G6 - Health equity in perinatal care: Integrating lay workers as a strategy to eliminate disparities

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Full Description: Georgia Health Policy Center (GHPC ), the South Carolina Center for Community Health Alignment, and NorthShore University HealthSystem (Illinois) will share insights on the integration of lay workers into the perinatal continuum of care. Communities are addressing disparities in maternal health and birth outcomes with a particular focus on those most impacted by inequities, including families of color, families living in rural areas, and those living in poverty. Perinatal lay workers and the services they provide are increasingly recognized as effective approaches to addressing health inequities, and the research has linked these roles to positive health outcomes. Communities are building unique models to embed perinatal community health workers (CHWs), breastfeeding peer counselors, and doulas in clinical/non-clinical contexts. GHPC will provide a brief overview of the national policy landscape for perinatal lay workers. Each state will present a program overview, followed by an interactive panel discussion of lessons learned and outcomes of integrating lay workers in South Carolina and Illinois. South Carolina: South Carolina has poor birth outcomes, higher maternal mortality than the US average, and 2.6 times worse pregnancy outcomes for Black parents compared to White parents. Part of South Carolina’s strategy includes developing programs with perinatal CHWs as the core of community outreach and family engagement. The CHWs have potential to improve health equity and outcomes as trusted members of the communities they serve, with the ability to bridge clinical and community care. Three programs use the perinatal CHW approach: a community-based doula program; a rural perinatal health program for Black families that incorporates Healthy Start/Nurse-Family Partnership; and a Latina health outreach program. They have formed a collaborative called “EACH Mom and Baby” to share resources and expand into more communities. They developed a best practices toolkit and have funded new expansion sites. Illinois: Racial and socioeconomic disparities in breastfeeding continue to be a concerning public health issue. While national rates of breastfeeding have increased in recent years, Black families, Latinx families, and low-income families continue to face additional barriers to successful breastfeeding. Research shows breastfeeding peer counseling (BPC) is linked with improved breastfeeding for Black and Latinx families. The ci-BPC program was launched at the NorthShore University HealthSystem Community Health Center in 2016. The program addresses breastfeeding disparities by delivering culturally-relevant peer education as an integrated intervention across the prenatal to postpartum continuum of care. The interventions are delivered by lay health workers who have breastfed an infant and received basic training in breastfeeding support. The Illinois team published initial findings in 2021, which showed positive outcomes.

Abbreviated Description: Improving equity in birth outcomes is a challenge that many communities have identified as a priority. Strategies that include lay workers in clinical or community care have been shown to reduce disparities. The lay workforce, including community health workers, peer support, or doulas, is critical to offering culturally-relevant support and building community. Georgia Health Policy Center will provide a brief overview of the policy landscape for perinatal lay workers. The panel discussion includes innovators from South Carolina’s Center for Community Health Alignment and NorthShore University HealthSystem in Illinois who will share how their programs are transforming the continuum of care and outcomes for persons of color, those living in poverty, and/or those living in rural areas.