MCH Leads Health Equity Edition – In order to advance health equity for MCH populations, beginning January 2023, MCH Leads will feature trainees’ health equity-focused work. We look forward to highlighting trainees’ experiences supporting the health and well-being of vulnerable and underserved populations and communities. Also, their work assessing and addressing the underlying causes of health disparities–and their efforts to promote diversity, equity, and inclusion–ultimately improving MCH outcomes. In addition, we encourage trainees to reflect on how the MCH Leadership Competencies are applicable to their health equity-focused stories.

Isabella Rose Walters

Isabella Rose Walters (she/her) is a second-year Master of Public Health candidate with a concentration in Community and Behavioral Health Promotion at the University of Wisconsin-Milwaukee Joseph J. Zilber School of Public Health. She is also part of her school’s Maternal and Child Health graduate certificate program, which is recognized as an MCH Public Health Catalyst Program. Before beginning her MPH in Milwaukee, Isabella graduated from the University of Minnesota-Twin Cities with a bachelor’s degree in biology and a double minor in Spanish Studies and Public Health. During the summer of 2022, she became the first graduate student from her school to participate in the Title V MCH Internship Program. Isabella was placed with the Louisiana Department of Health- Bureau of Family Health, where she co-led a program evaluation of the Bureau’s resource and referral processes for pregnant people and new parents/caregivers. This summer, Isabella began another program evaluation with the Wisconsin Department of Health Services as a Wisconsin Population Health Service fellow. Isabella is deeply passionate about working with maternal and child health populations to ensure they have equitable access to quality services needed to improve health outcomes. Connect with Isabella on LinkedIn

During the summer of 2022, I had the opportunity to work with the Louisiana Department of Health’s Bureau of Family Health (BFH) through the Title V MCH Internship Program. During this time, I co-led a program evaluation of BFH’s resource and referral process for pregnant people and new parents/caregivers living in Louisiana. The Title V MCH Block grant mandate requires state agencies administering the State’s program under this title to provide a toll-free telephone number. In Louisiana, BFH created a contract with the American Pregnancy Association (APA) to operate the 24/7 Partners for Healthy Babies (PHB) hotline. The overall objective of our program evaluation was to better understand the purpose of this hotline and how it fits within the larger landscape of resource sharing within the State. To do this we completed key informant interviews with BFH staff as well as representatives from the state’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Maternal, Infant, and Early Childhood Home Visiting Programs (MIECHV), a literature review of best practices, an environmental scan of what other Title V state agencies are doing, and a scan of the complementary PHB website. After gaining a better understanding of how pregnant people and families get information in Louisiana, we provided equity-based recommendations to strengthen BFH’s ability to connect residents with necessary resources. 

Competency 5: Communication

The evaluation we conducted with BFH was not only assessing how well BFH was communicating information but also the evaluation design that was based on the communication. The methodology employed to gather information about the PHB hotline required my co-evaluator and me to thoughtfully communicate with BFH staff and associated program leaders to better understand perceptions about the effectiveness of the PHB hotline. This was a learning process as we had to ensure that our interview questions communicated the information that was central to our evaluation question. Furthermore, we had to thoughtfully communicate our evaluation findings and recommendations to the Director of BFH, BFH staff, and other key partners.

Competency 8: Family-Professional Relationships

As MCH professionals, we are tasked with equitably communicating important health information to populations of interest in a meaningful and accessible way. Effective bi-directional communication between MCH professionals and families is important to facilitate strong information-sharing relationships. Because of this, it was important that our evaluation ensured that pregnant people and new parents/caregivers were receiving accessible information about the resources available to them in Louisiana. While our evaluation design did not include input from the public, we discovered that there was a lack of internal communication affecting how BFH was disseminating information. It was apparent from our key informant interviews that different BFH programs had their own ways of sharing information about resources, but these multiple channels of communication were making it difficult to streamline resource-sharing and referral processes for all families. 

Competency 11: Working with Communities and Systems

Our evaluation required navigating the multiple complex systems that influence the ways in which Louisiana families receive information from BFH. These systems included health care, home-visiting services, all levels of government, and other non-profit and government-funded programs (like WIC). During our evaluation, my co-evaluator and I quickly learned how siloed these systems were and the impact this had on equitably communicating information to families. The lack of frequent communication between these systems was hindering conducive referral and resource processes. One of our final recommendations regarding BFH processes was to utilize a centralized referral platform to streamline coordinated care efforts and provide families with a well-maintained resource database. This was recommended with the hopes that a centralized platform would help bridge together the complex systems impacting the ways in which Louisiana families receive information. 

Advancing Health Equity

Health equity is the backbone of MCH work and was a key tenant I incorporated into my work as a Title V MCH Intern. Through our evaluation of the PHB hotline and associated modes of communication, my co-evaluator and I were able to recommend changes that would ensure that all families in Louisiana are equitably receiving needed resources. Such resources ensure that these families have access to necessary services and are equipped with information to raise healthy babies. My time as a Title V intern taught me the nuances of MCH work and has inspired me to incorporate health equity into everything I do. 

Funding provided by the Center for Leadership Education in Maternal and Child Public Health at the University of Minnesota and the University at Albany School of Public Health Maternal and Child Health Public Health Catalyst Program, which are supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). This information or content and conclusions of related outreach products are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.