California Border Healthy Start Project: Reducing perinatal health disparities on the US-Mexico border

Although the demand for perinatal services is great in San Diego, CA, its health care safety net system is fragmented and overburdened. This border area is characterized by ethnic diversity; high levels of monolingual non-English speakers; low levels of educational attainment; and high levels of unemployment and poverty. Barriers to accessing existing services include cultural issues and language barriers; lack of trust; immigration status fears; and lack of available information. Project Concern International's (PCI) Health Resources and Services Administration-funded California Border Healthy Start (CBHS) project will work with eight core partners over the next three years to close health services and systems gaps, address prevailing barriers among the target population, and maximize utilization of existing services in areas with the poorest birth outcomes and highest levels of poverty in San Diego. CBHS will provide 540 high-risk women and their children with intensive prenatal and interconceptual case management services. Additionally, CBHS will reach 120,210 persons with health education activities. The community health worker (“promotora”) model is the major strategy for executing all core services. Promotoras are women from the same communities as their clients who share their language and culture. Promotoras conduct culturally appropriate community outreach activities where large numbers of women frequently congregate (e.g. churches, laundromats, beauty salons, grocery stores and drug stores). CBHS also works through PCI's successful health outreach program based at the Mexican Consulate of San Diego to identify eligible women. To unite and coordinate area prenatal services, PCI formed a consortium of reproductive health providers.