February Edition 2007 - New York Nonprofit Press

12 New York Nonprofit Press www.nynp.biz February 07AGENCY OF THE MONTHNorthern Manhattan Perinatal PartnershipMaternal Health from Womb to TombIn 1990, the infant mortality rate in CentralHarlem was the highest in the UnitedStates. Almost 28 babies out of every 1,000live births died before they reached the age ofone, more than three times the national average.Northern Manhattan Perinatal Partnership(NMPP) was born in response to this publichealth crisis. Over the past 15 years, NMPPhas developed a range of programs designed toimprove the health of pregnant and parentingwomen and their children. It works with networksof hospitals, health care providers andcommunity based organizations to reach andserve some of the City’s poorest and most vulnerablewomen. Partly as a result of its work,northern Manhattan’s infant mortality rate hasbeen reduced by more than 80%. By 2004, itsrate of 5.1 deaths per 1,000 live births was actuallybelow the national average of 6.5. Quitea turnaround!“We believe that every newborn has aright to live past their first birthday,” says MarioDrummonds, NMPP’s Executive Director.“NMPP’s mission is to save babies by helpingwomen take charge of their reproductive, socialand economic lives.”NMPP began as a vision of Dr. GeorgiaMcMurray, New York City’s first Commissionerat the Agency of Child Development. In1991, McMurray joined the New York UrbanLeague and launched a Healthy Start maternalhealth program. Healthy Start is a federal initiativedesigned to identify and develop community-basedapproaches for reducing infantmortality and improving the health and wellbeingof women, infants, children and theirfamilies. There are now more than 96 HealthyStart programs operating nationwide with fiveprograms, including NMPP’s Central HarlemHealthy Start, in New York State. In 1995,NMPP became its own 501c3 nonprofit corporationand Drummonds took the helm a yearlater.Healthy Start provides case managementand health education for pregnant women ormothers of children under the age of two. Adedicated outreach worker looks for womenat high risk of poor birth outcomes throughcontacts with local hospitals, clinics, CBOs,churches, food pantries and shelters. Theprogram’s case managers conduct assessmentsof the mother’s health status. Is she receivingprenatal care? Does she have health insurance;a regular physician? What is her general stateof health? Does she have specific risk factors;medical conditions like obesity or diabetes? Isthere an issue with substance abuse or HIV/AIDS? Does the woman have emotional ormental health challenges? Case managers alsodo a broader assessment looking at parentingand home making skills as well as financialand housing issues.The case managers meet a client’s needsthrough referrals to appropriate communityservices – doctors, mental health programs,food stamps, substance abuse programs, etc.“We provide parents with various incentivesto go to appointments,” says Segrid Renne,Director of the Healthy Start Program. “Weoffer food vouchers and shopping vouchers atvarious department stores. We also providethem with emergency pampers and formula.We have a whole array of things that pregnantwomen and mothers need. We can give themstrollers and play pens.”The Healthy Start program has a staff offour case managers – each with a caseload of25 women or families -- as well as a case managementsupervisor. “The majority of work isdone by going out to the client to make suretheir needs are met,” says Renne. “Case managersmeet with the women a minimum oftwice a month and more often when needed.”The program also features a Health Educatorwho provides one-on-one counseling andgroup sessions for women on how best to carefor themselves and their child. Developmentalassessments of newborns are done regularlyto identify any problems or concerns early on.“A large portion of our clients are homeless,”says Renne, a factor which complicatesthe woman’s ability to access prenatal servicesand Healthy Start’s ability to monitor her care.Healthy Start serves over 200 women andtheir children each year. Women typically staywith the program for a two year period.“HRSA (The Federal Health ResourcesServices Administration within the Departmentof Health and Human Services which administersHealthy Start) has designated us a Centerof Excellence,” says Drummonds. “This summer,we and six other programs will receive theaward. HRSA wants to replicate our programmodels in other parts of the country.”Healthy Start is just one ofseveral perinatal program modelsfunded by either the federal or stategovernment to address the healthneeds of women who are pregnant orparenting young children. There aresimilarities among them. They typicallyincorporate case managementservices, home visiting, health education,developmental screenings,etc. There are also some differencesin eligibility criteria and service delivery.NMPP offers the full menu,targeting different programs to specificcommunity catchment areasacross northern Manhattan.The Community Health WorkerProgram dates back to 1991. Theprogram serves 200 pregnant andMario Drummondsparenting families in East Harlem. “The ideais to work with high risk women, not onlyhealthwise but in other ways, immigration status,homeless women, people who don’t knowhow to navigate the system,” says Maria Guevara,Director of the program. “We do outreachin our community in all places we can thinkof -- beauty parlors, supermarkets, churches,shelters. Most of our clients are Hispanic,new immigrants from Latin America. Thesepopulations are easy to engage. They are moreneedy.”The Community Health Worker Programis funded by New York State’s Department ofHealth. The focus is on engaging pregnantwomen. “75% of the caseload is supposed tobe pregnant,” says Guevara. Children are onlyserved up to the age of one.Similar to Healthy Start, Guevara’s fourcase managers assess a client’s needs and makereferrals to appropriate services. “We developan assessment and a service plan,” says Guevara.“Let’s say a woman is five months pregnantand not going to a doctor for prenatal care.We have to engage her in clinical services, callto make appointments, get all the documentationshe needs and bring her to the clinical careprovider. It is a lot of work. In the beginning,we might see her once or twice a week.”Once again, New York’s shortage of affordablehousing is a significant complicationfor women who are pregnant or have recentlygiven birth. “We have instances where theNorthern Manhattan PerinatalPartnership’s Social Health MarketingGroup develops public informationcampaigns for government agencies.