Helping expectant mothers

Alicia Young and Belinda Robinson know what it's like to be pregnant and single with little income and fewresources. Bothwere lucky they found support, but they know many Kent County women in that situation don't.

They know it, because both now are community health workers helping low-income pregnantwomen get the medical care and other community services they need.

“I think there are a lot of services available, said Robinson, but many eligible women are unaware of those services or face numerous obstacles that make it difficult for them to receive proper prenatal care.

Only about 40 percent of themore than 4,000 Medicaid-eligible women in Kent County who give birth each year participate in the state Medicaid-sponsored caremanagement services, Maternal Infant Health Program, created to enhance prenatal care, said Jennifer Raffo, a research project manager for the Michigan State University College of Human Medicine.

That’s why the College of Human Medicine, through its department of obstetrics, gynecology and reproductive biology, is working with SpectrumHealth and other health care agencies in Kent County to undertake a project that will develop and study a streamlined community system of care tomake it easier for low-income pregnant women to receive the services they need, thus helping them deliver healthier babies. The five-year study is funded by an almost $2.5 million grant from the U.S. Agency for Health Care Research and Quality.

“A lot of moms don’t get connected with services because the system is fragmented,” Raffo said. “We don;t want to start any new services. We want to better use the services that already are available in the community.”

The study will look at ways of improving communication and coordination of services offered to low-income pregnant women by applying process improvement techniques that have helpedmanufacturing companies increase quality and efficiency, she said.

Even health care providers find it difficult to connect their patients with the many available services, Raffo said. A survey two years ago of physicians who deliver babies in Grand Rapidsarea hospitals found almost 80 percent have a limited understanding of services offered under the state;s Maternal Infant Health Program.

Many of the eligible women face obstacles to proper medical care, such as a lack of insurance, sufficient food, stable housing, child care, transportation and knowledge of the health care system. Some are victims of domestic violence and have higher health risks, including depression.

As community health workers in Spectrum Health’s MOMS (Mothers Offering Mothers Support) Program, a Maternal Infant Health Program provider, Young and Robinson help pregnantwomen overcome those obstacles and navigate the health care system.

‚ÄúAwareness is the key, getting the word out,‚"Young said. She recalled the fear and uncertainty she faced when she was 16 and pregnant. A public health nurse ‚Äúliterally changedmy life,‚Äù she said. ‚ÄúShe gave me the tools to be successful. She taught me how to believe in myself. Now, I have a chance to give back."

Yet she and Robinson know many expectant mothers are not so fortunate.

“I was one of those moms who didn’t know anything about the MOMS Program,” Robinson said. “I would have loved to have had this program. Imagine all of those women we’re missing.”

Working with local health care agencies, the College of Human Medicine over the next five years will study how to streamline the system and make it easier for more women to receive the services they need, said Dr. LeeAnne Roman, the study;s principal investigator and an associate professor of obstetrics and gynecology. Partners in the study include Spectrum Health, Priority Health, Michigan Department of Community Health, Kent County Health Department, Cherry Street Health Services, Arbor Circle and others.

“This project will demonstrate how a community and an academic institution can collaborate to transform prenatal care.” Roman said. “We will use multiple sources of data to drive the model development and to determine what works. Does it improve care, does it reduce costs, does it improve health and reduce persistent disparities and can it be adapted for other communities?”

“We know pregnant women, community health workers, nurses, social workers, physicians and others struggle to navigate the fragmented health care system. The project will strive to make it easier for all of them.”

—Information provided by MSU College of Human Medicine

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