Do our partners and communities have the resources and capacity for optimal maternal health outcomes for Black women and birthing people?
Creating Healthier Communities Black Birthing Initiative Readiness Matrix
CHC’s Black Birthing Initiative (BBI) aims to decrease the incidence of preterm birth among Black women and birthing people. This information, compiled from BBI implementation proposals, general research, and experiential encounters, is specific to Black birthing people and Black women.
CHC would like to thank our BBI partners for supporting the BBI data gathering and implementation efforts.Â
Cleveland
Cleveland has partnerships that offer robust community doula, midwifery care, and wrap-around service offerings to Black women and birthing people.
Black Birth Matters consists of a super connector partner and has the infrastructure to: 1) create a maternal health care ecosystem 2) recruit through the Making Opportunities Matter initiative and other outreach strategies, and 3) provide birth accompaniment, center birth advocate care in health systems, and to directly address social determinants of health needs.
Atlanta
Atlanta, through existing collaborative relationships, serves Black women and birthing people and their families in improving Black maternal health by providing resources, education and collaborative spaces.
Healthy Mother Healthy Baby Coalition of Georgia and the Center for Black Women’s Wellness can: 1) hire doulas through the Georgia Doula Access Working Group (GDAWG), 2) recruit and retain people to matriculate through the BBI through their extensive involvement in the community, and 3) provide resources, education and support.
Indianapolis
Indianapolis continues to mobilize effort to advance Black birthing outcomes with community outreach success and strong outreach strategies.
Conversations with Black pregnant and postpartum people, and Black maternal health stakeholders in Indianapolis displayed a significant lack of: 1) awareness around the birth advocates, 2) availability of birth advocates, 3) infrastructures for organizations to manage the monetary administration and implementation of the BBI.
Detroit
Building on the Detroit Regional Infant Mortality Reduction Task Force, the Detroit community has a long-standing history of mobilizing resources and services for Black women and birthing people to achieve optimal health.
Detroit has an extensive network to: 1) hire doulas 2) recruit and retain Black birthing people and women to matriculate through the BBI, and 3) provide direct community services and clinical care in a single location.
Black Birthing Initiative Readiness Matrix
BBI Matrix Expansion
Through funding from Elevance Health Foundation (formerly Anthem Foundation), CHC launched the Black Birthing Initiative in January 2022 to address the maternal health crisis and reduce preterm births. The information in this matrix, compiled from different sources and partnership-provided data, reflects the readiness of market and partners in Indianapolis, Cleveland, Detroit, and Atlanta.
| BBI Core Tenant | Indianapolis | Detroit | Cleveland | Atlanta |
|---|---|---|---|---|
| Robust Doula Workforce. 1:21 doula to birthing person ratio.Market bandwidth/doula pipeline to hire 4 new doulas- |
Indiana Minority Health Coalition is the only organization in Indianapolis advocating for the utilization and facilitating the availability of doulas through the:
Based on research and community engagement efforts, CHC has found that IMHC’s efforts are one of the very few focused on promoting Doulas for Black birthing people in Indianapolis. |
The Women Inspired Neighborhood Network (WINN) has a long-standing history of mobilizing Community Health Works (CHWs) as birth advocates who support Black birthing people. WINN CHWs are cross trained as Community based doulas which enables the provision of holistic care for moms and babies. CHWs are available for birth accompaniment. | The Cleveland community has successfully mobilized Doulas and birth advocates to advance Black birthing outcomes. These efforts have been led by key maternal health organizations including Black Birthing Communities (BBC). BBC works to provide perinatal support through its training of more than 75 women as Perinatal Support Professionals since 2017. | With organizations such as the Atlanta doula collective and the Atlanta Birth Doula, the Atlanta community has a robust doula and birth advocate workforce.
Healthy Mothers Healthy Babies Coalition of Georgia (HMHBGA) works to increase access to care and the availability of doulas in Georgia through their Birth worker scholarship and training program which has, to date graduated 65 birth workers. They also have a working group entitled. Georgia Doula Access Working Group (GDAWG) to improve doula access. |
| Resource Co-location.
Doula, Birthing Center/Direct Service Center, Case Workers in same geographic catchment area. |
Indianapolis currently has one Birth center. While they serve all populations, there is no birth center serving solely Black people.
From data gathered by CHC through discussions with community partners, no Black doulas serve the Indianapolis catchment area. The closest doulas are in South Bend, Indiana. |
The Women Inspired Neighborhood Network is situated within Henry Ford health system and began as a task force. Thus, WINN has historically been a resource co-location given its multi-service space. Black pregnant women are able to receive direct services through WINN and receive clinical services from their provider in the same space. | Between BBC, Village of Healing (VoH) and Pregnant with Possibilities Resource Center (PPRC), the Cleveland catchment area has a robust offering of resources to support the needs of their Black pregnant population.
BBC provides a community-based doula program and wrap-around services including transportation and nutrition to over 500 expectant mothers and families annually at highest risk of poor birth outcomes. VoH is a medical home in the Cleveland catchment area and serves Black pregnant women through midwifery care services. |
In Atlanta, there is currently one birthing center. There are a host of doulas and midwives in Atlanta that serve the Black birthing population. |
| Trusted, affordable external evaluators known to the community | From data gathered by CHC through discussions with community partners, there are limited external evaluators known to the community that center their efforts on evaluating and advancing maternal health programming. | From data gathered by CHC through discussions with WINN and Detroit partners, they detailed their extensive network of community-based evaluators for maternal health programming. The Detroit collaborative will work with an independent community evaluator of 25 years. | The collaborative and CHC joined to discuss BBC, VoH and PPRC community-based evaluators for maternal health programming. The Cleveland collaborative will work with an independent community evaluator who has worked in the Cleveland community. | From data gathered by CHC through discussions with HMHBGA and CBWW, Community Speaks LLC, a trusted consulting firm will work as a collaborative on the BBI. |
| Maternal health as a community priority.[1]
Catchment area that makes maternal health priority. As measured by public investment in Title V Maternal and Child Health Federal/state budget [1] Explore the title V federal-state partnership. Home Page. (2021). Retrieved February 23, 2023, from https://mchb.tvisdata.hrsa.gov/ |
Indiana – In FY 2021 $33,863,640 in Title V Maternal and Child Health Services Block Grant Program funds was spent to create Federal/State partnerships that enable each state/jurisdiction states to address the health services needs of its mothers, infants and children, which includes children with special health care needs, and their families. | Michigan – In FY 2021 $75,159,134 in Title V Maternal and Child Health Services Block Grant Program funds was spent to create Federal/State partnerships that enable each state/jurisdiction states to address the health services needs of its mothers, infants and children, which includes children with special health care needs, and their families. | Ohio – In FY 2021 $84,002,546 in Title V Maternal and Child Health Services Block Grant Program funds was spent to create Federal/State partnerships that enable each state/jurisdiction states to address the health services needs of its mothers, infants and children, which includes children with special health care needs, and their families. | Atlanta – In FY 2021 $299,348,277 in Title V Maternal and Child Health Services Block Grant Program funds was spent to create Federal/State partnerships that enable each state/jurisdiction states to address the health services needs of its mothers, infants and children, which includes children with special health care needs, and their families. |
| Deep pool of maternal health CBOs (# per birthing people).[1]
[1] Candid | . (n.d.). Retrieved February 23, 2023, from https://candid.org/ |
Indiana has 532 organizations dedicated to maternal health | Michigan has 771 organizations dedicated to maternal health | Ohio has 991 organizations dedicated to maternal health | Georgia has a total of 778 organizations dedicated to maternal health |
| Pre-existing working relationships between priority focused organization and Healthy Start site. | IHMC and Indianapolis Healthy Start (IHS) have always been familiar with the work of each organization, however, prior to the requirement of BBI to implement as a collaborative, they had no prior experience working collaboratively. | Women Inspired Neighborhood Network and City of Detroit Health Department will work as a collaborative to implement the BBI. | Black Birth Matters (BBM) is a collaborative partnership between BBC, PPRC, and VOH with the goal to collectively achieve optimal birth outcomes in the Black community. As Black-led and Black-serving organizations, BBM creates an ecosystem to help the Greater Cleveland community understand the role each organization plays in maternal and infant health. | HMHBGA and the Center for Black Women’s Wellness have been critical partners in addressing the themes mentioned above and seek to expand the scale and scope of its current offerings to support those disproportionately affected by prematurity, infant mortality, and maternal mortality in Georgia. |
| Independent Health Start. Healthy Start site located outside of health department (has ability to accept grants). |
CHC’s intended partner was Indianapolis Healthy Start (IHS). IHS is situated within Marion County Health Department and thus must abide by its operational policies. This poses a challenge to disseminating program funds and executing implementation efforts as all programming must go through an extensive approval timeline. Thus, this delays BBI screening and implementation efforts. | CHC’s intended partner is the WIN Network. WIN is situated within the Detroit Health Department but is not government operated and therefore can independently receive funds with no operational delay. | CHC does not have an intended healthy start site. Birthing Beautiful Communities is connected to healthy start in Cleveland. | CHC’s intended partner is CBWW. The organization is independent of their health department and thus can execute their own program and receive grants without operational delays. |
| Priority focused maternal health organization that is also a super connector.
 For the purposes of the BBI, the super connector is an organization that is able to connect a Black pregnant person to a birth advocate and SDOH resources |
CHC’s intended BBI partners were both IHS and IMHC. While IHS primarily provides direct SDOH services to their Black pregnant population, they did not provide access to birth advocates, given the limited availability of birth advocates in the Indianapolis catchment area. | The Women Inspired Neighborhood Network: Detroit is integrated clinical care with a special focus on addressing social determinants of health while building capacity for self-efficacy amongst participants. WINN provides direct services and has worked to the pregnant Black people they serve to birth advocates where needed and have traditionally integrated Community Health Workers into their care model. | CHC’s intended super connector organization is Birth Beautiful Communities (BBC). Their capacity to manage a project of this magnitude. BBC manages a cohort of birth advocates who work with pregnant Black people in their community | Healthy Mothers Healthy Babies Coalition of Georgia (HMHBGA) is the leading organization due to their capacity and reach in the community of Atlanta. They train and house doulas and work to connect them to pregnant people in the Atlanta area. |
| Priority focused organization with capacity to manage and hire 4 new doulas. | Given the limited availability of birth advocates in Indianapolis, the Indianapolis collaborative identified that hiring birth advocates to support the BBI implementation would be challenging. | Prior to the Detroit collaborative’s introduction to the BBI, they intended to hire more doulas to support their birth accompaniment efforts. The BBI allows them to hire enough doulas to cover their need in their catchment area. | Birthing Beautiful Communities (BBC) is a village of Doulas or Perinatal Support Professionals who primarily provide labor, pregnancy, social support to pregnant women at highest risk for infant mortality during the perinatal period. They will manage and hire the doulas for the BBI. | HMHBGA’s Pickles & Ice Cream Platform will provide service doulas/childbirth educators to participants. They currently lead the Georgia Doula Access Working Group (GDAWG) which works to expand access to doula care across the state |
| Priority focused organization with capacity to outreach to 360 birthing people. | In the collaborative proposal provided by IHS and IMHC, the proposed collaborative’s outreach plan included the use of marketing and advertising as a tool for recruitment. No intent information on in-person recruitment of pregnant and postpartum people was provided. In person recruitment is a pivotal outreach mechanism for Black pregnant people. | WINN’s historical efforts have included intense outreach efforts that have yielded their success. Since 2016,321 babies have been born through WINN programming. In an effort to matriculate 321 pregnant people through programing their outreach efforts needed to reach at least double this number.  WINN utilizes both social media and in-person (through clinics) recruitment tools to yield their success. | Black Birth Matters (BBM) is the collaborative partnership between BBC, PPRC, and VOH. They will work together with various marketing strategies to complete outreach for the BBI and matriculate pregnant people into the BBI. They will use social media, in-person methods and their community relationships to yield their success. | Healthy Mothers Healthy Babies Coalition of Georgia (HMHBGA) will perform outreach with the help of CBWW using various outreach methods. They will attend community events and utilize their community relationships for outreach purposes. |
| Priority focused organization with capacity to recruit 180 birthing people. | In the collaborative proposal provided by IHS and IMHC, there was no information on the proposed collaborative’s ability to recruit 180 birthing people, based on their current or previous program recruitment numbers. | Recruitment for enhanced Group Prenatal Care will be conducted in Henry Ford Health clinics as well as within the target community (metro Detroit). Given Detroit successful outreach, they are confident in their ability to recruit at least 180 pregnant people. | Pregnant with Possibilities, through the Making Opportunities Matter initiative, since March 2020 has more than 504 pregnant and parenting women have contacted regarding enrollment which shows recruitment possibility through the organization. | HMHBGA recently launched a pilot Medicaid program for full spectrum doula care which successfully recruited 395 birthing people. |
| Priority focused organization with capacity to facilitate 144 birthing people through program. | The collaborative proposal provided by IHS and IMHC, intended to have implementation take place at IHS and thus they would matriculate the 144 folks. Concern was expressed about their ability to matriculate 144 pregnant people through the BBI program. | Given Detroit successful outreach, they are confident in their ability to matriculate at least 140 pregnant people through BBI programming. | Village of Healing (VoH), an organization a part of the collaborative will be responsible for keeping track of the participants in the program as well as their engagement and use of the VoH as their medical home. | Center for Black Women’s Wellness will facilitate the birthing people and women through the program. |
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CHC: Creating Healthier Communities brings nonprofits, businesses and communities together to improve community health. Our focus is health equity, addressing underlying issues and removing barriers so everyone can thrive. Our work is driven by community need, and we direct programs, resources and support where they have the greatest impact. Together with partners, we’ve been creating healthier communities for more than 65 years.Â
