mortality and morbidity.

“To reach women of color, HUB community health workers and staff have built relationships with community organizations such as the FWA Gym, NAACP Johnstown Branch, and African American churches to assist with our grassroots outreach efforts,” Bird said. “Our community health workers also utilize health literacy and motivational interviewing techniques to meet their participants where they’re at and improve the line of communication between the participant and provider.”

Despite all that the Cambria County project team has accomplished thus far, they know the work isn’t over. Bird emphasized that core public health policies, programs and practices are needed to provide comprehensive health care and promote wellness during pregnancy, infancy and childhood.

“Adequate paid family leave is one policy that state and federal legislators could implement to promote wellness for the pregnant woman and the entire household,” Bird explained. “Postpartum recovery and time to bond with the child are both necessary to promoting positive health outcomes.”

Additionally, Bird called for federal, state and private programs to provide sustainable financing and reimbursement for community health workers, as there is currently no reimbursement mechanism for community health workers in some states.

“CHWs’ work is crucial to reaching vulnerable populations and improving poor health outcomes due to their lived experience and ability to connect with their participants,” Bird said. “They equip their participants with the lifelong skills needed to navigate resources and become their own best self-advocates.”

Learn more about strides that have been made in maternal and child health and be sure to check out the APHA Maternal and Child Health Section. And don’t forget to join us in continuing our celebration of APHA’s 150 years of impact on public health.

Watch webinars on the latest science

COVID-19 Conversations APHA National Academy of Medicine