Online Program

Improving access to prenatal care through community outreach workers

Monday, November 4, 2013

Michelle Sanchez, MSW, MPH, Maternal and Child Health Consortium of Chester County, West Chester, PA
Background: In the United States, infants born to women of low socioeconomic status have worse birth outcomes than infants of women of higher socioeconomic status. A known risk factor which contributes to this disparity is access to prenatal care. Early and adequate prenatal care can reduce rates of infant mortality. Methods: Healthy Start (HS) of Chester County is part of a national initiative to reduce rates of poor birth outcomes. The program uses community outreach workers to target women at high risk of delivering premature or low birth weight infants. Culturally-competent outreach workers build trusting relationships with participants to help them navigate the healthcare system and access resources such as prenatal care. Results: HS commissioned an independent evaluation by the Family Planning Council of Southeastern Pennsylvania which compared data of program participants with data of demographically similar women from the same communities. From 2003-2009, HS participants consistently initiated prenatal care in the first trimester at a lower rate than the community cohort. For instance, among the participants, the average for 2008-2009 was 43%- compared to 56% for the community cohort. Despite such disparity, the rates of adequacy of prenatal care as measured by the Adequacy of Prenatal Care Utilization Index were comparable. Among the participants, the average for 2008-2009 was 49%- compared to 53% for the community cohort. Conclusions: With guidance and support of community outreach workers, HS participants gained access to prenatal care and utilized services at similar rates to the community comparison group, despite starting prenatal care later.

Learning Areas:

Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Identify strategies used by community outreach workers to improve access to prenatal care

Keyword(s): Maternal and Child Health, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am responsible for the oversight of the evaluation systems of MCHC’s programs and the organization’s CHIPRA (children’s health insurance) grant from the U.S. Department of Health and Human Services. I have presented MCHC's program results at the national and statewide levels. I have a Masters Degree in Social Work and a Masters Degree in Public Health from the University of Pennsylvania.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.