Innovative 'HUB' model improves infant mortality and saves money: Saving the Smallest

The Abiye Project registered over 20,000 pregnant women using a community-based model to ensure they receive proper healthcare. The program connected women with trained health rangers who served as liaisons with traditional birth attendants (TBAs). When TBAs’ resistance stalled the program, the government introduced financial incentives, paying them for each patient referral, leading to more hospital births and a reduced child and maternal mortality rate.

Morehouse School of Medicine is training local women to become doulas through its Perinatal Patient Navigators program. A dozen participants — all Black women — recently graduated from the program after five months of training, ready to provide care and support to other women of color in rural communities. Studies show the presence of a doula improves labor and delivery outcomes, reduces stress and results in fewer expensive childbirth interventions, like C-sections.

Doulas are becoming a more widely used resource among pregnant people, particularly Black women who historically face racial inequities during pregnancy and childbirth. Groups like The Doula Network and the Southern Birth Justice Network are working to expand doula services by training and connecting pregnant women with certified doulas. Doula care is more holistic and studies show that women using doulas have about a 65% reduction in their odds of developing postpartum depression or anxiety when a doula is present during labor and delivery.

At Enrique Baltodano Hospital healthcare providers are working on improving patient experiences by implementing patient-centered care. From making surgery preparations more enjoyable for children to offering an array of services to expectant mothers, the doctors and nurses are aiming to reduce anxiety while making the patient's hospital stay more memorable.

To educate and prepare new mothers, Centering Pregnancy and Centering Parenting sites in the United States offer community-based patient-centered care in low-income areas. Centering offers interactive learning, check-ups, and social support, so that women can take charge of their health.

In 2017, residents of Kabuga Aisami in Kano built their own maternal and child health hospital to address maternal mortality rates and improve access to care. Led by the Kabuga Aisami Community Initiative (KACI), community members pooled resources to construct the facility, which includes two labor rooms, three wards with 40 beds, four laboratories, a pharmacy, 25 toilets, and three self-contained flats for doctors to enable 24-hour care. Patient volume has since increased by over 250%, and the hospital has expanded to serve 10 surrounding communities, as well.

The Mamacare Foundation has trained over 860 traditional birth attendants (TBAs) in hygiene, safe delivery practices, danger-sign recognition, and timely referral systems over the past decade to improve maternal care in the region. The program pairs each TBA with a supervising midwife, creating a collaborative bridge between traditional and modern maternal care. The training has increased referrals from TBAs to clinics by 40%, and district hospitals report fewer emergency cases arriving in critical condition since the Foundation has formed.

Three hospitals throughout Mississippi rank at the top for having the lowest number of C-sections in first-time, full-term pregnancies. The hospitals achieved this by making midwife care a regular part of the birthing experience, despite not having a midwifery certification program in the state.

Birth in Color's doulas are filling the maternity care gap as rural labor and delivery rooms close, disproportionately impacting people of color. Doulas provide physical, emotional and informational support before, during and after childbirth, and advocate on the mother’s behalf. Doula care leads to improved birth outcomes and lower rates of C-sections, and in April 2022 doula services were added under the state’s Medicaid program.

Encouraged by her own pregnancy experience, medical technology expert Abisola Oladapo worked with two of her colleagues to create Sister Agnes. It is an AI system that delivers periodic, timely information to pregnant women by calls and texts in local languages to empower them with information about their health. 79 percent of the women who used the service delivered in health centers, were four times more likely to survive the pregnancy, and the survival rate of their children was 33 percent higher than the national average.