‹ All Strategic Initiatives

Healthy Women, Healthy Babies 2.0

PROJECT ORIGIN

Healthy Women, Healthy Babies 2.0 is the next generation of the Healthy Women, Healthy Babies program. Healthy Women, Healthy Babies (HWHB) is a collaboration between health care provider practices and the Delaware Division of Public Health to improve birth outcomes across the state. HWHB improves access to high quality preconception, prenatal and interconception care for women of reproductive age in Delaware. HWHB 2.0 is a restructuring of the program initiated in 2019 to shift emphasis more to the social determinants of health along with the delivery of quality health care, prevention and treatment.

PROJECT OBJECTIVES & GOALS

The goal of this program is to improve birth outcomes across the state. The objectives include improving access to high quality preconception, prenatal and interconception care, addressing social determinants of health and strengthening the lifecourse-informed model of well-woman care.

Delaware desires to obtain certain services to reduce premature births; decrease in low birth weight (LBW) and very low birth weight babies (VLBW); decrease in disparity ratio of poor birth outcomes (for e.g., neonatal mortality and postnatal mortality between African American and White infants); decrease in infant mortality; and decreased birth defects.

The restructuring in 2019 will shift emphasis more to the social determinants of health along with the delivery of quality health care, prevention and treatment.

PROJECT STRATEGIES AND OUTCOMES

Research has shown that factors outside the clinic setting are an important influence on a person’s mental and physical (medical) wellbeing. Factors such as unhealthy housing, food deserts, lack of transportation, food insecurity, domestic violence, and legal issues can greatly influence a person’s health.  There are certain areas, or zones, within the state that are at higher risk for these social disparities. The HWHB 2.0 program seeks to reach women that live within these zones.

Additionally, the HWHB 2.0 program targets “high-risk” women in Delaware. Statistics show that among this high-risk population, there is a segment of women with a higher risk of poor birth outcomes. That segment is African American, Medicaid eligible women. In the State of Delaware, an African American infant is 2.5 times more likely to die (with 12.5 deaths per 1,000 live births) as compared to a white infant (with 5.1 deaths per 1,000 live births). This ratio represents a glaring disparity that DPH/DHSS sees as unacceptable.

African American women make up only 39% of past program beneficiaries. A recent program evaluation found that African American and Hispanic (62%) HWHB enrolled women whose delivery was paid by Medicaid had better outcomes as compared with African American and Hispanic non-HWHB women on Medicaid. Specifically, these women were: 11% less likely to smoke; 15% less likely to have preterm birth; and infants delivered by HWHB had lower neonatal mortality rates. Given this impact, it would be beneficial to increase enrollment of African American women. There are approximately 42,000 African American women of maternal age (i.e. between 15-45 years old) in Delaware, of which 65% (27,300) are Medicaid eligible. Increased enrollment of this higher risk population will facilitate access to enhanced care, better outcomes, and assist with narrowing the disparity ratio.

NEXT STEPS

The HWHB 2.0 program will be working with seven medical providers as well as community health workers throughout the state to reach women and babies at high risk for a poor birth outcomes. The HWHB 2.0 contracts will be in place on September 1, 2019, and providers can officially be announced at that time.