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Modernizing Approaches to Maternal Health Equity

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Maternal health is a perennial concern. But recent events, including an ongoing infant formula shortage, have shined a brighter light on issues surrounding the health of mothers and their babies.

Maternal health is a perennial concern. But recent events, including an ongoing infant formula shortage, have shined a brighter light on issues surrounding the health of mothers and their babies.

Simply put, maternal and infant health isn’t where it should be in the United States. Compared to other high-income countries, America has the highest maternal mortality rate by far, according to research from the Commonwealth Fund. Meanwhile, in a United Health Foundation analysis of infant mortality rates among 36 countries, the U.S. ranked near the bottom at 33.

And the numbers are getting worse. Data from the Centers for Disease Control and Prevention indicates maternal deaths have increased: From 2019 to 2020, the number of U.S. maternal deaths per 100,000 live births jumped from 20.1 to 23.8. The situation is more dire for Black and Indigenous mothers, who are roughly three and two times more likely, respectively, to die during pregnancy compared to white mothers.

Despite these sobering findings, there are ample opportunities to reduce America’s longstanding disparities in maternal health and better meet the needs of vulnerable communities by modernizing the way these populations are served, says Veronica Adamson, general manager of human services and public health at Gainwell Technologies. Specifically, enhancements to the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which serves about half of all U.S. babies, could help close equity gaps in maternal and infant health.

One opportunity to improve WIC lies in the recently introduced Healthy Meals, Healthy Kids Act. If passed, the bill would address some of the structural barriers to streamlining and extending eligibility for post-partum mothers. For example, the act would enhance mothers’ ability to use WIC benefits for online products by removing regulatory barriers for retailers. The act would also allow households that are already receiving benefits from certain government programs to be automatically eligible for WIC.

Outside of waiting for such legislation to pass, states and WIC agencies can take several steps to get mothers the assistance they need to take care of themselves and their children.

“The key to improving the health of mothers and their children is meeting them where they are,” says Adamson, who survived two high-risk pregnancies of her own.

What Can Agencies Do?

Rather than reinvent the wheel, agencies can begin by looking at ways to use or expand upon tools and programs already in place.

States already gather data that could be used to identify mothers who need help the most help. For instance, states could examine Medicaid claim information to identify at-risk mothers. Other information, such as Supplemental Nutrition Assistance Program data, can also be tapped to widen the safety net. Once the data has been fully analyzed, agencies can then improve their outreach to vulnerable populations.

“States must prioritize their ability to communicate with high-risk mothers through the channels and methods most likely to reach and empower them,” Adamson says. “WIC agencies are already deeply connected to the communities they serve, and technology innovations that build on existing knowledge and relationships will be the solutions that drive impact.”

Agencies can take advantage of low-effort opportunities in the form of digital innovations that are already established in a wide range of communities. Apps and platforms could be used to link mothers with text-based eligibility assessments as well as actionable and practical nutritional guidance.

“Through on-demand, omnichannel communication, mothers could learn more about nutritional needs, get answers to questions, identify local resources and receive important health tips,” Adamson says.

States can also partner with companies that could provide critical services to expecting and new mothers. A state might look to collaborate with a company like Uber Health to ensure individuals and families with limited transportation options have a ride to the doctor, pharmacy, grocery store or farmer’s market. Another partnership could be with a meal delivery service to help food-insecure households receive convenient, nutritious meals.

WIC agencies can also partner with private companies to modernize their systems. Gainwell, for example, currently works with nine states and 17 tribal organizations, to offer an array of solutions, including development and implementation of WIC management information systems, integration services with other state programs, cloud and traditional hosting services, mobile applications services — such as development of a flexible “my WIC” phone app that puts information at a participant’s fingertips — and more.

“Many of the community and state WIC programs we serve are facing significant staff shortages and burnout,” Adamson says. “Our modernized technology platforms and M&O [maintenance and operations] support enable them to focus on what’s most important to them — making a difference.”

Federal funding opportunities

While agencies have a plethora of digital options to meet the maternal health crisis head on, Adamson points out that many states face a challenge that can’t be fixed by technology: funding.

“While existing technology could be adapted and expanded to better connect mothers and children in need with vital resources, most states and their counties lack the funding to employ these tools within their current information systems,” Adamson says.

This reality speaks to the importance of aggressively going after federal dollars when they’re available. In September 2021, the U.S. Department of Health and Human Services indicated it would award states $350 million “to support safe pregnancies and healthy babies.” This money could make a world of difference for WIC directors in the trenches.

“By exploring opportunities to modernize current systems, including making better use of digital tools that already exist — telehealth, rideshare technology and text-based, omnichannel communication tools — states can maximize their investments and further stretch federal dollars to make a meaningful impact on health outcomes,” Adamson said. “With the aid of federal funding, states can dramatically and efficiently empower programs like WIC, increasing health equity while elevating the quality of care for all who rely on these vital programs.”